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Saturday, 08.08.2020, 06:50
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Childrens oncology

Childrens oncology

Childhood cancer have their own characteristics. For example, it is known that cancers in children, unlike adults, are casuistry, and are extremely rare. The overall incidence of malignant tumors in children is relatively small and is approximately 1-2 cases per 10,000 children, while in adults the figure is ten times higher. Approximately one third of cases of malignant neoplasms in children are leukemia or leukemia.

If 90% of adult tumors associated with exposure to external factors, the number of children growing importance of genetic factors. Of the environmental factors most relevant are:

Solar radiation (ultraviolet excess)

  • Ionising radiation (medical exposure, exposure to radon areas, due to exposure to the Chernobyl accident)
  • Smoking (including passive)
  • Chemical agents (carcinogens contained in water, food, air)
  • Catering (smoked and fried foods, lack of adequate amounts of fiber, vitamins, trace elements)

Medicaments. Medications with proven carcinogenic activity are excluded from medical practice. However, there is some research showing the relationship of prolonged use of certain drugs (barbiturates, diuretics, phenytoin, chloramphenicol, androgens) with tumors. Cytotoxic drugs used to treat cancer, are sometimes the cause of development of secondary tumors. Increase the risk of cancer immunosuppressant used after organ transplantation.

Viral infections. Today, there are a large number of studies that show the role of viruses in the development of many tumors. The most famous are the Epstein-Barr virus, herpes virus, hepatitis B)

Special role of genetic factors. Today we know of about 20 genetic diseases with a high risk ozlakachestvleniya, as well as some other diseases that increase the risk of developing tumors. For example, dramatically increases the risk of leukemia, the disease Fanconi, syndrome, Bloom, Ataxia-telangiectasis, illness Bruton, syndrome, Wiskott-Aldrich, syndrome, Kostmann, neurofibromatosis. Increase the risk of leukemia and Down's syndrome and Klinefelter's syndrome.

Depending on the age and type are three major groups of tumors occurring in children:
  • Embryonic tumors.
  • Juvenile cancer
  • Tumors of the adult type

Embryonic tumors arise as a result of degeneration or faulty development of the germ cells, which leads to an active proliferation of these cells, histologically similar to the tissues of the embryo or fetus. By the These include the: PNET (of the tumor from the neuroectoderm); hepatoblastoma; germinogenic of the tumor; medulloblastoma; neuroblastoma; nephroblastoma; rhabdomyosarcoma; retinoblastoma;

Juvenile tumors occur in childhood and adolescence due to malignancy of mature tissues. These include: astrocytoma, Hodgkin's disease (Hodgkin's disease), non-Hodgkin's lymphoma, osteosarcoma, sinovialnokletochnaya carcinoma.

Tumors of the adult type in children are rare. By the These include: the hepatocellular carcinoma, nazofarengialnaya carcinoma, clear cell cancer of of the skin, schwannoma and some others.

For diagnosis in pediatric oncology using the full range of advanced clinical diagnostic and laboratory studies:
  • Clinical and anamnestic data, including the study of heredity probandnye.
  • These medical imaging (MRI, ultrasound, CT or RTC, a wide range of X-ray diffraction methods, radioisotope studies)
  • Laboratory tests (biochemical, histological and cytological examination, optical, laser and electron microscopy, immunofluorescence and immunochemical analysis)
  • Molecular biological studies of DNA and RNA (cytogenetic analysis, Southern blotting, PCR and others)

Methods of treatment of childhood cancer are similar to the methods of treatment of adult patients, and include surgery, radiation therapy and chemotherapy. But the treatment of children have their own characteristics. Thus, in the first place they have is chemotherapy, which is due to the method of treatment of diseases of the protocol and its continuous improvement in all economically developed countries is the most gentle and most effective. Radiation therapy in children should have a rigorous justification, because may have implications for normal growth and development of exposed organs. Surgical treatment is now generally complement chemotherapy and only if it is preceded by neuroblastoma. Widely used new low-impact surgical procedures (embolization of tumor vessels, isolated perfusion of blood vessels, etc.), as well as some other methods: cryotherapy, hyperthermia, laser therapy. A separate type of intervention - stem cell transplantation, which has its own list of conditions, indications and contraindications, as well as gemokomponentnaya therapy.

After the basic course of treatment, patients need rehabilitation, which is conducted in specialized centers, as well as further observation, the appointment of maintenance therapy and the implementation of medical recommendations, all of which can be successful in the treatment in most cases.

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