Childhood cancer treatment in India has significantly advanced, offering children access to specialised care, modern therapies, and improved survival rates. Major pediatric oncology centres across the country provide comprehensive treatment plans that include chemotherapy, radiation, surgery, and supportive care tailored to each child’s needs. 

Multidisciplinary teams of pediatric oncologists, surgeons, psychologists, and nutritionists work together to ensure holistic recovery. Government initiatives and charitable trusts also support families financially, making care more accessible. With growing awareness, early diagnosis, and modern technology, India is steadily improving outcomes for children battling cancer across various types and stages.  

Cause of Pediatric Cancer- How We Define Childhood Cancers?

The exact causes of childhood cancer are often unknown, but most cases are linked to random genetic mutations that occur during early development. Unlike adult cancers, they are rarely caused by lifestyle or environmental factors. Some children may inherit gene mutations or have conditions that increase cancer risk, such as Li-Fraumeni syndrome or Down syndrome. Research into causes continues globally, including in India. Understanding these causes is essential to improving childhood cancer treatment in India, where early diagnosis and genetic insights are helping shape more effective, targeted treatment strategies for young patients.

• Genetic Mutations: Random changes in a child’s DNA during early development can lead to cancer.
• Inherited Conditions: Some children inherit gene mutations from their parents, such as in Li-Fraumeni syndrome or neurofibromatosis.
• Chromosomal Abnormalities: Conditions like Down syndrome increase the risk of certain cancers, like leukaemia.
• Immune System Disorders: Weakened or abnormal immune function can raise cancer risk in children.
• Environmental Exposures (Rare): Limited but possible exposure to radiation or harmful chemicals may contribute.
• Unknown Factors: In most cases, the cause cannot be pinpointed.

Childhood Cancer or Pediatric Cancer 

Childhood cancers are a group of diseases that occur in children and adolescents, typically under the age of 15. Unlike adult cancers, which are often linked to lifestyle or environmental factors, childhood cancers usually result from genetic mutations or developmental issues. They tend to grow faster and respond differently to treatment. Common types include leukaemia, brain tumours, lymphoma, neuroblastoma, and Wilms' tumour. Early diagnosis and specialised care are critical, as children require tailored treatment approaches that consider both their growing bodies and long-term health outcomes.

Screening For Childhood Cancer- Diagnosis of Childhood Cancer 

Unlike adult cancers, childhood cancers often develop quickly and are rarely detected through routine screening. Most pediatric cancers are diagnosed after the onset of symptoms rather than through formal screening programs. However, early detection remains critical, especially for children who have a known genetic predisposition or family history of cancer.

In such high-risk children, doctors may recommend periodic screening using blood tests, imaging studies (like ultrasound or MRI), and physical examinations. For example, children with Li-Fraumeni syndrome may undergo regular whole-body MRI scans, while those with familial retinoblastoma might receive routine eye exams starting shortly after birth.

No Routine Screening for All Children:
Childhood cancers are rare and grow rapidly, so standard screening programs like those used for adults are not common.

High-Risk Group Surveillance:
Children with inherited conditions (e.g., Li-Fraumeni syndrome, familial retinoblastoma, neurofibromatosis) are monitored with targeted screening protocols.

Screening Methods for High-Risk Children:

• Whole-body MRI scans for children with Li-Fraumeni syndrome.
• Eye exams for infants at risk of retinoblastoma.
• Ultrasound or CT scans are used in certain syndromes linked to kidney or adrenal tumours.
• Regular blood tests to check for changes in cell counts or markers.
  

Importance of Routine Check-ups:
Paediatricians play a critical role in identifying early warning signs during regular health visits. It is a physical examination for screening children by a doctor.

• Persistent lumps or swelling
• Unexplained fever or weight loss
• Frequent infections or bruising
• Headaches with vomiting
• Bone or joint pain
• Changes in behaviour or vision

India’s Growing Focus on Early Detection:

• Specialised hospitals offer risk-based surveillance.
• Awareness programs are helping parents recognise symptoms earlier.
• More families are accessing pediatric oncology services at the right time.

Recent Advances in Pediatric Oncology

Recent advances in pediatric oncology are transforming the way childhood cancers are diagnosed and treated. Genomic testing has enabled doctors to identify specific mutations, leading to targeted therapies like tovorafenib for BRAF-mutated gliomas. Immunotherapy, especially CAR-T cell therapy, has shown remarkable success in treating relapsed leukaemia. Liquid biopsies offer a non-invasive way to monitor tumour changes in real time. 

Techniques like proton beam therapy reduce radiation damage to healthy tissues, improving long-term outcomes. These innovations, combined with personalized medicine approaches, are significantly increasing survival rates and improving the quality of life for children undergoing cancer treatment.

• Targeted Genomic Drugs: FDA-approved tovorafenib treats BRAF-mutated low‑grade gliomas in children, shrinking tumours in ~70% of patients 
• Radionuclide Therapy: Lutathera® (lutetium‑177 dotatate) now cleared for pediatric gastroenteropancreatic neuroendocrine tumours, offering a new therapeutic option.
• Immunotherapy Breakthroughs: CAR‑T cell therapies yield curative outcomes in relapsed or refractory leukaemia, revolutionising treatment.
• Precision Medicine & Liquid Biopsies: Genetic profiling and non-invasive blood tests guide personalised treatments and monitor tumour response.
• Proton Beam Therapy: Planned at Kidwai Memorial in Bengaluru, promising reduced late effects compared to conventional radiation.

Childhood Cancer Symptoms

Childhood cancer symptoms can vary widely depending on the type and location of the cancer. Unlike adults, children may not be able to clearly express their discomfort, making it vital for parents and caregivers to observe unusual or persistent changes. Symptoms often mimic common illnesses but persist longer or worsen over time. Warning signs may include unexplained weight loss, fatigue, persistent fever, swelling or lumps, frequent infections, bone pain, or changes in behaviour. Early detection plays a critical role in successful treatment, so any long-lasting, unusual symptom should prompt immediate medical evaluation.

• Unexplained Weight Loss:
  Caused by cancer cells using up energy or affecting metabolism.
• Frequent Infections or Fever:
  Due to low white blood cell counts from leukaemia or bone marrow involvement.
• Swelling or Lumps:
  It may result from lymph node enlargement or solid tumours like neuroblastoma or lymphoma.
• Persistent Pain or Limping:
  Caused by bone tumours or leukaemia affecting the bone marrow.
• Bruising or Bleeding Easily:
  Results from platelet reduction due to blood cancers like leukaemia.
• Headaches with Vomiting:
  Possible signs of brain tumours include increasing intracranial pressure.
• Behavioural or Vision Changes:
  Tumours affecting the brain or optic nerves may trigger these symptoms.

Pediatric Cancer Treatment Protocols

Pediatric cancer treatment protocols are carefully designed, evidence-based plans that guide the treatment of childhood cancers. These protocols vary depending on the type of cancer, its stage, and the child’s overall health. They are created by pediatric oncology experts and are regularly updated based on global research and clinical outcomes. The primary goal is to maximise cure rates while minimising long-term side effects.

Treatment typically begins with a confirmed diagnosis through imaging and biopsy, followed by risk stratification. Depending on the cancer type—such as leukaemia, lymphoma, brain tumours, or solid tumours—the protocol may include one or more of the following: chemotherapy, surgery, radiation therapy, immunotherapy, or stem cell transplant.