What is Cancer
Childhood Cancer

Treating Children’s Cancer

Where are children in Malaysia treated for cancer?
In Malaysia, most children and adolescents (teens) with cancer will have their treatment at specialist paediatric cancer centres. These places include:

Public hospitals  
Private hospitals For more information about these hospitals, please refer directly to the hospitals’ website.
 

A child’s treatment
Having treatment for childhood cancer means that many health professionals will be involved. This team consists of doctors, nurses, social workers, dieticians, pharmacists, psychologists and allied health professionals. Before cancer treatment is started, a doctor will explain a treatment plan in detail and what the aim of the treatment is. A checklist of things that are helpful to know include the following:
  • What type of treatment is going to be given
  • How will the treatment be given (injection, tablet etc)
  • Who will give the treatment and where it will be given
  • How long the treatment will take
  • The risks (if any) of treatment
  • Side effects of treatment, both immediate and long term
  • Other possible treatments
  • Whether or not the treatment is part of a clinical trial
 

Staging children’s cancers
The stage of a cancer describes the size of the cancer as well as if the cancer has spread from where it started in the body to other surrounding tissue and organs.  Knowing the stage of a child’s cancer helps the team decide on the best treatment. 
Although the meaning of each stage may be different for different types of cancer, in general:
  • Stage 1 means that the cancer has not spread to other parts of the body
  • Stage 2 and 3 usually means that the cancer has spread to other tissues close to the main tumour
  • Stage 4 means that the cancer has spread beyond the main tumour to other parts of the body.  Doctors call this ‘metastasis’ or ‘secondary cancer’.


Treatments
There are three main types of treatment: surgery, chemotherapy and radiotherapy. Some cancers will need more than one type of treatment, for example a child may have radiotherapy and chemotherapy together. Below is a short description of each type of treatment. Many children may be given their treatment as part of a clinical trial.
 
For more information, the following websites have information about children’s treatments and their side effects:
The United States’ Paediatric Integrated Cancer Services (PICS) - The information book - Life after diagnosis, section 3.8. 
The UK Children’s Cancer and leukaemia Group - www.cclg.org.uk 
The United States’ Children’s Oncology Group - www.curesearch.org
 
Chemotherapy (cytotoxic drugs)
This treatment uses drugs that will help to kill cancer cells. When chemotherapy kills cancer cells, it may also damage healthy cells. Side effects can be hair loss, nausea and vomiting, mouth sores, low blood counts and loss of appetite. Side effects vary depending on the type of medication and usually go away once the treatment stops.
 
Radiation therapy
Radiotherapy uses high energy x-rays to kill or damage cancer cells to stop them from growing and multiplying. Radiotherapy damages cancer cells, but may also damage cells in the area being treated.
 
Before starting radiotherapy, the radiotherapy scientist/technician begins 'planning'. This means working out the exact position to place your child. Small marks will be drawn on the area of the body where your child needs treatment. This allows the radiotherapy to be given at the same place each time. Radiotherapy usually takes a few minutes each session.
 
Radiotherapy uses high energy x-rays to kill or damage cancer cells to stop them from growing and multiplying. Radiotherapy damages cancer cells, but may also damage cells in the area being treated. Radiotherapy side effects depend on how much is given and the part of the body being treated, and will be discussed in detail before treatment.
 
Surgery
Surgery might be used to remove all or part of a tumour at diagnosis. The type of operation a child has will depend on the type of cancer.
 
Biotherapy
Biotherapy uses the body’s immune (defence) system to fight cancer cells.  It may be used to help find the cancer cells in the body and help the body recover quickly from side effects, or prevent the spread of cancer cells.
 
Stem Cell transplant
A stem cell transplant (SCT) is a procedure used as part of some cancer treatments when the doses of chemotherapy are so high that the cells in the bone marrow are permanently destroyed. A SCT is also used if the child has cancer cells in the bone marrow. The transplanted cells may be from the child’s own cells, a relative or someone not related to the child, dependent on the type of cancer.
 
Complementary and alternative therapies
It is common for parents of children with chronic health conditions and with cancer to seek out complementary and alternative treatments.
 
Complementary therapies include massage, meditation and other relaxation methods that are used along with medical treatments. Many people find using one or more types of complementary therapies beneficial.
 
Alternative therapies are unproven and can include some herbal and dietary remedies that are used instead of medical treatment. Some of these have been tested scientifically and found to be not effective or even harmful.
 
Some complementary therapies are useful in helping children to cope with the challenges of having cancer and cancer treatment. However, some alternative therapies are harmful, especially if:
  • The patient uses them instead of medical treatment.
  • The patient uses herbs or other remedies that make your medical treatment less effective.
  • Families do not discuss these therapies with the child’s oncologist and team.
 
Be aware that a lot of unproven remedies are advertised on the Internet and elsewhere without any control or regulation. Before choosing an alternative remedy, discussion should be had with a doctor or your hospital pharmacist. 
 
Clinical trials
Clinical trials are used to try and find new and better ways of treating cancer and managing the side effects of treatment. Almost everything we have learnt to date about children’s cancers has come from clinical trials.

There are dozens of cancer related clinical trials in Malaysia at any time. As the details – including the criteria – are different for each trial, our Cancer Information Nurses will request for the right information and get back to you. You can also speak to your child’s oncologist for more information.

New treatments and research
New treatments are always being investigated and tested for all types of children’s cancers.  Scientists and doctors are continually looking for new ways to prevent, diagnose and treat children’s cancer and any late effects of treatment. They are seeking to discover whether other factors, apart from the few known possible causes, may cause the disease. Research is focused on:
  • The biology (function) of cancer cells, why cancer occurs and what new treatments can be used to fight it.
  • Medications that target the individual cancer cell directly.
  • Working together with children’s cancer centres across the globe to ensure new ways of treating cancer are measured and benefit as many children as possible.
Information Reviewed By:
Cancer Council Victoria with assistance from The Paediatric Integrated Cancer Service (PICS), parents and staff from the Oncology units at both The Royal Children’s Hospital, Melbourne & Monash Children's, Monash Health, Melbourne and ONTrac, Peter Mac Victorian Adolescent and Young Adult (AYA) Cancer Service.