In Part 1 of this series we explained that this series of articles is not meant to be medical advice, but a guide that may help you as a parent of a newly-diagnosed child with cancer cope just a bit better. Information is knowledge, and never more so than when you are dealing with childhood cancer!
These articles are meant to help you be the key part of your child’s treatment that you will need to be. Take what works for you according to your situation and your child’s temperament, personality, fears, strengths, and how they deal with adversity, and leave what does not pertain to your situation.
Part 5 will deal with Different Types of Treatment and Possible Side-Effects of that treatment. As this is quite a long section, I will split it into 5(i) Surgery 5(ii) Chemotherapy 5(iii) Radiation Therapy 5(iv) Immunotherapy and 5(v) Bone Marrow and Peripheral Blood Stem Cell Transplants.
Complementary and Alternative Medicine treatment (CAM) is very involved and will contain a lot of information, so that will be dealt with separately in Part 6 of this series of articles.
Childhood Cancer Treatment
Treatment for childhood cancer is not the same for every patient; a treatment plan is drawn up for each individual according to various factors.
Your child’s doctor and oncology treatment team will collaborate to draw up a treatment plan based on the type of cancer, the stage of the disease, your child’s general health, your child’s age, and various other factors.
Once the team has all the facts, a detailed treatment plan will be drawn up, outlining the exact treatment your child will receive, how often the treatment will be given, and how long the treatment will last.
Treatment plans are strictly individualised, so even children with the same type of cancer may not get exactly the same type of treatment. The oncology team will monitor your child’s response to the treatment, and may change the treatment plan if it seems that the treatment is not working effectively; they may even change the type of treatment completely.
Cancer is not an easy disease to treat, and unfortunately some of the treatments used cause unpleasant or unwanted side-effects such as hair loss, nausea, and diarrhoea. Side effects happen because unfortunately some of the cancer treatments not only kill the cancer cells but can also damage some of the healthy cells.
Bear the following in mind as your child starts their cancer treatment:
- Your child’s doctor will plan the treatment so that your child has as few side effects as possible;
- The type of side effects your child experiences and how bad they are will be depend on the kind of drug used, the dosage given, and the way your child’s body reacts;
- There are various ways to lessen your child’s side effects. Talk to the treatment team about things that can be done before, during, and after treatment to make your child more comfortable;
- Sometimes the team may decide to lower the treatment dosage slightly to help lessen or even eliminate unpleasant side effects. This will generally not make the treatment less able to destroy cancer cells or hurt your child’s chances of recovery; and
- Most side effects go away soon after treatment ends.
Not every child will suffer side-effects, and some children get very few. Side-effects will differ from child to child, even those who are receiving the same treatment. Your child’s doctor will be able to tell you what side-effects you can expect your child to possibly have based on the treatment plan, and how to deal with them should they occur.
In the previous article we dealt with Radiation Therapy and all it entails; this article will deal with Immunotherapy as a treatment for your child’s cancer and all this type of treatment entails.
The body’s immune system is a system which includes the thymus, the bone marrow, and lymphoid tissues. It protects the body from foreign substances and pathogenic organisms by producing an immune response.
The immune system knows when there are substances in the body such as bacteria and viruses that should not there, and attacks them. It also recognises changes in cells, such as when cells become cancerous, and attacks the cancerous cells.
Doctors had long suspected that the immune system could affect certain cancers, and even before the immune system was understood, Dr William Coley, a New York surgeon in the late 1800s noted that getting an infection after surgery seemed to help some cancer patients. He started treating cancer patients by infecting them with certain kinds of bacteria, which came to be known as Coley toxins. Despite the successes he had, his techniques were soon overshadowed when other forms of cancer treatment such as radiation therapy came into use.
Since then much more has been discovered about the immune system, and immunotherapy has become an important part of treating certain types of cancer and newer types of immune treatments are currently being studied for the treatment of many other types.
Immunotherapy, otherwise known as biological therapy, takes advantage of the body’s own ability to fight disease. In immunotherapy, cancer patients are given substances called biological response modifiers (BRMs), which are normally made by the body to fight cancer and other diseases.
Scientists are able to manufacture large amounts of BRMs for use in cancer treatment. BRMs destroy cancer cells and change the way the body reacts to a tumour, and could also help the body replace noncancerous cells destroyed by chemotherapy.
Several types of BRMs are used to treat cancer – below are four of the main types used:
- Colony-stimulating factors are proteins that stimulate bone marrow cells to develop red blood cells, platelets, and white blood cells.
- Cytokines are protein molecules secreted by cells of the immune system, in small amounts, to help regulate the immune system.
- Interferon is an antiviral protein produced by cells that have been invaded by a virus; it inhibits replication of the virus, slowing down the rate of growth and division of cancer cells, causing them to become sluggish and die. These agents have been tested against childhood cancers such as osteosarcoma, leukaemia, brain tumours, and neuroblastoma.
- Interleukins are another type of cytokine, and are made by lymphocytes. They promote macrophages, killer T cells and B cells, and other components of the immune system Interleukin-2, one of the most studied interleukins, causes certain kinds of white blood cells to grow and destroy tumours.
- Monoclonal Antibodies are antibodies produced in the laboratory by a single clone of cells or a cell line and consisting of identical antibody molecules. They recognise specific antigens; substances that the body knows do not belong and thus regards as “outsiders,” on the surface of cancer cells. Monoclonal antibodies can be directed against specific cell types, attacking and damaging or destroying cancer cells. They can also be used to deliver anticancer drugs or radiation directly to specific cancer cells. This technique is still being developed and is used only in clinical trials.
Different types of monoclonal antibodies are used in cancer treatments:
- Naked Monoclonal Antibodies (Naked mAbs) work by themselves with no drug or radioactive material attached to them.
- Conjugated Monoclonal Antibodies are joined to a chemotherapy drug or a radioactive particle
- Bispecific Monoclonal Antibodies are made up of parts of 2 different mAbs, meaning they can attach to 2 different proteins at the same time.
Possible Side Effects of Immunotherapy
As with most cancer treatments, immunotherapy can have some side-effects. Depending on which type of immunotherapy treatment is used, side effects could include:
- Flu-like symptoms such as chills, fever, muscular aches, weakness, loss of appetite, nausea, vomiting, diarrhoea, and, at times, a rash;
- Possible easy bleeding or bruising
Depending on the severity of the side-effects, hospitalisation may be necessary during treatment. These side effects usually go away after treatment ends. Should your child experience any of the above side-effects during treatment, consult your doctor.
Remember, if you are not sure of anything, speak to a professional on your child’s oncology treatment team; they will be only too glad to help give you information or allay any fears you or your child may have regarding the treatment.
You are not alone in this; there are many individuals out there able and willing to lend a hand, some support, or even just listen – do not be afraid to reach out for help!
Do some research on the internet, reach out to an organisation like Little Fighters Cancer Trust for a bit of support and information and/or access to resources that will help you find out more and make an informed decision regarding your child’s treatment.
Part V (v) of this series will deal with Bone Marrow and Peripheral Blood Stem Cell Transplants