What you don’t know about cancer treatments

Before I was exposed to the world of childhood cancer, I thought I knew about cancer treatments. I knew about chemotherapy – it made you sick, and it made you lose your hair. I knew about radiation, and that sometimes cancers could be surgically removed. At least, I thought I knew.

But these are only the most basic, first-stop treatments, and I didn’t even know much about these. Children fighting cancer are subjected to numerous procedures which are beyond barbaric, and more research is desperately needed to find more humane, more effective treatments.

There’s a huge variety of chemotherapy drugs, all with different side effects beyond the recognizable nausea and hair loss. Some have late-onset side effects including heart damage, 30 years or more down the road. Some can increase the risk of secondary cancer (as does radiation), cause damage to the kidneys, or permanently damage hearing.

But there is much, much more.

Surgery may sound simple enough, but for a tumour in the brain, it can cause permanent damage and leave jagged scars from ear to ear. For osteosarcoma (bone cancer), surgery can mean full limb amputations, and for neuroblastoma it can mean losing a kidney, or involve delicately extracting the tumour from the spinal column.

Radiation is given 5 days a week, often for 5-7 weeks in a row. Young children have to go under general anaesthetic for each treatment (which carries its own risks), as they cannot lie still enough on their own. Side effects can include fatigue, nausea, memory loss, bowel damage, infertility and rarely secondary cancer.

Treatment for leukaemia often involves more than 3 years of chemotherapy. Chemotherapy is not just the intravenous infusion most people think of – it can also be taken as orally, administered as intrathecal chemo, which is delivered directly into the cerebrospinal fluid via lumbar puncture, or even be injected directly into the brain via an ommaya reservoir. Sometimes children have seizures, or experience extreme allergic reactions to chemo drugs, even ones they have previously taken with no issue.

Chemotherapy and the accompanying immunosupression don’t just mean children can’t play with their friends, dig in the dirt or eat takeaway chicken – it also comes with a host of prophylactic drugs and procedures. Mouth wash and gum ointment must be applied every 4 hours to help reduce ulcers. For infants, nappies must be changed regularly (while wearing gloves) to reduce skin damage from toxic excretions – even so, severe nappy rash can be hard to avoid. Drugs given to prevent bacterial infection can cause photo-sensitivity, increasing the risk of sunburn and skin cancers. The ports, lines and tubes inserted into their bodies to make it easier to give medications also increase the risks of infection, and are often easily pulled out, necessitating immediate trips to the hospital and additional surgeries to reinsert them.

Some treatment regimes include steroids, which can cause extreme weight gain, excessive thirst, anxiety, delusional behaviour, diabetes, glaucoma or osteoporosis.

Mega-therapy is a form of high dose chemotherapy never given to adults. It is so toxic that children need to be catheterized so that the chemicals in their urine do not burn their skin, and they have to be bathed every 4 hours around the clock.

Immunotherapy, which uses the body’s own immune system to fight cancer, can cause fatigue, nausea, fever, diarrhoea and rash. Worse still, some forms of this treatment, such as those given to treat neuroblastoma, have a primary side-effect of pain. To combat this, children are often also given a continuous infusion of fentanyl or morphine, and must be closely monitored to avoid overdose.

MIBG therapy, also for neuroblastoma, involves infusion of the radioactive MIBG molecule which is readily absorbed by the cancer cells, effectively targeting radiation directly to the tumour and minimizing damage to healthy tissue. However, it also leaves the child so radioactive that they have to stay alone in a lead-lined isolation room for around 3 days, until their levels drop enough to be safe. Most children diagnosed with neuroblastoma are under the age of 5.

These treatments are brutal, and parents subject their children to them every day to save their lives. Research is vital to find kinder, more effective methods of treating cancer.

Donate to childhood cancer research

The Kids’ Cancer Project
Children’s Cancer Institute Australia

This post is part of our series in support of Go Gold Australia and Childhood Cancer Awareness month.
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