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By Dr. Shweta Bansal,
Shweta.Bansal@rfhospital.org

Hope & faith with dedicated treatment can go long way. A 14 year old boy, Aniket (name changed), living in a remote village near Jaipur was brought to Mumbai with a recurrence of blood cancer.

“The Doctors in Jaipur told me my son will die in few days as he had recurrence of blood cancer, which is difficult to cure" said the father. The decision to take my son to Mumbai was not an easy one. Our close relatives who belong to lower middle class family refused to pay for the treatment because they felt spending on a child with dreaded disease like cancer was a waste of money.

Parents met Dr. Shweta Bansal, Paediatrics Hemato-Oncologist who is presently attached to Reliance Foundation Hospital (RFH). On reviewing the child’s history & treatment provided in Jaipur, it was concluded that the child is a case of early relapse of acute Lymphoblastic Leukemia- T cell type (a type of blood cancer). The aggressive nature & the early relapse had made the case as ‘very high risk disease’ with, only treatment option left as chemotherapy followed by bone marrow transplant (BMT).

When Dr. Bansal tried to counsel the parents, they simply refused the BMT therapy as it was beyond their means financially. As a doctor it was difficult call, because no literature or published results supports without bone marrow transplant in each cases. In fact, the conventional chemotherapy in reported to be successful only in 10-20% of cases.

The parents were very hopeful & the child said “I will be alright, please start the chemotherapy”. The conviction in the voice of the child was very touching, hence instead of refusing the treatment, he was started on high dose intensive chemotherapy procedure.

Treating a child with relapsed leukaemia is a big challenge for any oncologist. Since their immune system is already compromised they are more prone to infections & other complications. The child was started on chemotherapy based on ‘Relapsed Acute Lymphoblastic Leukaemia protocol’, which is a highly intense protocol.

After first chemotherapy, his white blood cell counts crashed, he also had severe oral ulcers & high fever. However, with continuous monitoring & strict supportive treatment protocols, he overcame this toxicity issue. The most important aspect in leukaemia treatment is, if the patient is able to survive the toxicity, there are high chances that he / she will be cured of the Leukemia.

The child had multiple complications with the chemotherapy drug cycles, but with his will power & perpetual hope, he overcame all of them. Finally the determination of the child & doctors efforts achieved the cure. Yes, our little solider was cured of his disease, Blood Cancer. He is now off therapy & doing well.

The credit also has to be given to referring physician from Jaipur, who could suspect the gravity of the situation & referred the case to Dr. Shweta in Mumbai.

Across India, the Incidence of childhood cancer cases is estimated to be about 50,000- 60,000 per year. With a cure rate as high as 80% for many childhood cancers, doctors say cancer deaths among children can be avoided if treatment is started early & not abandoned.

Cancer is one of the most feared disease. In adults’ cancer, surveillance & early detection is possible, but the situation is not the same in childhood cancer cases. The cancer news in a child came with devastating consequences, it not only affects the child, but uproots the entire family.

Several people living in rural parts of India do not know enough about cancer. This lack of awareness results in a number of cancer-related deaths that could be prevented with the help of better information & timely intervention.