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Advances in Childhood Cancer | NIH News in Health

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February 2023






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Making Personalized Treatments a Reality

Children often get bumps, bruises, sneezes, and sniffles. It doesn’t seem like they could get something as scary as cancer. But they can.

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Every year, more than 10,000 kids in the U.S. will get a diagnosis of cancer. Some cases are caused by changes in certain genesStretches of DNA you inherit from your parents that define features, like your risk for certain diseases. that are passed from parents to their children. But these are rare. The causes of most cases of cancer in kids aren’t known.

Advances made over the last few decades have led to more children surviving cancer than ever before. And a better understanding of the disease means that more children with cancer are getting personalized treatments.

Treating Childhood Cancer

Cancer isn’t just one disease. There are many different kinds. But all cancers start when some of the body’s cells begin to grow uncontrollably. Sometimes, these cells spread to other parts of the body.

“Leukemias are the most common types of cancer that we see in children,” says Dr. Nita Seibel, a childhood cancer specialist at NIH. These are cancers that start in certain types of blood cells.

Next most common are cancers of the brain, nerves, and spinal cord. Lymphoma—another type of blood cancer—also occurs in kids and teens. Children may be affected by tumors of the eyes, adrenal gland, kidneys, muscles, and bones.

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Common treatments for childhood cancers include surgery, chemotherapy, and radiation therapy. These can be used in combination or alone.

Chemotherapy and radiation therapy work by killing fast-growing cancer cells. But these treatments can also damage normal cells. This damage can cause side effects like infection, hair loss, and nausea. But these often go away. Other side effects, like hearing loss, may not go away. And some can appear after treatment stops.

Some kids may need other treatments, such as immunotherapyTreatments that train your body’s disease defense system to fight cancer. or a stem-cell transplant. Different types of cancer need different treatments.

Until recently, it was common for all kids with the same type of cancer to receive the same treatments, explains Dr. Will Parsons, a child cancer specialist at Texas Children’s Hospital. But the discovery of certain gene changes, called mutations, in cancer cells has started to change this. These mutations cause cancer cells to grow out of control.

A new type of treatment called targeted drugs can block the effects of these harmful mutations. They cause cancer cells to stop growing, or to die, without causing as much damage to normal cells. Targeted drugs often have fewer side effects than chemotherapy.

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“Targeted drugs have gone from a theory to a reality over the past decade,” says Parsons. This breakthrough has been aided by faster and cheaper tests to pinpoint cancer mutations, he explains.

Researchers are testing ways to expand gene mutation screening for kids with cancer. One ongoing study is called Pediatric MATCH. The study is trying to match the mutation found in a child’s tumor with a drug targeted for the specific gene mutation, instead of for a specific type of cancer.

Personalizing Treatment

CAR T cells are the newest, most personalized cancer treatment. To make CAR T cells, immune systemA collection of specialized cells and organs that protect your body against invading germs and other microscopic threats. cells called T cells are collected from the blood of a person with cancer. The T cells are then modified in the lab so they can find and kill cancer cells. Millions of these designer cells are then grown and infused back into the patient.

“CAR T cells have made a big difference for kids whose leukemia has come back after treatment,” says Seibel.

“Right now, they’re reserved for patients whose disease has come back, or who have a high risk of relapse,” says Dr. Nirali Shah, a child cancer specialist at NIH. One reason for that is that standard treatments usually work very well. Another is that CAR T cells are expensive to make because they’re custom made every time.

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Researchers are testing so-called off-the-shelf CAR T cells, which could be made in big batches and used for many kids. This could reduce the cost and time needed to produce them. “But we need to know if their effect is going to last as long, and if the side effects are going to differ,” she says. “So they need to be further evaluated in clinical trials.”

CAR T cells and many other new treatments for children with cancer are being tested in studies called clinical trials. If your child has cancer, talk with your health care team. They can help you learn about all the treatment options.

When Less is More

Personalizing treatment can also mean adjusting the amount of therapy a child gets. That often means a lower risk of side effects.

For some cancer types, researchers can predict which tumors have a low risk of coming back. Kids at low risk of relapse may now be able to get lower doses of chemotherapy or radiation therapy. They may even be able to skip some toxic treatments entirely.

Reducing the amount of treatment can make a big difference in quality of life both during and after treatment. But no matter what treatments are needed, many side effects can be managed. For example, drugs can manage symptoms caused by chemotherapy, like nausea.

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Some cancer treatments may have what are called late effects. These are side effects that can occur months or even years after treatment. They include trouble with learning and development, damage to the heart, and increased risk of other cancers later in life. This is another reason why researchers want to reduce the amount of treatment whenever possible.

For some treatments, late effects are still unavoidable. So personalized care after treatment, called survivorship care, is vital for any child who’s been treated for cancer. Survivorship care plans help guide the type of care kids will need to lead their healthiest life possible.

“It’s part of the whole package of cancer treatment,” says Seibel. “We want to make sure that kids have the highest quality of life possible as survivors.”

Find advice and information about supporting a child with cancer.

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Health 360° Partners With Ap In Healthcare, Health News, ET HealthWorld

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Health 360° partners with AP in healthcare

Visakhapatnam: Health 360°, the healthcare division of Australia-based humanitarian group of companies Global 360°, has signed an investment agreement with public entity Andhra Pradesh Medtech Zone Limited (AMTZ). The strategic partnership will help build and develop healthcare facilities in Vizag which will be equipped with world-class facilities and life-saving medical equipment, to be provided by AMTZ.

The first in a series of healthcare projects in the pipeline is a 200-bed greenfield hospital built in two stages with each stage having 100 beds. It is scheduled for completion in mid-2023. The hospital will provide a wide and diverse range of medical specialties and procedures. Health 360° CEO, Dr Guru Yajaman, said: “We are honoured to have AMTZ onboard for this collaboration as we see a valued partner in them. They are one of the leading medical technology manufacturers in the world. This is a massive initiative that is very close to our hearts and consistent with our mission to deliver seamless healthcare experience to the people of India.”

Dr Jitendra Sharma, MD and CEO of AMTZ, said: “We are thrilled to announce that AMTZ is committed to working with Health 360° to revolutionise the healthcare industry. This partnership marks the beginning of a new era in the democratisation of medical technology. This would be the first hospital in India to be operated using only ‘Made in India’ medical equipment.”

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C3 Introduces Innovative Menstrual Hygiene Kit to Empower Young School Girls, Health News, ET HealthWorld

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C3 Introduces Innovative Menstrual Hygiene Kit to Empower Young School Girls

Pataudi, Haryana: To help young girls navigate puberty – which is often a time of significant physical and emotional upheaval – C3 has been working in five schools of Pataudi district, Haryana. The initiative is supported by Open Text, and has been equipping over 1000 adolescent girls with life skills, digital and financial literacy, and information on menstrual health and hygiene.

C3 introduced an unique, first-of-its-kind resource – Navya Kits – to the girls under this intervention. A collection of products and information that would help these young girls understand and manage their periods and dispel myths and taboos surrounding menstruation, these Navya Kits are a cornerstone for adolescent menstrual hygiene. The kits contain six reusable pads (that would last up to 2 years), a hot water bottle for menstrual pain management, a diary with interactive information on menstrual hygiene and taboos, and a detergent bottle that will help the girls wash and re-use their pads. To further supplement wider usage and safe disposal of sanitary napkins, C3 has also begun setting up incinerators in all of the five schools in which the initiative has been running.The Navya kits are also an essential tool for future advocacy around menstrual hygiene, and is something C3 will aim to disseminate through its other adolescent health initiatives as well.

At the launch event, Vandana Nair, Lead, Adolescent and Young People Program at C3, further emphasized the importance of educating young girls about menstrual hygiene, stating that “Menstruation is a natural bodily process that they will likely experience for several decades. By providing them with accurate information and resources, we can help them understand and manage their menstrual cycle and dispel any myths or taboos surrounding menstruation.”

Dr Tanaya Narendra, popularly known as Dr Cuterus, an Instagram influencer with over a million followers and author, was also present at the launch, and interacted directly with the young girls to answer their pressing concerns, to encourage them to have open conversations around menstruation, and providing valuable insights on how young girls can maintain their menstrual health. According to Dr. Cuterus, “this initiative by Centre for Catalyzing Change (C3) is absolutely unique, fun, and important for all the adolescent girls between the ages of 11-13. The products in the Navya kit will help young girls be prepared for their first period and also give them the right information in an engaging manner.

Ms. Pushpanjali Saikia, CSR Lead India from Micro Focus now Open Text, reasserted the need to provide girls with all the necessary information to help them achieve both better health and future success. This includes digital literacy, larger emotional and physical wellbeing, and the confidence to seek out better opportunities and better life choices in today’s increasingly digitized world.

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Every disease has a non-biomedical component; these societal aspects merit consideration as well:Shalini Bharat, Director & VC, Tata Institute of Social Sciences, Mumbai

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Every disease has a non-biomedical component; these societal aspects merit consideration as well:Shalini Bharat, Director & VC, Tata Institute of Social Sciences, Mumbai

Shahid Akhter, editor, ETHealthworld, spoke to Shalini Bharat, Director and Vice Chancellor, Tata Institute of Social Sciences, Mumbai, to figure out the non-biomedical determinants and identify vulnerabilities underlying health issues.

Collaboration and partnership in healthcare
If you remember, SDG 17 (Sustainable Development Goal) is about collaborations and partnerships, and I think in healthcare, more than anywhere else, collaborations and partnerships matter. Today, all of us probably complement each other’s characteristics or competencies, and the problems are so unique and complex that one size does not fit all. Similarly, one solution also will not bring the kind of results desired. and therefore, we need to build multiple partners onto the same platform. The other issue that requires us to bring a partner is that we have recognised that most issues, including all diseases, have not just a biomedical side to them but also a non-biomedical side to them, which means that we bring social dimensions. These are interdisciplinary and multidisciplinary focuses, along with a medical approach. We need to work in teams. I think it is very important and critical to work in multidisciplinary teams and to work in a collaborative way.

Need for social counselling in healthcare
If we look at the TB issue, we recognise today that, despite treatment being available, we have not been able to control TB as a problem in the country. In fact, India has almost one-fourth of the world’s TB burden. and that is because in the last several years we have only seen this as a bio-medical problem. Now, increasingly, we have realised that we need to understand that people had multiple issues before they had TB or as a result of TB. They have this problem, but they also lose employment at times, they fall into the poverty bracket, there is a huge stigma around the disease, and then there is the gender dimension: men have different consequences, but women have and face different consequences. There is a great deal of need for counselling to be done here. And counselling is not just about taking care of psychosocial issues but also linking them to health services, other government schemes, and so on. And all this requires that we work alongside biomedical providers. But then there are those that can provide psychosocial care; we also need to bring in community leaders; we also need to bring in peer members, that is, those who have survived TB, and they become champions and provide peer-based counselling. So this is one great example, and this is now happening in India.

Collaboration in TB care
From our own example, we know that, as an academic institution, we are providing support to the government, that is, the Central TB Division, in the form of providing trained psycho-social counsellors, providing training for them, and being able to look at drug-resistant TB as one of the issues. In four states, we are providing psychosocial care and counselling to drug-resistant TB cases. In addition to that, we are also finding that public-private providers are also collaborating in TB care.

Tata Inst. of Social Sciences
The Tata Institute of Social Sciences is a community-engaged university and India’s premier social science university. We have four campuses: Mumbai, Hyderabad, Tuljapur, which is a rural campus, and Guhati, in the northeast. This institute started as an institute for the professional training of social workers, but in the last several years we have grown to more than 50 PG programmes, four robust UG programmes, and 18 PhD programmes. And I think this is one of the only universities that has applied social science as its focus, and we have almost seven thousand students at this point in time, along with a school of vocational education. So a very multi-disciplinary social science university

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