Childhood malignancies differ from adult tumours in their nature, characteristics and behaviour. Their unique radiological and histopathological characteristics demand a team approach, with experts from multiple specialties.
The work of the Paediatric Surgeon commences with the diagnosis of the malignancy through clinical, radiological, and at times by means of either a tru-cut or an open biopsy of the tumour. Depending on the Paediatric Surgeon’s expertise, even certain large tumours may be resected primarily.
However, some patients require chemotherapy pre-operatively to shrink certain large tumours, and to downstage them to facilitate curative surgery with less morbidity and mortality to the patient. This chemotherapy is delivered through special devices called Chemo-ports or Central Lines that are surgically placed by the Paediatric Surgeon.
Paediatric Oncology commonly involves surgical resection of the following tumours:
- Wilms’ Tumour or Nephroblastoma
- Lymphomas and Non-Hodgkin’s Lymphomas
- Testicular and ovarian malignanices
- Sacro Coccygeal Teratomas
Long term follow-up with biochemical tests, as well as with scans are needed for revaluation, and the child is once again reviewed and managed by the oncological team for the best outcomes. With the current diagnostic methods and surgical expertise, combined with adjuvant chemo and radiotherapy, clinical outcomes have improved.
Standardized international protocols have contributed immensely towards reducing the toxicity from chemotherapy by tailoring its dosages and regimens into precise and definitive protocols and algorithms for each stage of the malignancy.
It is both encouraging and heartening to see children improve, survive, and many a time get cured of their underlying disease.