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Childhood Cancer Awareness Q&A with Niketa C. Shah, MD

September 08, 2022

As we honor childhood cancer awareness month, what do you want our patients and families to pause and remember?

I wish that all our patients and families remember that in this new DNA age, we should not be frightened by the diagnosis of cancer as we have had many advances in the field of cancer care in the last decade, with an increase in success rates.

How much progress has been made in the care of children with cancer over the last 5-10 years? Any recent advances?

In childhood cancer, we have identified many new agents and modes of treatment to precisely target cancer cells with less side effects than routine chemotherapeutic agents, which carried many side effects. This new targeted therapy approach has helped increase success rates in cure with less side effects.

What would you say to a caregiver who may be hesitant to enroll a child in a clinical trial? What role do trials play in the care of childhood cancers?

Clinical trials help us to get a better understanding of any cancer and improve its prevention, diagnosis, treatment, and overall care, and even help us to achieve increased success rates in cure. They help us to bring new lab innovations to the bedside using a very thorough, systemic approach. A team of professionals is involved in developing these clinical trials and a separate monitoring team makes sure all the steps in clinical trials are taken very carefully, making sure participants are well informed about the details of study they are participating in, and safety of the participant is evaluated and monitored appropriately. Many such clinical trials in the past have helped us bring newer innovations to the standard of care and thus improved cancer care.

A stem cell transplant is often part of the treatment plan for children with blood cancers and can be life-changing for many. How are these typically performed for children and what is the prognosis following a transplant?

Stem cell transplant is a complex process which involves the following steps:

  • Identification of the right patient who can benefit from this process.
  • Finding an appropriate donor for each transplant patient who can safely donate their stem cells without any impact on their own health.
  • Removing a patient’s abnormal bone marrow (which is causing life-threatening disease) using different agents (conditioning therapy) such as chemotherapy+/- radiation therapy and different immunosuppressive agents.
  • Collecting healthy stem cell/bone marrow from the donor and infusing them into the patient
  • Settlement process of new healthy bone marrow/stem cell from the donor into the patient (recipient’s) body which can take anywhere from 2-4 weeks. During this time period, patients may experience many side effects due to the conditioning therapy they received and absence of any healthy bone marrow cells before the new donor cells start working.
  • Close monitoring of post-transplant complications and long-term side effects of transplant process.

What are some of the biggest challenges you face in caring for cancers in childhood? What supportive care options are available?

I must say, being in this field for almost two decades now, we are facing less challenges in taking care of cancer cases in children as there are so many newer treatment approaches than before. And they have offered improved success rates which were not there before. We have many support groups which help children with cancer and their families go through this journey smoothly. Still, we have to continue improving in this field so that no child dies from this disease. I am sure we will reach that goal at some point in the near future.

Submitted by Eliza Folsom on September 08, 2022