Warriors and Survivors - Children Cancer Stories by Rukh Yusuf - Blog #09

I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in Pediatric Oncology unit of a public hospital for several years. The mission of this blog is to bring to you the real-life stories of child patients suffering from cancer. Cancer is still a difficult disease to handle and treat. However, when it strikes the children, some so young that they cannot even speak, their agony is beyond expression and words. Let us pray especially for children suffering from cancer for early and complete remission. May Allah shower His Merciful Blessings upon them. Aameen.

Strength is not related to age or maturity, it is s Allah’s blessing which He bestows on whosoever He wants.  Today I met seven years old Sadia, a symbol of happiness, confidence, and strength. Sadia is a young cute child, but she knows her disease in detail. When she was five years old, she had abdominal pain with intermittent fever. Mother first took it as mild fever then got her checked up. Nothing ruled out. She had few episodes of fever and pain again. Mother took her to hospital, but her symptoms did not settle as earlier.

Her pain got severe and later she had abdominal swelling. She was taken to hospital where she was admitted in emergency and investigations and treatment started. Tumor ruled out after thorough examination and series of tests. Further investigations revealed Sadia was suffering from WILMS Tumor.  Doctor said it was an emergency and she should be hospitalized. Her biopsy was done, and chemotherapy started later.

Wilms tumor (also called nephroblastoma) is a type of childhood cancer that starts in the kidneys. It is the most common type of kidney cancer in children. About 9 of 10 kidney cancers in children are Wilms tumors. Nearly all cases of Wilms tumor are diagnosed before the age of 10, with two-thirds being found before age 5.

Wilms tumor is often first noticed because of abdominal swelling or a mass in the kidney that can be felt upon physical examination. Some affected children have abdominal pain, fever, a low number of red blood cells, hematuria, or high blood pressure.

About 5 to 10 percent of patients develop multiple tumors in one or both kidneys. Wilms tumor may spread from the kidneys to other body parts, sometimes kidneys are not involved and tumor occur in the genital tract, bladder, abdomen, chest, or lower back. It is unclear how Wilms tumor develops in these tissues.

With proper treatment, children with Wilms tumor have a 90 percent survival rate. However, the risk that the cancer will recur is between 15 and 50 percent, depending on traits of the original tumor. Tumors usually recur in the first 2 years following treatment and develop in the kidneys or other tissues, such as the lungs. Individuals who have had Wilms tumor may experience related health problems or late effects of their treatment in adulthood, such as decreased kidney function, heart disease, and development of additional cancers.

The incidence of Wilms tumor varies among populations, with African Americans having a higher-than-average risk of developing this cancer and Asians having a lower-than-average risk. Wilms tumor rarely develops in adults; only about 300 such cases have been described.

Changes in any of several genes are involved in the formation of Wilms tumor. The tumors are thought to arise from immature kidney tissue that never developed properly. These immature tissues are known as nephrogenic rests. Most cases of Wilms tumor are not caused by inherited genetic factors and do not cluster in families. Approximately 90 percent of these cancers are due to somatic mutations, which means that the mutations are acquired during a person's lifetime and are present only in the tumor cells.

Chemotherapy was started to treat Sadia’s tumor, and she and her mother bear chemotherapy and its side effects patiently hoping for a cure after it. After six chemotherapy cycles, her nephrectomy (kidney removal) was planned. Brave little flower went through this surgery too. It is heartening to see her when she shows her surgery site lifting her shirt and saying that her kidney has been removed in her stammering voice.

Sadia belongs to a middle-class family from Lahore. She has four sisters and one brother, she is youngest flower. Her father sells milk, but the family seems quite contented. Her elder sisters are very good at studies, and they have secured good grades in College. Not only Sadia is contented about her condition but also her mother is grateful to Allah that her child has been managed timely and she is recovering now.  With stammering words, she said that her mother wants her to be doctor but she wants to be a teacher. She wants to rejoin her school as early as possible.

Let’s pray for her health and that her disease never recur and she follow her dream to be a teacher. Aameen.

 

Note: names have been changed to protect identity.