Friday, September 19, 2025

Warriors and Survivors - 231

Children Cancer Stories by Rukh Yusuf - Blog # 231


I am Rukh Yusuf, Clinical Pharmacist, also specialized in Total Parenteral Nutrition and Bone Marrow Transplant. I have been working in the 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.



Childhood Cancer Awareness Month: origins, the gold ribbon, and the global state of play

Why a month and a symbol matter

Childhood Cancer Awareness Month (observed in September in much of the world) is more than a public relations exercise, it is a coordinated platform to advance rapid diagnosis, secure resources for curative and supportive care, highlight survivorship and late effects, and push for systems level equity. The gold ribbon adopted internationally as the symbol for childhood cancer intentionally evokes value and rarity: “gold” to represent that children are precious and deserve prioritization in research, care and health policy. ACCO

How this movement rose to prominence

Public recognition and nationaldeclarations in the U.S. and coordinated global advocacy (professional societies, parent organizations and WHO partnerships) gradually consolidated September as the focal period for awareness and fundraising. In parallel, WHO and partner institutions created formal global initiatives to translate awareness into measurable gains in access and survival. World Health Organization





What causes childhood cancer? A practical clinical summary

• Etiology is heterogeneous and often idiosyncratic. Unlike many adult cancers where lifestyle exposures predominate, most pediatric cancers arise from developmental biology and genetics: somatic mutations during growth, inherited cancer-predisposition syndromes (e.g., RB1, TP53/Li-Fraumeni, etc.), chromosomal rearrangements, and less commonly specific environmental or infectious agents.

• Risk gradient and preventability: A minority of childhood cancers are plausibly preventable by environmental modification; most are not. That does not reduce the value of primary prevention where identifiable (e.g., reducing therapeutic radiation exposure where feasible), or of secondary strategies (early recognition and rapid referral).

• Clinical implication: maintain low threshold for evaluation of persistent unexplained signs (prolonged fever, pallor, weight loss, lymphadenopathy/masses, focal neuro signs) and prioritize timely diagnostic pathways to pediatric oncology.

Latest global numbers (key facts you need at a glance)

• Annual global burden: ~400,000 new cases of cancer are diagnosed each year among children and adolescents (0–19 years). World Health Organization

• Survival disparity HIC vs LMIC: In high-income countries where comprehensive services are accessible, >80% of children with cancer can be cured; in many low- and middle-income countries (LMICs) cure rates remain well below 30%, largely driven by delays in diagnosis, lack of diagnostic/treatment infrastructure, abandonment of therapy, and treatable-mortality (infection, malnutrition). World Health Organization+1

• Global 5-year net survival (average): Pooled global estimates illustrate a stark gap, recent aggregated estimates place global 5-year net survival in the 30–40% range (estimates such as ~37.4% are cited in advocacy and analytic summaries), underscoring inequity and the opportunity for impact. Children's Cancer Cause

• Trajectory in survival: High-income settings show continued improvement five- and ten-year survival have risen substantially over recent decades (for many common childhood cancers, 5-year survival now exceeds 80–90%); population trends from 1970s to the 2020s show major gains driven by risk-adapted chemotherapy, refined radiotherapy, transplant, supportive care and targeted agents. However, gains are uneven by cancer type (e.g., certain high-grade brain tumors and diffuse intrinsic pontine glioma still carry very poor prognosis). PMC

Where to focus clinical and public-health effort now

1. Systems for early detection and referral. In LMICs, downstaging (earlier stage at diagnosis) could deliver large survival gains. Strengthen primary care recognition, referral pathways, and pathology/imaging access. The Lancet

2. Access to standard therapies and supportive care. Many deaths are preventable (infection, hemorrhage, organ toxicity). Policies assuring essential cytotoxic and supportive medicines, blood products, and trained pediatric oncology nursing reduce mortality. World Health Organization

3. Reduce treatment toxicity and plan survivorship. In HICs the urgent agenda is reducing late effects organ toxicities, secondary malignancies, neurocognitive and psychosocial impacts while maintaining cure rates. Pharmacogenomics, dose optimization and less-toxic targeted approaches are central. PMC

4. Global partnerships and capacity building. The WHO Global Initiative for Childhood Cancer (goal: at least 60% global survival by 2030) is the operational framework for coordinated improvement; it prioritizes essential packages, workforce training, and data systems. Clinicians should engage with national cancer control plans and regional networks. World Health Organization

Final reflections

Awareness months do not substitute for systems change, but they catalyze resources and political will. As clinicians we must translate awareness into durable commitments: robust early diagnosis pathways, access to safe curative therapy, investment in survivorship, and international solidarity that closes the survival gap. Practically, that means advocating for reliable supply chains for pediatric oncology drugs and blood products, embedding pharmacogenomic approaches where evidence supports them, and supporting long-term follow-up structures that enable healthy survivorship.



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