Osteochondrosis 

Development of oncology in childhood Yap. Children's oncology

Unlike oncological diseases in adults, children's oncology has its own features and differences:

  1. The overwhelming majority of tumors arising from children is
  2. Cancer in children are less common than adults
  3. In children, non-epithelial tumors prevail over the epithelial
  4. In children's oncology there are immature tumors capable of ripening
  5. Specific for some malignant formations in children is their ability to spontaneous regression
  6. Exists genetic predisposition To some tumors, in particular, to the retinoblastoma, chondromatosis of bones and intestinal polypose.

Cancer Cancer in Children

The reason for the appearance of any cancer in children is a genetic failure in one of the healthy cell cells, which leads to its uncontrollable growth and appearance.

But cause this genetic cell failure can series. But here the children's tumors have features. Unlike adults, children have no risk factors associated with lifestyle, such as smoking, alcohol abuse, work in harmful production. In the adult, in most cases, the appearance of malignant tumors is associated with exposure external factors Risk, and for the appearance of a tumor in the child have more important.

That is why, if the child has evolved a malignant disease, his parents should not blame themselves, as it was most likely to warn or prevent this disease, it was most likely not in their forces.

Factors increasing the risk of cancer in a child:

1. Physical factors

The most common physical risk factor is a long-term impact on the child. solar radiation or hyperinsolation. Also, here refers to the impact of various ionizing radiation from medical diagnostic devices or due to man-made disasters.

2. Chemical factors

Here, first of all, there is passive smoking. Parents need to be fencing the child from the effects of tobacco smoke. Chemical factor is the wrong nutrition of the child. The use of GMO products, carcinogens, food intake in fast food restaurants. All this carries a decrease in the proper number of vitamins and microelements in the children's organism and accumulates in it of carcinogenic substances, which, in modern worldIn abundances are not only in food, but also in water with air.

In addition, there is another chemical risk factor, which is often dangerous to children. Many scientific research has proven communication long use Some drugs, such as: barbiturates, diuretics, phenytoin, immunosuppressants, antibiotics, chloramphenicol, androgens, with the development of cancer in children.

3. Biological factors

Biological factors include chronic viral infections, such as: Epstein-Barra virus, herpes virus, hepatitis B virus. Many foreign studies have established an increase in the risk of oncological diseases in children with viral infections.

4. Genetic risk factors

Currently, children's oncology has about 25. hereditary diseasesincreasing the risk of developing tumors in a child. For example, Tony-Debra Fanconi disease dramatically increase the risk of leukemia.

Also increase the risk of cancer in children by Bloom Syndrome, Ataxia-TelangiTasia, Bruton's Disease, Viscott-Oldrich Syndrome, Kostmann syndrome, neurofibromatosis. The risk is increasing to ill leukemia in children with Down syndrome and Kleinfelter.

Against the background of the Burnevil Burnevil syndrome, in half of the cases, a tumor is developing under the name of heart rabradomioma.

In addition to risk factors, there are several theories about the causes of cancer in children.

One of theories belongs to the German doctor Julius Condheim. The basis of its germinal theory is the presence of children, ectopedized cells, admissions that have the ability to reincarnant in malignant cells. That is why terators, neuroblastomes, gamarters and Wilms tumors do not have a familiar malignant structure. This is rather malformations, the blastomatous nature of which occurs only as a result of malignant rebirth of cells.

The second theory belongs to the scientist Hugo Ribberta. According to his theory, the hearth chronic inflammation or radiation exposure, serves as a background for the occurrence of tumor growth. That is why it is so important to pay attention to chronic inflammatory diseases in childhood.

Symptoms of cancer in children

Children's oncological diseases on the early stages Almost always flows imperceptibly for parents of the diseased child.

This happens, due to the fact that the symptoms of cancer in children are similar to many symptoms of innocuous childhood diseases, and the child cannot clearly formulate its complaints.

Also, children are widespread by injury, manifested by various bruises, abrasions, bruises that can lubricate or hide the early signs of cancer in a child.

For the timely detection of an oncological diagnosis, the child's parents is very important to monitor the obligatory passage of regular medical examinations in kindergarten or school. In addition, parents must pay close attention to the emergence of a child with various non-leaving and unusual symptoms for him. Children are in the risk group, as they can inherit genetic changes from their parents in the DNA structure. Such children should regularly undergo medical examinations and be under the non-primary control of parents.


When the child appears, symptoms who are alarming, immediately consult a pediatrician doctor, or to the children's oncologist.

The signs of cancer in children include many symptoms, but we will focus on the most common of them:

1. The inexplicable appearance of weakness, accompanied by rapid fatigue.

2. Pallothy skin Pokrov.

3. Unfinished appearance on the body of a child of swelling or seals.

4. Frequent and inexplicable body temperature lifts.

5. Education of serious hematomas at the slightest injuries and weak blows.

6. Non-flow pains localized in one body section.

7. Uncharacteristic for children, forced body position, with slopes, during games or sleep.

8. Strong headaches accompanied by vomiting.

9. Sudden violations of vision.

10. Rapid, capeless weight loss.

If you have found one or several symptoms from your child, you should not panic, almost all of them can accompany various infectious, traumatic or autoimmune diseases. But this does not mean that when such symptoms, self-treatment should be engaged.

With any signs of you, immediately refer to the doctor's doctor either to the children's oncologist.

Diagnosis of cancer in children

Diagnose the presence of a malignant tumor in a child is very difficult. This is due to the fact that the child cannot clearly formulate its complaints. He plays his role and a peculiar course, and ambiguous manifestations of child oncology in the early stages.

All this makes it difficult to the process of identifying and differential diagnosis of cancer in children from other frequently encountered childhood diseases. It is because of this, in most cases, the oncological diagnosis is placed when the tumor is already beginning to cause various anatomy-physiological disorders in the work of the body.


In the presence of alarming symptoms, in order to avoid medical errors, already at the first stage of the examination of the patient child, the suspected oncological diagnosis should be displayed in the diagnosis, in addition to other alleged diseases.

A huge responsibility lies in the Pediatrician or children's Surgeon., They are the first to conduct a child survey and offer an algorithm for further action. On the primary reception at the pediatrician, it is not always possible to identify the tumor, so the identification and diagnosis of cancer in children are much more successful when performing several types of screening tests at once.

In modern medicine to diagnose oncological diseases in children use All available screening and diagnostics methods, such as the.

Every year in the world, more than 200 thousand children find oncological diseases, and half of them are dying. The tenth of cases of cancer is detected only in the third stage, and in 8% of children, cancer is diagnosed on the fourth stage, which complicates the treatment and reduces the chance of survival.

We talked about the difficulties of diagnosis of oncology in children, the reasons for increasing the incidence and role of parents in the process of treatment with the main children's oncologist of the Ministry of Health, the Deputy Director of the Children's Oncology of the Russian Oncology Scientific Center named after Blokhin Vladimir Polyakov.

Maya Mice, Ayf.ru: Is there a tendency to increase the number of young patients you and your colleagues?

Vladimir Polyakov: Yes, such a trend is traced. More notable processes occur in adults, the number of patients with cancer, cancer younger, began to hurt people aged 20-25 years. An increase in incidence in children is also celebrated in all countries of the world, including us. But in Russia it is partly due to the improvement of statistics - that is, the numbers grow also because of better accounting of the sick.

- How can I explain the increase in incidence?

Exceptionally factors of the external environment. Where there is a bad ecology, there and the number of malignant tumors in children is higher than in more favorable regions. But I note that at all increased the incidence of children by any diseases, these are infections, and allergic reactions, and much more. All negative accommodation factors, nutrition, unfavorable psychological situation - affect people. It greatly affects the lifestyle of parents - from how they behave, how they live, whether they drink whether they are smoking, the health of children is directly dependent. Now the health of the population is generally worse, so the children are born more weak. If you take statistics according to the apgar scale (the system of rapid assessment of the state of the newborn - approx. Ed.), Then children 9-10 points were born, and now - 8-7. That is, the general background is worse.

- Is it possible to talk today about the possibility of cancer prevention in children?

It is possible, but it is important to say how adults live. The health of young children depends on the parents. All diseases transferred to the woman during pregnancy, work in harmful production, the place of residence of the future mother is affected. There are some data indicating the connection of the development of malignant tumors in children with previously spent abortion women. The age of a woman is also important when it gives birth to a child - the longer, the greater the probability of the appearance of the neoplasm. Therefore, it's good when a woman gives birth to 19-20 years, but taking into account today's tendency to socialization and its own implementation in life, people are late thinking about children. Men are all the same factors, except that they are more often abused by alcohol, tobacco, incorrectly feed on. All that is generally not good, and can become a factor in the development of malignant tumors.

In children of adolescence, the disease provoke injuries, hormone bursts, all transferred diseases, stress, even unhappy love can not pass for nothing. They are just like adults, depending on the environment and experience its influence.

- Why do children sick cancer? What are theories on this score?

Any factors launches the mechanism that disrupts the normal cell division. Today there are different theories - why it is that the mechanism for the formation of cancer cells is launched. Basic is chemical and viral theory. Chemical indicates the effect of the factors of the external environment, and viral suggests that the virus, falling into the body, so affects the cell that unlocks the capabilities of its tumor transformation. That is, the virus thus affects the immune system that it cannot stop this division. But these are only theories. If we knew exactly the nature of cancer, they could go to another level of treatment. But while we have only funds that can save a child from cancer - this is chemotherapy, radiation and surgical species Impacts, immunotherapy, and now developing cancer biotherapy.

Photo: RIA Novosti / Vladimir Song

- What tumors most often found in children?

If you take all tumors for 100%, then approximately half of them make up malignant tumors of blood tissue, the most frequent form is acute lymphoblastic leukemia, which, on our happiness, we learned to treat effectively. Slightly most The tumors of solid nature are tumors of soft tissues, bones, liver, kidneys, retina, thyroid gland and other organs. Among all solid tumors, brain tumors are dominated. The possibilities of cure with different malignant neoplasms are not the same. Something is treated successfully, something worse, but in general, if you take all patients, then recovers 80% of patients.

- Do many children come to you in a launched state?

This problem is huge and hard-time. Even in those countries where medicine is at a very good level, children often fall into the branch in a critical condition. In small countries, this problem is less relevant. Firstly, there are less than the population, secondly, it's getting closer, it's easier to get to the specialized center and check the causes of the child's bad well-being.

We have this problem relevant due to the large area. While the child from far villages falls into the district center, and then at the regional center - the time passes. In the district centers there is no children's oncologist, so at this level it is understood that the child develops a malignant tumor, at the initial stages it is very difficult.

Pediatricians are infrequently found with a malignant tumor, so specific symptoms can simply be not identified. A negative role is played by the absence of oncological alertness. Children are now a big load, therefore, for example, headache Or fatigue can not alert.

At the same time, oncological diseases are often masked for other diseases, for example, for respiratory infections. You need to score alarm when the disease is not amenable to standard treatment methods. But often the child is treated to the latter until they can't understand that the disease flows atypically. In incomprehensible situations, it is always better to immediately assume the worst of all diagnoses. After all, the smaller the stage is the easier and more effective treatment.

Often later detection of cancer is associated with the dislike of parents to visits to the doctor in the clinic, parents do not like to led children due to queues, the spread of infections.

- How to understand the degree of seriousness of the child's ailment in time?

There are no accurate initial signs, most often is masks of other diseases. For example, if respiratory diseases recur or leak atypically, it is already a reason to alert. As a rule, the development of the disease is accompanied by increasing lethargy, weakness, irritability, refusal of food, weight loss, decrease in activity, increased fatigue - it all serves as a reason to appeal to doctors. The reason for this state can be anything, especially since many tumors in children have a hidden localization. In any case, it is better to call a doctor to the house or seek advice. A competent doctor always suspects something, will offer additional research.

- What role do parents play in the treatment process?

Many parents are hard to endure the news of the disease of their child, they are not clear to them what to do next how to live. But when they fall into the department, it becomes easier - they see that they are not alone with such a misfortune, not alone in their misfortune, and it becomes easier. They see that someone is treated, someone better - it gives hope and strength to fight.

We also have psychologists with parents and older children. Little kids often do not understand what exactly they sick, but teenagers - they realize themselves, their future, and the struggle for a good psychological attitude is also given to them as hard as adults.

Parents should always be at the same time with the doctor. When there is a good contact with the doctor, there is trust and mutual respect, then you are already fighting together, there is a coordinated alliance. If this is not, the treatment is obtained by mechanistic. The attention of parents, their obedience and fulfillment of all the recommendations of the doctor. The role of mom in treatment is very large, especially considering that medical personnel is often missing.

And who will care for the child better than mom? We have all moms are near the children. Although by law, children over 4-5 years old should be in the hospital without parents. And we have even teenagers with mothers, this is important not only from a technical point of view, for example, for hygienic care, a child, but also with moral. Parents are very closely monitoring the condition of children, they are the first to notice something, pay attention to the complaints or the peculiarities of the child's behavior and turn to medical personnel at the board or help.

Department of Children's Surgery

ESSAY

on the topic:

"Features of children's oncology. Etiopathogenesis of tumors.

Features of treatment.

Organization of oncological assistance to children. "

Performed:

student 604 groups

pediatric faculty

Berezkin A.A.

Krasnoyarsk, 2008.

Perhaps there is not a single industry of practical medicine, which for such a short time reached such results as children's oncology. Currently, on average, given all stages, which comes to specialists of the patient with a tumor, it is possible to save up to 70% of children with malignant neoplasms.

IN
last years, great attention is paid to the organization of specialized cancer assistance to children. Children's oncological departments and clinics have been created in major cities. This is due to the fact that childhood tumors have their own characteristics in the frequency of defeat of certain organs, clinical symptoms and the flow of process, as well as methods of recognition and treatment, to a large extent that distinguish them from adult tumors.

According to most statistical data, in all countries there is an absolute increase in the incidence of children with tumors, including malignant. Among the various causes of death in children aged 1 to 4 years, malignant tumors are in third place, moving in an older age group to second place and yielding in frequency only mortality from accidents.

In general, genuine forms, in particular papillomas and polyps of ENT organs (the cavity of the nose, larynx, ear) and the rectum, as well as vascular and pigment tumors of the skin (hemangioma, lymphangioma, peels) are significantly dominated among the tumors of children's age. Less often occur tumors associated with developmental deposits: teratomas, dermoid and epidermond cysts.

The causes and patterns of development of malignant tumors in children are considered from the same positions that in adults, although the age-related features of immature developing tissues, hormonal factors and malformations, which at a certain stage show a tendency to malignant transformation at a certain stage.

Special, specific for some children's neoplasms, is the ability to be involved in spontaneous (spontaneous) regression (reverse development). It is characteristic not only to benign forms - hemangioma, youthful papilloma, but also malignant tumors of the sympathetic nervous system (neuroblastoma) or retina of the eye (retinoblastoma). The reasons for this phenomenon remain unclear. Did not receive explanations and the second peculiar phenomenon: when these malignant in their structure of the tumor with age lose signs of malignancy and proceed as benign neoplasms.

One of the most important features of children's oncology is the existence of a family predisposition to some tumors - retinoblastoma, chondromatosis of bones and intestinal polypose.

Features of children's oncology

Morphological features


  1. In childhood, tumors developing from mesoderm are dominated.

  2. Rare tumors of epithelial origin.

  3. Characterized by a combination of tumors with defects of development.

  4. Congenital tumors prevail.

  5. Frames are embryonic tumors.

  6. Tumors arising "de novo" are dominated, i.e. primary.

  7. Malignization benign tumors It is rarely observed.

  8. Hemoblastosis make up about half of all malignant onco-scabers.

  9. Some malignant tumors have a capsule (nephroblastoma, neuroblastoma).

  10. Part of the benign capsule tumors do not have and have infiltrating growth (hemangioma, desmoids).

  11. Some benign and malignant tumors may be subject to regression (hemangioma, neuroblastoma).

  1. Small number of visually observed tumors.

  2. Localization of the most common tumors in hard-to-reach places.

  3. There are difficulties related to the receipt of anamnesis in young children, the absence or objection of complaints.

  4. Silent disguised course of most tumors.


  6. The need for anesthetic support in a number of studies.

  7. The need for a combined implementation of several studies is simultaneously (to reduce the timing of the survey and reduce the number of anesthesia).
Features of treatment

  1. Large tumors violate topographic-anatomical relationships, which may make it difficult to carry out surgical intervention.

  2. The need for simultaneous correction during the operation of the defect and tumor removal.

  3. There is a postulate "Large operations in small children."

  4. It is characterized by a high sensitivity of malignant embryonic tumors to ionizing radiation.

  5. There are serious consequences of radiation therapy (inhibition of blood formation, the occurrence of secondary tumors).

  6. The high sensitivity of malignant embryonic tumors to chemotherapy products is characteristic.

  7. There is a large number of adverse negative effects and complications from antitumor drugs (myelodepression, nephro-, neuro-, hepato, cardiotoxicity).

  8. The rapid evaluation of the results of treatment (with 2-year-old unreasonable and non-resistant survival, children are considered practically recovered).
Morphological features

  1. In the percentage of expression of the tumor of mesodermal origin (sarcoma) in childhood, about 84%, epithelial - 5-6%, the remaining tumors (approximately 10%) have a mixed structure.

  2. In world literature, a large number of combinations in childhood of tumors with congenital defects development and genetic disorders.

  3. Congenital tumors are called those tumors that have a child at the time of birth.

  4. Embryonal is considered tumors developing from embryonic cells, but they are not always there at birth and can appear in different times Children's age.

  5. Primary tumors predominate (for example neuro- and nephroblastomes, osteogenic sarcoma, etc.), malignancy is rarely (for example, melanoma from the nevus).

  6. Gemoblastosis is 45%, i.e. Almost half of all malignant tumors.

  7. Malignant tumors having pseudocapsula are nephro- and neuroblastoma, and for a long time She does not germinate.

  8. Benign tumors having the properties of malignant growth (fast, infiltrative growth, absence capsule), but at the same time being absolutely mature morphologically, are hemangiomas and desmoids.

  9. Regression (reverse development) may undergo benign hemangioma, and from malignant tumors - neuroblastoma (in 1%), which is gradually moving to ganglianevrom, which are mature tumors that have a benign flow. Sometimes they completely disappear even after partial removal by the method of "scattering".
Features Clinic and Diagnostics

  1. The relatively small number of visually observed tumors.

  2. The most common tumors in children are located in hard-to-reach areas.

  3. The difficulties of diagnosis are due to the complexity of obtaining anamnesis in children of younger, the absence or disjustness of complaints. More older children need to take into account when collecting anamnesis, the desire of a child to hide some symptoms of the disease because of the fear of pain during examination, unwillingness of hospitalization.

  4. Most tumors in children are hidden under "masks."

  5. The predominance of common symptoms over the local.

  6. The need for anesthetic support.
Etiopathogenesis of tumors

Etiology of tumors in children

Factors of outer and internal medium, which can be causes of tumors, are called carcinogenic. Distinguish physical, chemical, viral carcinogenesis.

Of physical factors Special attention deserves various types of ionizing radiation. As a result of nuclear tests, accidents at nuclear power plants, submarines and large-scale ships acquired the spread of radionuclides in the environment, they fall into the human body with various ways (with food, water inhaled by dust). And since the half-life of the main radioactive elements is calculated by decades, the pathogenic effect of them on the body is chronic, long. Children are more sensitive than adults to radiation.

The irradiation of the thyroid area can cause a malignant tumor in it, especially in girls. The probability of development of a malignant tumor is directly proportional to the dose of irradiation. The time of occurrence, by literary data, hesitates from 6 to 35 years since the exposition. A sharp increase in frequency (more than 30 times) of thyroid cancer in children (tumors, extremely rarely found in a normal children's population) in areas infected with radionuclides after Chernobyl catastrophe, indicate the undoubted influence of ionizing irradiation on the development of thyroid cancer in children.

The development of secondary tumors after radiation therapy is one of the most serious complications of this type of treatment.

Solar radiation. It is known that the occurrence of skin cancer is largely induced by the impact of UV rays. Since for the occurrence of this cancer, a long latent period is needed, in children skin cancer - an extremely rare event. The exception is the skin cancer arising against the background of a pigment kservoch, which is a genetically determined state. In children suffering from a pigment kservoch, even very moderate insolation causes malignancy.

There are clear data that in areas with high insolation, melanoma mortality is significantly higher than in the northern regions.

Chemical agents. Science is known a large number of chemicals considered carcinogenic. They own aromatic hydrocarbons (benzpiren, benzannotopzen et al.), Aromatic amines (aniline dyes), nitrogenous compounds, pesticides (herbicides, pesticides, insecticides), mineral fertilizers, flavonoids, asbestos, etc .. nitrates contained in food may transform in human body into mutagenic (oncogenic) N-nitro-substances.

Long-term contact with asbestos causes mesothelioma pleura from and adults working with this material. The combination of asbestos exposition with tobacocco increases the risk of developing lung cancer in tens of times. Mesothelioma arising from children, differs in histological characteristics of the "adult" mesothelioma, and in the pathogenesis of its appearance asbestos hardly plays a role.

Smoking - famous carcinogenic factor for development light cancer. There are works based on a large statistical material, ruleing to the transplacental effect of tobacco to the offspring. So, in smoking women, children are twice as often as non-smoking. Regarding children, it is also necessary to remember that the "passive" smokers receive 70% of all harmful substances contained in tobacco smoke, and this may cause a lung cancer in adulthood.

Medicines. Currently, drugs are known, reliably and significantly increase the risk of malignant tumors in children:


  • diethylstilbastrol, causing carcinoma vagina;

  • nitrosoamines that increase the risk of brain tumors.
Prolonged treatment with Androgens, taken earlier with the anemia of Fanconi, is associated with the high risk of developing hepatoblastoma. The cytostatics themselves used to treat tumors may cause the development of a secondary tumor: alkylating agents and epipodofilotoxins are responsible for the occurrence of secondary leukemia (mainly myeloid). There is information and immunosuppressants. Patients receiving immunosuppressive therapy after organ transplantation (kidney, bone marrow) have a large risk of developing malignant tumors, such as lymphomas and liver tumors.

Diet. A number of products in the cooking process can highlight proteinpyrolisats that are carcinogens. Carcinogenic impacts can also have numerous preservatives used in recent years by enterprises of the food industry. At the same time, some products containing vegetable fiber and caratinoids, on the contrary, are antagonists that impede the development of cancer.

Viruses. The role of viruses in the etiology of cancer is discussed from the beginning of the 1960s. The idea of \u200b\u200bthe viral nature of cancer in children is expressed. So, in, links with the endemic spread of African lymphoma (Burkitt lymphoma), mainly in children aged 4-8 years, received a lot of data that testify to the involvement of the virus to the emergence of this neoplasm. The role played by the Epstein Barra virus (VEB, or EBV) in the evolution of some tumors is intensively studied. The most well-known examples of this influence are Nazofarengial Cancer and Lymphoma Berkitta. It is believed that EBV can induce the process of "immortality" in cells exposed to spontaneous pathogenetic mutations (i.e., induce the ability of cells to self-product). This process and lies and the basis of increasing growth.

Viral theory is trying to use and to explain some other systemic neoplasms, in particular, leukemia. It is also indicated for the overall possibility of horizontal transmission under lymphogranulomatosis, which may indicate the infectious nature of this neoplasm.

The role of infection in the pathogenesis of lymphogranulumatosis is discussed in very many works. From this point of view, it is interesting that in developing countries, where there is a high level of infectious incidence among young children, the earlier origin of Hodgkin's disease is registered than in developed countries. It is assumed that the disease of lymphogranulomatosis at an older age in developed countries is associated with the lack of early contact with the pathogenic factor.

It is now well known that the infection of women with the Herpes HPV virus increases the risk of developing the cervical cancer in tens of times.

Although most children with hepatocellular carcinoma and do not have a history of viral hepatitis B, the connection of these two events is also recognized as very close.

Thus, there are many etiological factors in carcinogenesis, but in world literature, the viral nature and origin of tumors are becoming increasingly preferred.

Theories of pathogenesis

The occurrence of tumors is the appearance and reproduction of the tumor cell in the body, capable of transmitting the properties acquired by it in an infinite row of generations. Therefore, tumor cells are considered as genetically changed. The beginning of the growth of the tumor gives one cell, its division and division of new cells arising from this is the main method of tumor growth. Thus, two factors are needed for the occurrence of a tumor: the occurrence of the changed cell and the presence of utopia for the smooth growth and reproduction.

To explain the origin of tumors in children use theories that are adopted in general oncology. These are theories:

1) Physical

2) Chemical

3) viral carcinogenesis

4) Disorders of Apoptosis

5) immunological incompetence

6) genetic predisposition

7) contact inhibition I.T.D.

Violation of apoptosis. "Breakdown" of the mechanism of genetically determined death of cells accumulated mutations contributes to their subsequent infinite division.

Of great interest is theory of immunological control. The body has special mechanisms for the recognition and destruction of "marriage" cells, which are essentially alien for the body. The body struggles with them in the same way as the cells falling outside (bacteria or transplanted organs) with immune system. But also one "beautiful" day of the immune system gives a failure, for some not enough reasons, misses the "defective" cell capable of continuous reproduction and uncontrolled growth.

In all likelihood, it is the impairment of the immune system that are defining in the development of tumors, since the occurrence of a cellular marriage is inevitable, and it all depends on how reliable and effectively it is recognized and is detected and timely destroyed.

The concept of the role of immune mechanisms in the development of malignant neoplasms was nominated in 1909 by Erlich, and then expanded by many researchers. Research Recently confirmed the essential importance of the immunosuppression factor in the development of tumors.

According to this theory, practically healthy man The possibility of malignant transformation of cells, which is contained by the protective forces of the body. This theory finds its confirmation in the fact that children with breakdowns of the immune system are more often a malignant tumors.

Hereditary genetic theory. About 101 genetically determined syndromes are known, which predispose to the development of non-cultural processes in childhood. It has been proven that in the etiology of a number of congenital tumors in children, genetically playing factors play a major role. This is primarily characteristic of Retinoblastoma and Nephlablastoma.

The development of the most common embryonic tumors is associated with structural changes in the chromosomal apparatus, in particular, with the deletion (loss) of certain sections of the chromosome, as a result of which the action of the suppressor tissue-specific mechanisms is included and certain oncogenes are activated.

The most fundamental discovery in this area should be considered mapping suppressor genes with a retinoblastoma, nephoblastoma and neuroblastoma. The neuroblastoma gene is located in 1, nephoblastoma - in 11, retinoblastoma - in 13 chromosome. These mutational changes can occur both in the germinogenic (sex) cells (then they are considered hereditary and transmitted on autosomal dominant type offspring) and in the somatic cells of the child (in these cases the tumor is not inherited). To transform a mutant cell in malignant, it is necessary to have another event, most often the mutational, in the same cell. The probability of the second event determines the penetration (probability of manifestation) of the tumor.

Loss of contact inhibition of growth. The violation of the regulatory properties of the cytoplasmic membrane of cells by virtue of chronic pathological impact leads to their uncontrollable rape growth.

Fischer-VaselsFormulated in the 20s of the 20th century attracts the greatest value in the occurrence of tumor growth with conditions in which the fabric receives powerful physiological or pathological impulses to growth over a long period. They may arise due to the re-death or regeneration of tissues (frequent effects of X-rays), or under the influence of rapid growth of tissues in certain age periods.

The pathogenesis described above can be applied to explain oncopathology at any age. But there are also hypotheses adapted specifically for children's oncology.

Konheim's theory It was proposed in the 70s of the XIX century according to this theory, the tumors occur from persistent embryonic adventures that arose due to imbridegenesis. During the intrauterine development of the fetus, the embryonic fractures of tissues occur. Unused during the construction of the body, these ectopedized cells can not be exposed for a long time. With the accession of internal and external stimuli, these primitives can give tumor growth. An objection to the theory of conjima is certain factors: the preemptive development of tumors in old age, and not in children; The predominance of neoplasms in organs, where there are no special complexity of the formation during the period of embryonic development. Thus, tumors in adults relatively rarely arise from gill arcs, embryonic ducts, and more often from the epithelium of the gastrointestinal tract. At the same time, it is convenient for children's oncology, because, most common tumors in children (nephroblastomes, neuroblastomas, meduloblastoma, hepatoballastomes, retinoblastoma are developing during the embryonic or early postnatal periods from immature organs and tissues. The theory of Congeem also explains the combination of tumor with defects, the preferential connecting genesis of neoplasms and the absence of prematubic diseases. Experimental confirmations are also important indicating the possibility of "spontaneous" malignation of ectopyed embryonic cells. The same theory can explain the origin of many benign tumors in children and tumor-like innate tissue development anomalies consisting of local tissues and alien tissues for this localization - Gamart.

The theory of transplacentar blastomogenesis. This is one of the last theories, proposed in the 50s of the XX century. According to this theory, most neoplasms in children arise through the penetration of carcinogenic substances through the placenta. Almost all drugs used in obstetric practice pass through the placenta. The experiment has proven the permeability of the placenta for strontium-98, which caused osteosarcoma in the born rats in the parenteral nutrition of the mother. Numerous statistical studies indicate that the risk of tumors in children becomes higher if the mother has been exposed to X-ray radiation (this may be the usual X-ray examination). The risk is the higher, the more often the irradiation was carried out.

Thus, factors that can be used to construct the theory of origin of tumors in children, the following:


  • Congenital nature of most early childhood tumors

  • Communication of malignant tumors with defects

  • The hereditary nature of some tumors

  • Immunological incompetence in tumors

  • Spontaneous regression of a row of tumors

  • Transplascent blastomogenesis.
Features of treatment

  1. Violation of anato-topographic relationship. At the fetus, after the birth of a child or early childhood, when the correct relationships of the organs were not fully developed, the binder was not strengthened, the fiber is gentle and very elastic, the tumor with solication violates the usual arrangement of the organs familiar to the surgeon. You can observe various non-standard, sometimes paradoxical, the location of the organs. In some cases, the relationship between the organs is so changed that it is difficult to establish where the neoplasm is located: in the abdominal cavity or in the retroperitoneal space.

  2. Combination of tumor with congenital vices. Complicated operational intervention and a frequent combination of tumors with various defects of development. A combination of a number of defects with a tumor, especially against the background of topographic anatomical disorders, makes it difficult not only to refer to the surgeon and makes additional difficulties in operational intervention, but sometimes makes it impossible to radically remove the neoplasm. The presence of vice often makes it difficult to evaluate the effectiveness of the treatment carried out, especially in cases where the vice cannot be corrected. In these cases, a detailed topical preoperative diagnostics is needed, allowing the surgeon to better navigate during the operation.

  3. "Large operations in small children." In a pediatric clinic, it is often necessary to spend large operations Little children. Surgical operations are often carried out in children with large, difficult tumors located in the skull, mediastinum, retroperitoneal space. At the same time, often neoplasms are striking children, and mainly under the age of 3 years. Here, the principles of cancer radicalism come into conflict with the postulates of children's surgery (by organo-breaching principles). Surgeon, operating little baby With a tumor, must take into account and clean oncological problems: surgery, if possible, must be radical.

  4. High sensitivity of malignant tumors in children to ionizing radiation. It is an effective component of comprehensive treatment. With radiation therapy, the doctor must take into account higher and diverse sensitivity to radiation, both tumors and the body of the child as a whole. With a number of tumors in children, remission can be achieved, and sometimes complete cures alone only radiation therapy.

  5. Side effects and consequences of radiation therapy. The exposure of children, especially in early childhood, can cause serious consequences, because The child's body is violently growing and, at the same time, labile, not fully formed. Side effects and consequences of radiation therapy can be avoided or significantly reduced them with good technique and thoughtful irradiation mode, even those side phenomenawhich are still inevitable.

  6. High sensitivity of malignant neoplasms to antitumor chemotherapy drugs. Almost all malignant neoplasms in children are highly sensitive to various antitumor drugs. The most common tumors in childhood, in contrast to those in adults, the use of polychimotherapy, which truly produced a revolution in children's oncology is perfectly reacting.

  7. A large number of spare phenomena of polychimotherapy and protective drug therapy Baby girl with a tumor. When conducting medicinal antitumor therapy, fast, unpredictable drops of blood indicators, changes from the nervous system, the emergence of a number side Effects and complications, especially this should be considered in cases where many drugs are used. It is necessary to clearly calculate the doses of drugs while using several methods simultaneously and carry out adequate symptomatic therapy using drugs that improve the quality of life.

  8. Features of assessing treatment results. One of the features of children's oncology is the possibility of a faster assessment of the results of treatment. It is noted that the overwhelming majority of children who lived without metastases and recurrences of 2 years becoming practically healthy. Based on a large statistical material, a certain time unit has been created, which is called the "risk period", it determines the period in which relapses or tumor metastases may occur. Regarding this period there was a discussion that was not over and now. Observation of the child Pediatrician (or children's oncologist, which is better) must lead until he proceeds to an oncologist who treat adult people.
Organization of oncological assistance to children

Children's oncology as practical and scientific discipline was born in the 60s of the XX century.

According to WHO, in 1961, among the causes of death at 100 dead aged from the age of 14, 9.8% accounted for malignant tumors, aged 5 to 14 years old - 14.3%. In 1976, WHO reported that in 23 economically developed countries, mortality of children as a result of cancer came to second place, yielding only mortality from accidents. Statistical information about the incidence of children malignant tumors The most widely and in detail are developed in the United States, where there is a single children's caterzer register in the country. Forecasts of the National Institute of Cancer in the United States and its Special Program are small: one of the 330 Americans under the age of 20 will sick malignant tumor.

Unfortunately, the data of Russia on the incidence of children are far from cancer, since the bodies of statistics do not receive accurate information (sometimes not fixed up to 50% of the diseased), and there is no single children's caterzer register in the country. Therefore, the most accurate figures are represented only by selective studies in cities, where accurate accounting is conducted. So, in Moscow for 100 thousand children's population of boys - 14.5 and girls - 13.5. In absolute figures, this is 220-250 children per year. In St. Petersburg, the incidence among boys amounted to from 13.9 to 22.9 per 100 thousand children's population, among girls - respectively from 12.3 to 15.5.

Since the 70s, children's oncology began to stand out in independent scientific and practical discipline. Features of children's oncology and allowed it to allocate it in an independent specialty, which was approved by the Ministry of Health of the Russian Federation in 1997. And, perhaps, there is not a single branch of practical medicine, which would achieve such results for such a short time.

For forty years since 1960, children's oncology has passed a big way. Children's oncological departments began to be organized. The first children's oncological department in the USSR was established in January 1962 in Moscow. In 1966, the same name was organized in St. Petersburg. Over the next ten years, another 16 such offices appeared. Unfortunately, with the collapse of the Union, many of them ceased to exist.

Since 1970, international organizations of children's oncologists appear. With an international anti-cancer Union in 1971, the Cancer Committee was created in children, then the problematic commission on children's oncology in Eastern European countries, since 1967, gradually expanding, organized international society of pediatricians. Intensive international ties, many cooperative studies of children's oncologists allowed the fastest to introduce the newest achievements of science in the practice of oncological pediatrics and achieve the best results In the treatment of tumors in children.

By 1994, there were 15 children's oncological offices in the country, and where they are not - territorial oncological dispensaries and, partly, hematologic, neurosurgical and urological units of the institutions of the general treatment network. To date, the provision of children's oncological beds in Russia is 0.25-0.28 per 10,000 children's population.

To date, the oncological service in pediatrics, in contrast to the state system of oncological assistance to adults, organizationally imperfect. With a pediatric oncological service there is only one research institute (Institute of Children's Oncology Oncology Scientific Center, RAMS) and one department of children's oncology in the Russian medical Academy Postgraduate education. In regions where there are no specialized children's oncological departments and cabinets, various specialists have help to help children with malignant tumors, far from always having sufficient knowledge in the field of children's oncology.

The most appropriate is centralized assistance to children with malignant tumors, consisting of several links, each of which performs its functional tasks. This is a pediatric general polyclinic department, where a general examination is carried out, a preliminary diagnosis is made and, if necessary, the child is hospitalized or in a common children's hospital, or immediately into a specialized children's surgical department, where a more in-depth examination is carried out. An important place in this network is a consultative oncopediatric cabinet, which should be organized in each area. It includes:


  1. organizational and methodological work to obtain reliable statistical data on the incidence, causes of nestness, structure, mortality of children;

  2. diagnostic and differential diagnostic process;

  3. special outpatient therapy;

  4. dispensary observation;

  5. rehabilitation.
It is necessary to take into account the clinical groups of cancer, which is needed to select the treatment regimen. Filling into accounting documentation, strategy and tactics of the doctor, the timing of observation and the procedure for dispensarization, deontological considerations are determined by the clinical group.

Clinical groups of cancer patients:

Ia - patients with diseases suspicious on malignant neoplasm.

IB - patients with prematubolic diseases.

II - patients with malignant tumors subject to special treatment, including:

IIA - patients with malignant tumors to be radical treatment;

III - Persons healing from malignant neoplasms (practically healthy people).

IV - patients with a launched form of disease, subject to palliative or symptomatic treatment.

Accounting is carried out by regional and urban-based oncological dispensaries (in addition, there may be up to 50% of patients). Below are the main types of oncological documentation.

All patients are filled with "Control Map of Dispensary Observation" (ONKO) - Form No. 030-6 / y. The source of information for filling control cards are: "Notice", "Extract from the medical record of a stationary patient with a malignant neoplasm" (form No. 027-1 / y), " Medical Card. An outpatient patient "(form No. 025 / y)," Extract from the protocol of a medical conference on how to identify the patient with a launched form of malignant neoplasm "(form No. 027-2 / y). Based on the control cards, "report on patients with malignant neoplasms" (Form No. 35) is drawn up. One of the sources of information is the "Medical Death Certificate", which must be treated with the civil status record authorities (registry office).

An important criterion for organizing oncological assistance is the morphological confirmation of the diagnosis. Unfortunately, it is clearly not enough the number of pathomorphologists specializing in children's oncology, so such a percentage of incorrectly established diagnoses (up to 15%). Nevertheless, due to the large proportion of hemoblastosis in the structure of the incidence of children, the rate of morphological confirmation of the diagnosis is quite high (81.2%), although in a number of territories does not exceed 50%.

Oncological diseases on preventive inspections in children's teams are rarely detected. The small effectiveness of the profression is associated with insufficient oncological alertness in relation to the child. A very important indicator of the organization is the percentage of nestiness (patients with IV clinical group). Comparison of the distribution of for the first time identified diseases of children by malignant neoplasms according to the degree of prevalence of the tumor process with adult patients is almost impossible due to the high proportion among children of unusable diseases (again the lack of children with oncological diseases). On average in Russia in 1993 in 76.6% of children, the diagnosis was detected in the far stages of the disease. At the I-II stages of the disease, the diagnosis was detected only in 23.4% of children, and in the regions - and less. The amount of the share of the dead to 1 year from the moment of the diagnosis is largely determined by the quality of treatment. To a certain extent, it depends on the number in this group of diseases with high death. Therefore, both indicators do not reflect the real neglence, comparable to adult patients, which speaks of the difficulties of rendering and taking into account oncological assistance to children. In most territories, Russia per 100 newly identified sick children accounts for 44-54 dead. In some regions of the country, this indicator is approaching 100%.

The introduction of the achievements of diagnosis and treatment into the children's oncology, the accumulation of experience has significantly improved the results of treatment. More and more children become practically healthy, and therefore the greater contingent of children should be under dispensary observation. Terms of active observation, comprehensive control examination and conduct, if necessary, anti-inflicted treatment depend on the nature and course of the tumor process. Thus, with solid tumors, antitumor therapy usually continues two years, with malignant lymphomas - three years, during leukemia - five years (these are conditional and can change due to changes in the treatment regimens). In these periods, the patient is examined after 1.5-2 months. Subsequently, the frequency of the survey increases to 3-6-12 months. Formally, the dispensary observation of patients with a malignant tumor is carried out up to the age of 15, however, when recurring the tumor process, the question of the continuation of treatment in the children's office and at an older age is often. In recent years, there has been a question about the inclusion of adolescents, young men and girls under 18-20 in the contingent of patients. A relatively small absolute incidence of children with malignant neoplasms is an objective reason for creating independent, far away from another children's oncological offices by 50-60 beds serving regions with a population to 4-5 million. It takes into account that sick children should be hospitalized in the department Repeatedly for the control examination and carrying out the necessary treatment. In recent years, departments have been created for the rehabilitation of children after cure from malignant tumors. Rehabilitation activities in children with tumors can be successfully carried out in general rehabilitation institutions. From properly organized oncological assistance, ultimately, the results of the treatment of children with malignant neoplasms depend. This is especially seen when comparing the results of treatment in various stages of the tumor process. Reduced launched stages of malignant neoplasms in childhood, and this is due to the organization of oncological assistance to children, will significantly improve the results of treatment.

All the recovered children are becoming more and more, before the children's oncologists there are questions of their quality of life. To solve them, methods of medical, psychological and social rehabilitation of children and adolescents who have undergone treatment for a malignant tumor are being developed. Medical and genetic counseling of children and their parents are carried out.

Approximately this is today the state of children's oncology. Seven of the 10 child cancer patients can be saved. But this, of course, is far from the limit.

BIBLIOGRAPHY:


  1. Darina A.N., Yurchuk V.A., Sukhovykhov O.A., Tsats M.V. Actual questions of children's oncology. Manual for work practical doctors - child surgeons, pediatricians, general surgeons - Krasnoyarsk, 2007.

  2. Dunov L.A., Goldobenko G.V., Kurmashov V.I. Children's oncology. Training edition. - Kursk: KGMU, Moscow: "Lite", 1997.

  3. Materials of the press conference "Children's Oncology - another chance to survive", Article Lion Dornova "Children's Oncology: Search for new features."

According to research, Children's oncology is a fairly frequent problem. And according to statistics, the boys are 2.5 times more often than girls.

Although in some varieties, the frequency of manifestation of cancer between the floors is about the same and on average is 1 sick on 10,000 healthy kids.

And, although the children's cancer is studied quite actively in our time, no one can say about the reasons for its occurrence. At the moment there are two main hypotheses of the origin of the illness.

The first is viral - based on the fact that the virus, getting into the body, is so changes so much the process of cell division and activates their hidden mutagenic ability, which becomes an impossible stop of this reaction, and the body continues to reproduce the "unhealthy" cells again and again.

At the same time, immunity does not recognize them as foreign, since in nature they are initially normal cells, which means that they do not kill them, which makes it possible to exacerbate this state.

The second is chemical - testifies in favor of the influence of the surrounding factors on our inner medium and the ability to cause mutation processes.

Causes of cancer in embryos and newborns

It is impossible to say reliably that one or another factor caused oncology, but you can try to understand what causes of cancer in children. Most scientists adhere to the opinions that children's oncology in most cases is a genetic predisposition.

It should not think that cancer particles are inherited. If you and your ancestors have been established a similar diagnosis, it is not at all necessary that it will also be at your child. So, some very small gene or its site can carry a factor that will subsequently provoke an abnormal division of cells. But he will manifest or not - is unknown.

Also can not be overlooked and the living conditions around us. Even in the state of the embryo is very important which lifestyles are parents.

If they smoke, we use alcoholic beverages overly, take narcotic substances, do not comply right mode Nutrition, live in contaminated by radiation and exhaust gases by the neighborhood, the future mother does not follow the reception of additional vitamins and the trace elements necessary to the fetus, then all this may affect the future. Born in such conditions, the baby is already in the risk group.

Causes of diseases in older children

Risk factors at an early age:

  1. Passive smoking - should not be given to the will of such a bad habit when crumbling. This not only may in the future cause the mutation, but it will simply weaken its body every time more and more.
  2. Eternal nutrition.
  3. Frequent reception of medicines, their use without doctor control.
  4. Accommodation in the area with increased level radiation; Frequent irradiations due to medical intervention.
  5. Dust and gas supply.
  6. Transfer viral infections more often put. If viruses are easily leaving in the body, this indicates a weak immune defense and, possibly, a violation of the work of the blood-forming organs, which is not protected lymphocytes.
  7. Exposure to solar irradiation to more than eight hours per day (most often in countries with a hot climate with constant location on the street).
  8. An unfavorable psychological background (be it a mental load or problem in society).

As you can see, the spectrum of such factors is quite wide.

Types and periods of oncology

Cancer in children may arise at an absolutely any age, but at the same time it will have its own characteristics of origin and flow, depending on which mutation occurred. Severe three periods of cancer cells:

  • Embryonic. The process of mutation occurs in the womb due to non-compliance with the healthy lifestyle of the mother. Sometimes tumor cells can be transmitted through the placenta.
  • Juvenile. The formation of mutations begins in healthy or partially damaged cells. Brain cancer in children most often meets preschoolers and adolescents.
  • Adult tumors. There are quite rare. Affect, mostly fabric.

Oncology in children can be classified in the frequency of occurrence of a particular type of illness. It is noted that leukemia is the most frequent ailments in the kids, their share accounts for about 70% of all cases. The second place is occupied by cerebral cancer in children, as well as the defeat of the central nervous system. In the third place of the disease of the skin and genital organs.

How to suspect the disease

Unfortunately, children with oncological diseases come to a specialist in this area extremely late. In the first stage - no more than 10% of patients. The kids who are diagnosed at this stage are cured for the most part. Significant plus is the use of gentle children's medicine.

But all the other cases are found much later, on 2-3 stages, when the signs of cancer become more visible. At the fourth stage, the disease cure much harder.

Symptoms of cancer in children appear very late. This insidious disease is always masked under the other aids (ORZ, influenza, angina, etc.). Recognize the first calls is not easy.

If your child has no visible symptoms of some particular disease, and at the same time it continues to be nervous, to be plaqueless, complain about pain or malaise, you should immediately contact the pediatrician to establish reasons.


Common symptoms Cancer in children can become:

  • lethargy;
  • fast fatiguability;
  • increase in cases of respiratory diseases;
  • pallor skin;
  • unstable and no provoked body temperature lifts;
  • inflammation of lymph nodes;
  • apathy;
  • changes in the psychological state;
  • impairment of appetite and fast weight loss.

Types of cancer

Consider some oncological diseases in children in more detail.

Leukemia

Accompanied by the appearance of malignant neoplasms in the blood system, for a long time proceeds asymptomatic. The initial signs are often implicit, and they do not pay attention.

If you have noticed that for a long time, your crumbs keep the temperature, it is weak and badly, the pallor appeared, the loss of appetite, weight loss, it quickly gets tired and shorter load appears, coordination in space and vision began to deteriorate rapidly, and the lymph nodes are constantly inflamed. In the absence of infectious diseases, it should immediately go to the reception to the oncologist.

An important indicator of leukemia is also frequent and long-term bleeding due to poor coagulation. After conducting the most common overall blood test, oncologist will quickly determine the cause.

Tumors of the head and spinal cord

Tumors of the head and spinal cord are in second place. If the tumor touched on the head not vital centers, it is difficult to notice, it does not cause complaints to the most recent Stages. But if it is located in the vital areas of the brain and in the barrel of the dorsal, then there will immediately have obvious symptoms:

  • dizziness;
  • strong pain (especially in the morning, not leaving);
  • morning vomiting;
  • apathy;
  • closedness and immobility;
  • coordination disorders.

The infants marked the friction of the head and face, crying and screams due to the fact that they cannot tell about their discomfort. At an older age, maniacal inclinations may be marked.

An increase in the head and scoliosis is noticeable from external signs. With the damage to the spinal cord, the pain is enhanced in the lying position and pokes during the seating.

And the place of the lesion becomes insensitive. Sometimes consensus appear.

Lymphogranulomatosis and lymphosarcoma

Lymphogranulomatosis and lymphosarcoma are lesions of lymphatic nodes. With lymphogranulomatosis, cervical lymph nodes are most affected. They are painless, the skin around them does not change in color, the main difference is that the anemia and swelling are constantly alternate, but the inflammation itself holds at least a month.

Lymphogranulomatosis is diagnosed mainly in the third or fourth stage. Dish, mainly children aged 6 to 10 years. In suspected, puncture from the inflamed node and histological examination of the Point to confirm the diagnosis and the establishment of the degree of the disease are prescribed.

Lymphosarcoma amazes selectively any lymph node or the entire system, therefore, there are complete damage to the abdominal region, chest or nasopharynx. Depending on which part of the body is amazed, the signs are disguised as similar diseases (abdominal - constipation, diarrhea, vomiting both with intestinal infections; breast - cough, temperature, weakness, like colder).

The danger of this ailment is that, if you prescribe warming up (assuming ARZ), it will only aggravate the process and accelerate the growth of the tumor.

Nephoblastoma

Nephoblastoma, or malignant neoplasm in the kidney, is found quite often under the age of 3 years. She does not give to know about himself for a very long time, and it is often detected with a prophylactic inspection, or at the started stage, when a significant increase in one, less often in two, the sides of the abdomen. It is accompanied by diarrhea and a minor increase in body temperature.

Neuroblastoma

It is worth saying about neuroblastoma, as this is an exceptionally children's disease. She affects the kids to five years. The tumor affects the nervous tissue, and her favorite habitat is abdominal cavity. At the same time, bones, chest, small pelvis organs are affected.

The first signs are chromoty and weakness, as well as pain in the knees. Due to the reduction of hemoglobin, a anemic type of skin is manifested. There are swelling of the face and in the neck of the neck, when the tumor of the spinal cord is noted incontinence of urine and stool. Neuroblastoma very quickly gives metastases in the form of tubercles on the head, which is celebrated by parents.

Retinoblastoma

Retinoblastoma affects the retina of the eye. Her signs are very typical. The eye blushes, itches.

Observed symptom of "cat eye", since the tumor goes beyond the crystal and becomes visible through the pupil, reminding white spot.

It may be affected both one and both eyes. In rare cases, everything ends with complete loss of vision.

Diagnostics

Symptoms of oncology in children to identify quite difficult. Malignant neoplasms are noted by chance in the diagnosis of other disease or with preventive inspections.

To confirm oncology, conduct a number of surveys and analyzes:

  • common clinical analysis blood and urine;
  • Ultrasound, CT, MRI;
  • x-ray;
  • spinal puncture;
  • biopsy affected area.

Treatment technique

Often, treatment starts 2-3 stages. The process of recovery in many ways it depends on how quickly starting therapy. Patients are always put in the hospital, as they are undergoing a 24-hour supervision. There is a course of radiation and chemotherapy.

In severe cases, prescribe surgical operations. The exception is neuroblastoma: first operation is carried out and only then prescribed drug treatment to curb the growth of cancer cells.

In compliance with all measures, the percentage of complete recovery or the offensive remission is more than 90%, and this is a very good result.

Nowadays, thousands of drugs, hundreds of studies and most of the ailments are completely cured in 100% of cases are invented. But at the same time, the task of all parents to be vigilant and with suspicion of oncology immediately contact a specialist.

Prevention


The prevention of cancer in children is to comply with the rules of a healthy lifestyle, as well as the elimination of the parents to the causes of the occurrence of the ailment, which was mentioned at the beginning (environmental conditions, bad habits, etc.).

We hope now you can recognize the signs of oncology in a child, the features of this childhood pathology, and also understood how the cancer is taken.

2102 0

Oncology- Science of tumors; children's oncology - Science on tumors in children. 6 million people die from malignant neoplasms in the world, about 200,000 children are dying. As a result of a sharp decline in mortality and incidence of many children's infections and other diseases to the fore, there were diseases that previously attracted the attention of doctors.

These include primarily malignant tumorswhich currently occupy the second place among the causes of child mortality. Observations accumulate, indicating the increase in the incidence of some malignant neoplasms in children. The originality and features of the tumor process in childhood led to the fact that a new scientific and practical discipline appeared at the junction of oncology and pediatrics - children's (pediatric) oncology.

Despite the relatively small frequency of malignant tumors and the possibility of full cure of patients, mortality from them in children remains high. This is due to the fact that, unfortunately, most children come to treat in far-closed stages of the disease when conducting specific therapy is considerable difficulties. The main reason for this is due to a weak oncological alert in relation to the child and, in particular, inadequate knowledge in the field of children's oncology.

A children's doctor (and a doctor of any specialty) rarely faces a sick child, affected by a malignant tumor. For all medical practices, a regular pediatrician welcomes no more than 8 children with a tumor. Hence the errors in the diagnosis and the fact of therapy.

Successes in children's oncology are associated with the organization of oncological assistance, with an increase in knowledge in the field of children's oncology, diagnosis and treatment of tumors in children. From this ultimately depends the life of the child. The experience of children's specialized oncological offices clearly shows that the results of the treatment of tumors in children depend on the timely diagnosis, which is determined by the oncological alertness of the children's physician and the timely hospitalization of children to a specialized institution.

Therapy

For example, the complex therapy of nephoblastoma in children's oncological departments makes it possible to achieve recovery in 90% of children, in non-specialized offices - 20%. If the children came to treatment in a timely manner, then the developed treatment regimens allowed more than 70% of them, and in some neoplasms (for example, with regionaloblastoma, lymphogranulomatosis) and 100% of patients with children.

Treatment of children with malignant tumors today is directed not only to save their lives, but also to help recover full life. This can be achieved, inspiring children through parents and close desire to lead a healthy lifestyle, while controlling provoking factors and supporting the resources of a child, family and society.

You can solve these problems, only arming doctors with knowledge in the field of children's oncology.

Children's oncology is a visual example of how with the active use of modern accurate sciences and natural science, you can achieve good results in a short period of time.

Children's oncology as a scientific and practical discipline has only no more than 40 years. The first children's oncological departments began to be created only in the 60s of the 20th century, then many articles dedicated to tumors in children began to be published.

At the same time, the current possibilities of child oncology when using comprehensive treatment in most cases make it possible to achieve full cure. The combination of polychimotherapy with radiation and medicinal, as well as other

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