In India, CNS tumours are the third most common childhood cancer behind leukemias and lymphomas. However, CNS tumours are a heterogeneous collection of many pathologies and till recently there has been limited data from India describing their epidemiology. For this reason the recent paper in Neurology India made welcome reading (Jain et al, 2011). In terms of results, the paper does not offer anything spectacularly new. The most common primary pediatric brain tumors were astrocytic tumors (34.7%), followed by medulloblastoma and supratentorial primitive neuro-ectodermal tumors (22.4%), craniopharyngiomas (10.2%) and ependymal tumors (9.8%). The most common astrocytic tumor was pilocytic astrocytoma.The two main caveats to interpreting this information are - that it is not population-based data and the information is collated from pathology reports. Upto 20% of childhood CNS tumours may be diagnosed on the basis of radiology only and this group of tumours would be missing.
Despite all this, what has been most fascinating for me is the fact that this paper is a joint effort of seven institutions with nearly 4000 childhood CNS tumour patients. Such multi-institutional studies are not frequent in the paediatric haematology-oncology literature from India and the effort of the authors needs to be acknowledged.
Dear Raman
ReplyDeleteOne reason if I want to run away from Oncological Sciences is the ever increasing numbers of lovely children bearing the burden of cancer in my OPDs.
Two conferences- RGCI Ped Cancer conf under the leadership of Dr. Gauri and Ped Surg Onco conference in Dr. Sareen's Department.
Startling facts were presented by Indian Pediatricians dealing with child hood cancers.
Yet my request to create a pediatric cancer registry and link it to ICMR or a similar responsibility to be taken by ISMPO fell to deaf ears.
We have got to learn that mutual admiration of the sorts is not going to help in preventing Ped Cancers. Disturbing as it is the late stage presentation and mismanagement of these cases that has wiped out out the Hopes to Say confidently what the "Mother of Oncological Sciences in India" once said," They also have a tomorrow".
Your messaging on pediatric cancer oncology will may change this pathetic scene.
Dear Prof Manoj
ReplyDeleteI welcome your comments. A specifc childhood cancer registry would indeed be useful. Although a population-based registry would be ideal, much can be achieved by hospital-based registries - There are several institutions in India who are now entering data on to INDIAPOD and some on POND4KIDS. This is a promising start and needs to be built upon.