Gold September 2022: childhood cancers may be diagnosed earlier and treated better

Gold September 2022: childhood cancers may be diagnosed earlier and treated better

In cases of children, cancers may develop within a few weeks, therefore it is crucial not to ignore alarming symptoms. This year, the organisers of Gold September want to pay special attention to early symptoms, need for oncological caution, support for ill children and their parents, and also opportunities for better diagnostics and treatment.

In Poland, cancers are diagnosed every year in 1.200 children. In adult cases cancers usually develop over a period of several years, while in children cancers may develop rapidly. It is impossible to prevent cancers, though it is possible not to ignore worrying symptoms – and these early symptoms are the focal point for the organisers of Gold September, also known as the Childhood Cancer Awareness Month.

Although cancers in children are rare, the onset of a disease may happen at any age, even in infancy. “During Gold September, we want to remind people about the fact that childhood cancers exist and educate people on symptoms to enable detection of cancers as early as possible; we would also like to discuss what can be improved in diagnostics and treatments,” – says Professor Tomasz Szczeański, President of Polish Society of Pediatric Oncology and Hematology, Head of Department of Pediatric Hematology and Oncology SUM in Zabrze, Poland.           

Gold September 2022 in Poland: centrally and locally

Gold September 2022 is celebrated round the world with a slogan: ‘Gold for Hope. Cure more and cure better’. Every year, important buildings in many different countries are illuminated with golden light (including the European Parliament) in order to manifest that treatment of childhood cancers is our priority. Also in Poland, significant building are lit (among others: the Presidential Palace, the Palace of Culture and Science, Spodek in Katowice, and the Silesian Stadium). As the symbol of childhood cancer functions the Golden Ribbon – gold colour symbolises strength and courage, but also the fact that children are our most precious treasures.

“Many initiatives will be run locally by various foundations, yet one of the central points will be the 50th Anniversary of paediatric haematology in Silesia, which will be organised by the Polish Society of Pediatric Oncology and Hematology and will take place on 20-21 September in Zabrze under the patronage of the First Lady of Poland. One of attractions will be a picnic for doctors, nurses, and patients, but also for policy makers who have a significant influence on the way in which childhood oncology and haematology is organised. We are also planning a scientific-educational section: a series of lectures on advances in paediatric oncology and haematology. People who coordinate diagnostics and treatments of particular childhood cancers will share their experience with the audience. We would also like to address the questions: Where are we at in treatment of childhood cancers and in which direction are we heading?” – says Professor Szczepański.

This year, there will be another edition of the Pyjamas Run organised by the Gdy Liczy się Czas Foundation. “Pyjamas are the basic clothes for children staying in oncology hospital wards. By putting pyjamas on we show our solidarity with the ill kids. The run will take place on distances of 500 m, 1.500 m and 5 km – so that everybody could take part in the event. We are also planning a competition for the best pyjamas: we want the event to be cheerful, because helping gives you wings and provides happiness which we’d like to share with children suffering from cancers and the children’s parents who really need all of our positive energy. Every event connected with oncology that we organise spreads positive emotions – we want to support kids and their parents,” – says Natalia Voytsel, the Foundation’s founder and mother of Daria who was cured from cancer. “My daughter ended up in an oncologic ward when she was 11 years old. Before that she had been a healthy girl, she had practised horse-ridding, a day earlier she had played football and nothing had suggested that she was ill. Then it turned out that she had stage 4 cancer! That’s why we want to tell other parents that it is vital to examine your child once a year, similarly to regularly diagnosing your car – and your child is so much more important than a car. It’s worth doing morphology and abdominal USG, which can save the kid’s life,” – emphasises Natalia Voytsel.

All Polish departments of paediatric oncology and haematology and numerous oncologic foundations are engaged in the campaign. “We often prefer to avoid hearing about issues that are difficult or evoke fear, and cancer is often associated with a death sentence. But the truth is that it should be not. We are talking about childhood cancers and our aim is to spread the knowledge and “warm up” the image of childhood cancers. We want to demonstrate that if we are cautious enough, then we may deal successfully with cancer diseases in children,” – says Professor Katarzyna Derwich.

Gold Lublin

In Lublin, the organisers of Gold September are planning the Gold Parade (participants are going to wear golden ribbons and golden capes), workshops for kids, face painting, a picnic combined with educational activities, handing out leaflets and informational materials concerning cancer symptoms in children and also types of medical examination shat should be conducted by family doctors. Other topics include consultations with paediatric haematologists and nutritionists. Participants will also receive information on blood and marrow donating.

The Lublin events are planned to take place on Sunday, 25th September. At 1:00 pm, on Plac Litewski, the event will be opened with a vocal and percussion workshop during which children together with the host presenter, Sylwia Lasok, will compose and perform the Golden Song. At 3:00 pm, the Gold Parade will set off from the Lublin City Hall, led by a group of Lublin Drummers. The parade participants will march along Krakowskie Przedmieście to Plac Litewski, where at 3:30 pm the Final will take place. At the stage located on Plac Litewski, there will be various artistic and educational performances. Another attraction will be a tent camp with animated films for children, where kids and their parents will have an opportunity to meet doctors and representatives of associations helping children with cancers.  

This whole series of events will be complemented by illuminating scenic Lublin buildings with golden light, including: Arena Lublin, the IT Institute at UMCS and also the iconic tree, called “baobab”, growing on Plac Litewski.

Don’t miss it: it can be a symptom of cancer in a child

Cancers in children do not produce distinctive symptoms: similar symptoms may accompany many other diseases. However, once alarming symptoms appear, it is crucial to go to the doctor to verify the causes. 

“One alarming symptom is a change in behaviour – e.g. an infant struggling to eat or an older child losing appetite; a two year-old who has already learned to walk suddenly ceases to do so or starts limping. In older children, it is possible to observe declines in physical fitness, fast tiredness, drowsiness or lassitude. Other symptoms include reoccurring fevers or low-grade fevers that are caused by infections. Also itchy skin and bone/joint pains may appear – a special attention should be paid to aches appearing at night and waking the child up,” – says Professor Katarzyna Derwich, Paediatric Oncology, Haematology and Transplantology Clinic at Karol Marcinkowski Medical University in Poznań and also Chief Editor of the website    

Other alarming symptoms that should awake parents’ caution are: untypical headaches, nausea, reoccurring vomiting – especially in the morning, despite the fact that the child is not suffering from an infection, and also nose-bleeds, tendencies for bruising, appearance of petechiae. “Not every symptom must signify cancer, however, it is important for parents to bring the child to the doctor who should order basic tests in order to verify the causes,” – adds Professor Derwich.  

Oncological caution should be also observed by paediatricians and family doctors. “When a child comes for periodic examinations or vaccinations, the paediatrician should undress the child and carefully examine the skin and any swollen lymph nodes that enlarge in cases of lymphomas and acute leukaemia; the abdomen should be also examined (in 75% of patients with freshly diagnosed acute leukaemia it was possible to feel the enlargement of the liver and spleen). Another constant element of basic medical examination in boys should be checking the testicles. If the doctor has any doubts, they should order a complete blood cell count with a WBC differential; and also abdominal, lymph node and testicular ultrasound,” – stresses Professor Derwich. “Unfortunately, we still get cases of adolescent boys with massive testicular tumours, who were too embarrassed to show the lumps to their parents or doctors,” – adds Professor Szczepański.    

Unfortunately, during the pandemic, especially in its first phase, there were many delays in diagnostic processes of infants, which were caused by, among others, obstacles in direct contact with doctors, too commonly adopted e-consultations, and also fears of parents concerning visits to medical centres. “Therefore, it is especially important to remind people of the need to treat seriously any alarming symptoms. We have been talking about it for years – not only in September but throughout the entire year,” – points out Professor Derwich.

Improved therapy results; need for better financing of diagnostics

When recognised early, cancer in children is curable in 90-100%, while its therapy may be less intense, which means also less straining for the body and causing fewer adverse effects, including those delayed ones. “It is very important because not only do we want to cure the child, but also to avoid post-treatment adverse effects, so that the child’s life will not differ significantly from their peers,” – says Professor Derwich.

Another goal of Gold September is expressing solidarity with children suffering from cancers and with the children’s parents; showing that cancers are curable even when diagnosed at advanced stages. In recent years, we have observed significant improvements in diagnostics and treatments, which are becoming more personalised and customised for the young patient. “We have at our disposal more and more available forms of treatment that are less exhausting for patients when compared with traditional chemotherapy. These new methods include for example immunotherapy which increases efficacy of treatment while at the same time decreasing its toxicity. In some patients we may also use the CAR-T treatment. There are many new developments as far as new therapeutic methods are concerned,” – says Professor Szczepański.   

The most crucial stage is qualifying the child for a particular form of treatment – for which we need very precise diagnostics based on molecular biology. “We have specialist laboratories that are capable of high-level diagnostics. This aspect always increases the odds for successful curing of the disease, even if the cancer is already at an advanced stage, because the child may be given a targeted therapy. Unfortunately, precise diagnostics is expensive and we do not have a suitable system for its financing, especially in cases of solid tumours or cancers of the central nervous system. Hospitals often are not able to cover the diagnostic costs from their therapeutic budget, while without a thorough molecular knowledge of the tumour it is not possible to chose the most appropriate therapy. And that’s why we are calling for systemic changes,” – explains Professor Szczepański.