This September, we are observing the Childhood Cancer Awareness Month, which aims to increase awareness about childhood cancers and to raise funds for research and treatment for children with cancer. The most common types of childhood cancers in the Philippines are: Leukemias (cancer related to the blood), Lymphomas, Brain Tumors, Bone Tumors and Abdominal Tumors. One of the factors that contribute to the development of childhood cancers are genetic processes that occur during the first 1000 days. For example, advanced maternal age of 40 years old and above have a higher risk of giving birth to children with Down Syndrome - a condition where an individual has an extra chromosome. When combined with other environmental exposures such as radiation during pregnancy, drugs, and carcinogenic agents from cigarette smoking - the child is 10 - 20 x more at risk of developing Leukemia when they reach 2 - 6 years old. Childhood cancers are considered multifactorial which means that they develop due to the interplay of genetic factors and high-risk environmental exposures. Thus, by controlling the environmental exposures during the first 1000 days and early childhood, we could also lower the risk of developing childhood cancers. Here are some strategies that we can do during the first 1000 days to prevent childhood cancers:
Before Pregnancy. If the woman is 35 years old and above and is planning to get pregnant, early genetic counselling for possible pregnancy risks is recommended because advanced maternal age increases the risk of giving birth to a child with Down Syndrome. Mothers with comorbidities and other medical conditions may also have maintenance medications or treatment that must be considered for possible harm to the fetus.
During Pregnancy. During pregnancy, it is important for the mother to avoid high risk environmental exposures that may increase the risk of developing cancer or may affect fetal development such as:
● Cigarette smoking or secondhand smoke
● Alcohol
● Ionizing Radiation
● Risky sexual behaviors such as unprotected sex which may increase the risk of contracting Sexually Transmitted Diseases (STD’s) such as genital warts
● Cancer promoting foods such as processed meat and red meats especially smoked food items and those charred or grilled over charcoal.
● Moldy nuts or seeds that may contain Aflatoxins which may promote cancer development
During this period, the mother can also focus on adding cancer protective foods such as:
● Fruits and vegetables
● Foods rich in antioxidants such as Green Tea, Turmeric, Soy, Red Grapes and Berries
● Omega-3 rich foods such as Fatty fish, flaxseed oil and Walnuts
Birth to Early Childhood. Exclusive breastfeeding and nutritious complementary feeding are the main factors that contribute to the infant’s nutrition and health during early infancy. Aside from these, childhood cancer can be prevented by completing immunization against Hepatitis B which decreases the risk of Hepatocellular carcinoma in adolescence and adulthood. This is the Hep B vaccine which is also given with the BCG vaccine by 0-2 weeks after birth. There are a total of 4 doses that must be completed within their first year then another catch-up vaccination before 2 years old. Another cancer protecting vaccine is the Human Papillomavirus (HPV) vaccine that protects against cervical cancers and HPV-positive oropharyngeal cancers and anal cancer. The HPV vaccine is recommended to be given by 8 - 18 years old.
Aside from vaccines, it is also good to limit early exposure to high radiation such as CT scan and secondhand exposure to cigarette smoke to reduce their risk of developing cancers in later life.
/AET
References:
• Punongbayan, R.A.L., Morelos, A.M.R., Tan-Lim, C.S.C., De Vera, A.S.M., Aherrera, J.A.M., Tiongson, M.D.A., Banzuela, E.P.C. (2020). Pedia Platinum, 1st ed. Quezon City: Top Practice Medical Publishing Corporation.
• Kliegman, R.M., Geme III, J.W.S., Blum, N.J., Tasker, R.C., Shah, S.S., Wilson, K.M. & Behrman, R.E. (2020). Nelson Textbook of Pediatrics, 21st ed. Canada: Elsevier.
• Raymond, J. L., & Morrow, K. (2020). Krause and Mahan’s Food and the Nutrition Care Process E-Book. Elsevier Health Sciences.
