A two-year-old boy who was suffering from a ruptured malignant renal tumour, got a new lease of life at Jaslok Hospital and Research Centre, Mumbai. The child had complained about severe pain in the abdomen and was also suffering from rapid breathing. He looked pale and lacked vitality.
Paediatric Onco-surgery Consultant Dr Kant Shah, who led the team of doctors, said a complete evaluation of the patient found that he had a ruptured renal tumour which was stabilised for the time being by blood transfusions. The tumour, called Wilms Tumour, which is the commonest cancer of kidneys in children while it is highly curable, it can turn fatal if ruptured.
According to Shyam Srinivasan from the Department of Paediatric Oncology at Tata Memorial Hospital in Mumbai, the cure rates of childhood malignancies are inferior in India when compared to upper-middle-income countries. “There is a paucity of quality data addressing the outcome of childhood Wilms Tumour (WT) from India,” according to a review report led by Srinivasan. The review titled, 'Wilms Tumour in India: A Systematic Review', included 17 studies on 1,170 patients. Ninety-four per cent of the studies were published after 2010.
Researchers found advanced stage (III and IV) disease in 46 per cent of patients and the overall survival ranged between 48 and 89 per cent. As per Srinivasan, a substantial proportion of children with Wilms Tumour from India are at the advanced stages of the disease. "Despite several limitations, the current systematic review showed a modest survival among Indian children with Wilms Tumour. Ensuring early access to expert care along with the involvement of social support teams may further improve the survival of WT in India," the report noted.
At Jaslok, an immediate surgery had to be performed for the little boy where a left-sided nephrectomy with lymph node sampling was done. The patient recovered well from surgery in the PICU and was then shifted to the ward. During the admission, Paediatric Oncologist Dr Amit Jain and Radiation Oncologist Dr Sharmila Agrawal initiated chemotherapy on the fifth day of surgery and radiotherapy on the ninth day, as per protocol. The patient then underwent six months of rigorous treatment and is now thriving.
“It is important for parents to understand the seriousness when kids mention that they are suffering from pain and be alert. This case also proves that a multi-disciplinary care pathway is important for such cancers in children where a paediatric onco-surgeon is an anchor but joint care with other specialists is mandatory throughout the course of treatment. We are proud to have facilitated this little boy’s miraculous escape from a ruptured tumour,” said Shah.
Speaking about his ordeal, the father of the patient said, “We hope our kid will survive this and go on to live a long and normal life.”