UNAIR NEWS – The number of cancer cases on children from time to time is increasing. In 2014, there were 144 cases, while in 2015 there were 206 cases. In 2016, the cases reached 252 new cases.
From some cases of cancer on children, almost half of them were leukemia or blood cancer. The most leukemia suffered by children were Acute Lymphoblastic Leukemia (LLA).
The professor of Pediatrics, Prof. Dr. I Dewa Gede Ugrasena, dr., Sp.A (K), said that the data number of cases of LLA was gathered from Dr. Soetomo General Hospital (RSDS). If in 2015, there were 105 new cases, in 2016 there were 108 new cases handled by RSDS.
Even the number of cases is increasing, the cause has not been known yet.
“We can detect the cause of TB and Leprosy from the blood of the patients. But, the causing factor of Leukemia or any other cancers has not been known yet,” said Prof. Ugrasena during interview.
Quoting the researches, Leukemia may be caused by chemical and physical substances, kids often consume food and drink with preservatives. The preservatives are believed to be the cause.
On the other hand, the blood cancer patients detected after the explosion of nuclear reactor in Chernobyl Ukraine in 1986. “Some experts hypothesized that atom or physics can also cause cancer,” added the specialist.
Parents should be sensitive for early detection of cancer. The early symptom of children with leukemia is a fever happening for two weeks and some bleeding on the skin and mucosa.
“W (parents) should be able to differ solid and blood cancer. Solid cancer can be seen early. During bath, a mother can feel a lump on or in their children’s body,” stated Prof. Ugrasena.
Therefore, parents are suggested to visit cancer facility if there is a sign of cancers.
Genetic Polymorphism
Some specialists have standard protocols in treating blood cancer on children. However, treatments can fail because of some factors, one of them is genetic reason.
Genetic Polymorphism is a genetic occurence carried by children since they were born. The number of blood cancer polymorphism cases are quite many. The head of Indonesian Pediatrician Association of East Java also said that the cases are a third of LLA cases.
Polymorphism rejects chemotherapy drugs in killing the cancer cells. In the research titled “Single Nucleotide Polymorphisms of Interleukin-15 is Associated with Outcomes of Childhood Acute Lymphoblastic Leukemia” published in Paediatrica Indonesiana in 2016, Prof. Ugrasena and team studied the resistance of the diseases to methotrexate (MTX) used in chemotheraphy.
“They are resistance. So the patients usually pre-tested for polymorphism. If there is a resistance, we change with the medication,” said the doctor from Tabanan, Bali.
Government Must Participate
There are some obstacles in leukemia treatments in Indonesia. National Health Insurance does not cover immunophenotyping test. It is necessary to determine disease phase.
“With phenotyping test, we know whether the patient included as high risk or not. It determines the therapy given to patients,” said the Head of Child Inpatient Installation RSUD Dr. Soetomo.
The test costs Rp 1.2 million. It is expensive and it makes the poor patients had more difficulties.
“We can do it, but the government or hospital does not want to support and BPJS does not cover it, so it does not become a routine test,” said Prof. Ugrasena.
Beside the problem of this test, chemotherapy drugs availability also one of the causing factors of low survival rate of children with leukemia. According to him, drugs availability is not supporting the patients’ willingness to be cured. He also said that there are three or four kinds of chemotherapy drugs unavailable including methotrexates.
“Patients are in confusion. They finally buy in Malaysia as they want to be cured. It is covered by BPJS but it cannot get into Indonesia when there are many cases for it. The drugs are not always available,” he said.
He then encouraged the government to ensure the rights of the people to be healthy by making the drugs available and the patients can be treated properly. The survival rate for children with LLA can be even lower. (*)
Author : Defrina Sukma S
Editor : Binti Q. Masruroh
