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Childhood Cancer in India
Context:
According to the National Cancer Registry Programme (NCRP), childhood cancers (0-14 years) account for 4% of all cancer cases in India.
The Dual Faces of Childhood Cancer: Triumph and Tragedy
- In 2018, Aarav, an 18-year-old from Mumbai, was diagnosed with Hodgkin’s Lymphoma, shattering his dream of becoming an investment banker.
- Yet, he persevered—studying for Chartered Accountancy exams while undergoing chemotherapy—and emerged as an All India topper. However, not all childhood cancer stories end in victory.
- Meena, a 10-year-old from Pune, faced a different fate.
- Her mother’s late-stage breast cancer forced her father, an autorickshaw driver, to reduce work hours.
- With their income collapsing, Meena was pulled out of school, trapping her in generational poverty.
Causes of Childhood Cancer
- Childhood cancer typically arises from genetic changes in single cells, leading to tumors. Unlike adult cancers, most childhood cancers do not have a known cause.
- Some chronic infections like HIV, Epstein-Barr virus, and malaria are risk factors for childhood cancer, particularly in LMICs.
- Around 10% of childhood cancer cases have a genetic predisposition.
- Cancer prevention efforts should focus on preventing cancer in adulthood, such as vaccinations for hepatitis B (liver cancer) and human papillomavirus (cervical cancer).
The Silent Victims
- While direct medical costs are high, the financial toll extends far beyond hospital bills, affecting children’s education and future economic security.
- For many families, cancer forces difficult choices:
- Children drop out due to financial strain.
- Older siblings take on caregiving roles or low-paying jobs to support the family.
- Students struggle academically due to emotional and financial stress.
- Example: Sridevi, a second-year college student from Hyderabad, had to work multiple jobs to pay for her father’s oral cancer treatment, affecting her studies and mental health.
Treatment and Supportive Care
- Standard therapies include chemotherapy, surgery, and radiotherapy.
- Access to WHO-listed essential medicines and multidisciplinary care is crucial.
- Post-treatment monitoring is necessary to prevent recurrence and manage long-term side effects.
The Hidden Financial Burdens of Cancer
- Loss of income: Patients often need long-term leave or lose their jobs. Caregivers, including children, are forced to reduce work hours or quit entirely.
- Travel and accommodation expenses: Patients from rural areas must frequently travel to urban hospitals, adding costs.
- Daily living expenses: Special diets, caregiving needs, and hospital visits increase household spending.
- Mental health impact: Many patients and families need therapy or counselling, which remains unaffordable.
Insurance and Government Support
- Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) reduces direct medical costs, but indirect financial burdens remain largely unaddressed.
- Disability riders in insurance policies can provide income support, but strict eligibility criteria and high premiums limit access for low-income families.
- State-level interventions:
- Indian Railways and Air India offer discounted fares for cancer patients.
- Himachal Pradesh and Haryana provide free bus travel for patients.
- Monthly pension schemes in states like Haryana, Tripura, and Himachal Pradesh offer financial relief.
Way Forward
- To break the cycle of poverty and educational disruption, policies must move beyond medical aid and address indirect costs:
- Caregiver support: Financial aid for family caregivers to prevent income loss.
- Educational interventions: Flexible schooling options for children affected by cancer. Scholarships and grants for cancer-affected families.
- School-level support like extra coaching, extended deadlines, free meals, and mental health counselling.
- Employment protections for parents of children with cancer.
