At the Forefront of Paediatric Cancer
Five years ago, if a child was diagnosed with cancer in Cambodia, the outlook was grim. Few if any resources for treatment existed. There were no facilities offering radiotherapy, haematology, intensive chemotherapy or palliative care.
Today, the landscape looks a bit different, as Angkor Hospital for Children (AHC) works to build a network of paediatric cancer care centres across Cambodia, beginning within the hospital.
In 2013, AHC first began treating retinoblastoma, a rapidly growing tumour of the eye, as well as other low-stage solid tumours.
“By treating the low-risk tumours and retinoblastoma, it helped us get familiar with malignant treatment,” says AHC oncologist Dr Vireak.
Partnerships with organizations like the American Society of Haematology (ASH), St. Jude Children’s Research Hospital, and Harvard University helped further establish the oncology program at AHC, with international experts visiting the organisation several times a year to provide education, as well as hosting AHC physicians for trainings abroad.
After five years of developing expertise in low-stage cancer care, which includes treatment through chemotherapy and management of side effects, AHC was primed to treat more complicated cancers.
‘AHC has a very good setup,’ explains Dr Vireak. ‘We have a good ICU where we can provide treatment to children if they have side effects. We have a blood bank, and we can not only give red blood cell transfusion, but we have platelet transfusion also. We provide proper antibiotic use, which is very important when we treat cancer patients and they have side effects. We have a good system of social workers, who not only provide emotional support to the children, but also follow-up care. And the most important thing is we have a lot of support from the management level.’
By mid-2018, AHC was able to treat its first patients with leukaemia, becoming Cambodia’s first centre to treat the disease in children. To date, over 60 patients with cancer are treated yearly, including four patients with leukaemia – cases which continue to do very well.
Along with treatment, part of the challenge has become education, as there is little awareness and understanding of cancer within the community.
“Childhood cancer in Cambodia seems to be new for everyone, and especially for the family,” says Dr Vireak. “They have little knowledge about cancer in children. Parents don’t know what cancer is until their child gets cancer – I encounter some parents who say they never knew what cancer was.”
Because of late or improper diagnosis, along with a lack of access to quality treatment, less than half of those children diagnosed with cancer face positive outcomes. If and when they finally see an oncologist, their cancer has developed to a stage where there is little chance for effective treatment, and chances of survival are bleak.
For these children, whose cancer has developed to a higher or metastatic stage where the cancer has spread, AHC provides palliative care. This specialty service is offered nowhere else in Cambodia, for adults or children alike.
“We help them to feel comfort until the last day of their life,” says Dr Vireak. “We also provide emotional support to the family, and our social workers visit the parent after the patient passes away.”
Along with emotional support and counselling from social workers, AHC provides pain and symptom management, nutrition and accommodation if needed. As always, compassion is the cornerstone of care.
“I can’t stand seeing [patients] suffer, especially from the pain,” says Dr Vireak. “Without helping them, without giving them the pain management – I think it is a lot of burden for the parent. Because not only is the patient suffering, the parent is also suffering. And as a doctor, you’re also suffering to see that happen. So by providing palliative care at AHC, it’s the last thing that we can do even if we cannot cure them.”
Yet high costs of both palliative and curative care – with each case costing roughly $2,800 per patient – can be prohibitive. From the cost of chemotherapy, to facilities like isolation rooms that keep patients at adequate distance from those with infectious diseases, complex cancer care is costly. But with AHC’s focus on paediatric specialities that are not currently offered in Cambodia, providing cancer care is integral.
AHC needs your help to deliver specialized, free, holistic cancer care to children. Donate and give life to the dozens of children who visit AHC with cancer from across Cambodia each year. Visit angkorhospital.org/donate.