Children with a haematological illness or cancer
Malignant haematological diseases and cancers are rare in populations under adult age. The diagnostics and treatment of cancer and serious haematological illnesses are concentrated to the university clinics. There are about 150 children under the age of 16 who present with a new cancer annually, of these 25–32 are from the Tyks catchment area.
The three largest diagnostic groups are:
- leukaemias (blood cancers)
- brain tumours
Treatment of cancer and haematological illnesses
The treatment of paediatric cancers and haematological illnesses takes several years and follow-up continues until adulthood. The amount of information and knowledge on these diseases is massive and the theories on the mechanisms causing the cell to become cancerous are abundant. Still, the primary reason for cancer in childhood is not known.
All children with a serious haematological illness or cancer that requires intravenous medication get a central venous catheter (infusion port or tunnelled central venous catheter) inserted to facilitate treatment. Because haematological and other cancers are rare among children and young people, only internationally developed treatment programs are followed and the treatment results are closely monitored in Finland and internationally.
Our treatment results are of the same level as the international results, and the new leukaemia treatment programs have put us in the international lead.
Benign haematological illnesses
In addition to treating malignant illnesses we, especially at the haematological outpatient clinic at Tyks, also treat patients with non-malignant (benign) haematological conditions. Among these conditions are defects of blood coagulation, especially haemophilia, and various forms of anaemia and conditions associated with illnesses of white blood cells and platelet production.
Children and young people may also have benign tumours. One of the biggest groups among the various benign tumours are the haemangiomas, vascular tumours appearing like rubbery, red nodules ("birthmarks"). Tyks harbours a treatment team that manages patients with this type of tumours.
Follow-up is an important part of treatment
An important function of the paediatric haematology outpatient clinic is to screen for, follow up on and treat the adverse physical and psychosocial effects that may emerge from having and treating a serious haematological illness or cancer in childhood.
Cancer treatments given to a child who is still growing may cause problems in many organ systems, and these problems may not surface until years after the cancer treatment has been concluded.
The paediatric haematology unit at Tyks provides follow-up to patients until adulthood. When five years have passed from the end of treatment, follow-up visits take place at intervals of 1–2 years. The purpose of these late follow-up visits is to observe any problems related to growth, puberty, organ systems and cognition. If problems arise, the patient is referred for further examinations and treatment to the appropriate specialist unit.
As the child concludes primary school and moves toward adulthood, matters like training and education, military service and psychosocial capabilities need consideration and decisions are needed on how to arrange follow-up throughout adult life for each patient.
Follow-up rests on an individual assessment of risk which is based on international recommendations. In 2015, we have started a late-effect clinic for adult survivors of childhood and adolescent malignancies, too. This outpatient clinic is called STEP-clinic and it is led by an experienced nurse with a broad consultation team.