DEPARTMENT OF PAEDIATRIC ONCOLOGY
Rohilkhand cancer institute is one of the Premiere Centers of Paediatric oncology established in the city of Bareilly, Uttar Pradesh, India. The institute was started with the intention of providing patients with State-of-the-art Paediatric oncology facilities of international standards with comprehensive cancer care at affordable, nominal charges. The Department provides comprehensive medical education in the art and science of Pediatric medicine and imparts preventive, curative and promotive health care to the dependent population of children and adolescents as well. Four postgraduate students are admitted every year. It aims to cultivate, encourage and sustain an attitude toward basic and advanced research at all levels. The Pediatric care facility includes the Pediatric OPD, Pediatric ward, Intensive Care Units and an office complex.
Pediatric oncology in India:
India, in many ways, is shining today. It has transformed into an economic powerhouse and is slated to become the third-largest economy in the world. It has taken giant strides toward alleviating poverty and eliminating caste and gender inequality. Sadly, this economic progress has not percolated down to other domains, including medical care. For us, concerned with the care of children with cancer, the state of pediatric oncology in the country today leaves a lot to be desired.
Progress in Pediatric Oncology is one of the biggest success stories in oncology in the last millennium. The 5-year survival for all pediatric cancers is now 75–80%. However, the outlook of pediatric oncology in most resource-challenged countries including India is appalling. Although we have made steady progress in the last few decades, we are still far behind the current international standards.
Pediatric oncology service :
Pediatric oncology as a speciality was virtually nonexistent in the early 1980s in India. Most children were treated, often unsuccessfully, by adult oncologists in a few cancer centres or by self-trained paediatricians in medical colleges. There was a lack of good-quality pediatric cancer units (PCU) and multidisciplinary or protocol-based care. There were only a handful of pediatric oncologists, who were usually trained abroad. In a nationwide survey of pediatric oncology services in 1988, 50% of cancer centres had adult oncologists treating children, only 10% had trained pediatric oncologists, and less than 15% had dedicated beds for pediatric patients or facilities for platelet transfusion. A similar survey done recently in more than 275 medical colleges or cancer centres revealed a better but far from an ideal picture – more than 50% of medical colleges did not have facilities or expertise for treating children with cancer.
What should be the future course of pediatric oncology in India?
The future strategy should focus on all three aspects of pediatric oncology. To strengthen pediatric oncology service, the best way forward is through optimal utilization of existing infrastructure by creation or augmentation of PCUs at university hospitals and regional cancer centers, equipped with necessary diagnostic and therapeutic facilities. These PCUs should be linked to satellite centres with paediatricians trained in shared care. To promote pediatric oncology research, an important initial step would be the creation of a national childhood cancer registry that could generate data related to the epidemiology and end results like the Surveillance Epidemiology and End Results (SEER) program in the US.
Finally, in order to foster pediatric oncology education, postgraduate students should be exposed to the exciting and gratifying aspects of this field. This could, for example, happen through short-term rotation in a PCU. The INTPPO program should evolve into a 3-month structured training program at good centres from a 2-day workshop module at present. Lastly, Promote-Pediatric should focus on large-scale national coverage of primary care providers through the Indian Medical Association and Indian Academy of Pediatrics for maximum impact.