Our aim is to create a long lasting cooperation between the Kids Cancer Foundation, Vilnius University Hospital Santaros Klinikos, Hospital of Lithuanian University of Health Sciences Kauno Klinikos and all others involved in the work and with the focus on helping kids with cancer and their families.
Our focus is to create activities around kids with cancer and their families and increase awareness about the work being put into curing the decease. We want to improve conditions and abilities for the hospitals and specialists working with the topic as well as collect funds for the support and bring resources for the needed research.
Every year about 100 children are diagnosed with cancer in Lithuania. Fifty years ago all these children would have died. Today, due to the efforts of many dedicated people as well as the progress of medicine and science in general, almost 80% of patients are cured. The aim for the future is to treat them all.
To treat childhood cancer, a broad multidisciplinary approach is needed, including: hospitals, medical professionals, scientists as well as cancer sick, government and supporting organisations. The Kids Cancer Foundation by Danish Chamber of Commerce in Lithuania will represent the latter one.
Generally, the ancient Greeks are credited with being the first to recognise cancer in the 4th – 5th century B.C. However, cancer treatment has gone through a slow process of development. Cancer was a fatal disease until the post World War II era when it was noticed that mustard gas which was used during military action, was able to kill bone marrow cells. The compound was studied by the scientists and found to work against cancer of the lymph nodes called lymphoma. Scientists continued working and not long after, pediatric oncologist prof. Sidney Farber of Boston demonstrated that aminopterin, a compound related to the vitamin folic acid, worked against leukemic cells in children with acute leukemia. This was a major turn in the progress of treating cancer, and a huge achievement in treatment of childhood cancer that is considered to be one of the greatest success stories in the history of medicine. Only a few decades ago, the prognosis for children facing cancer was not nearly as favourable as it is today. During the 1970s, about 1 of 2 children diagnosed with cancer survived. Now, 8 children out of 10 are long-term survivors. However, there is still a long way to go.
Huge success in treating childhood cancer was achieved due to variety of scientific studies performed all over the world. It was not only in the development of new drugs, but also in better understanding of cancer cells. Nowadays we are approaching the so-called ‘individualised therapy’, meaning that therapy will depend not only on the type and genetic properties of cancer cells, but also on the specific features of the patient. Since childhood cancer is a rare disease, pediatric oncologists unite into international collaborative study groups to collect data from a larger number of patients. International clinical trials compare new treatments to standard treatments and contribute to a better understanding of treatment benefits and risks. Lithuanian pediatric oncologists have a close collaboration with the Nordic Society of Pediatric Oncologists and Haematologists. A good example of an international collaboration and joint clinical trials is when Lithuania joined the scientific/clinical treatment protocol NOPHO ALL2008 for treatment of children with acute lymphoblastic leukemia. This led to an increase in long-term survival rates by 10%, from about 75% to 85% (Figure 1).
The figure shows four survival curves from different time-periods. Survival curve representing the period from year 2009 to 2012 has increased significantly. This was the period after Lithuania joined an international scientific/clinical protocol in collaboration with our Nordic colleagues. Long-term survival rates for these children increased by 10%, from about 75% to 85%. The process of this scientific clinical study is still ongoing: laboratory investigations continue to be done, data continues to be collected and analyses continue to be done by responsible people in participating countries. Having sufficient data to make conclusions, new international protocols (Nordic/Baltic) will be developed and the new processes of scientific lab testing, data analysis and discussions will start again. We believe that the new protocol will increase survival rates as well as decrease acute and long-term toxicity.
Childhood oncologists in Lithuania are taking parts in various other international scientific studies and projects: international project for treatment of acute myeloid leukemia; project collaborating with the Nordic countries for fertility preservation for children treated of cancer; European project addressing the inequalities in survival from childhood cancer across Europe; PANCARE (Pan-European network for care of survivors after childhood cancer) and others.
Because more children are surviving cancer, more attention is focused on long-term outcomes and the quality of life of these cancer survivors. Some problems are medical, such as permanent side effects of treatment, the possibility of other cancers caused by treatment, and the need for long-term treatment and medical follow-up. Other problems are emotional or social challenges, such as getting health insurance, relationship changes that may result from life-threatening illness, or learning to live with the possibility of cancer coming back. Therefore, to treat childhood cancer, a broad multidisciplinary approach is needed, including: hospital and medical professionals, scientists, cancer sick, government and supporting organizations.
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