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LOOKING AFTER A CHILD WITH CANCER

Looking After A Child With Cancer

Cancer in childhood is uncommon. It can affect any part of the body - the most commonly affected are blood, muscles, bones and organs.

Children’s cancers do not always act like, get treated like, or respond like adult cancers. Do not compare adult cancer to cancer in children.

TYPES OF CANCER : There are two main types of cancer

1. BLOOD CANCER

Leukemia is a type of blood cancer where the white blood cells in the bone marrow divide too quickly. The bone marrow is the soft part in the centre of our long and at bones. In Leukemia the bone marrow gets so clogged up with unhealthy blood cells that there’s no room for healthy blood cells to grow.

Lymphoma is a type of blood cancer where the white blood cells in the lymph nodes divide too quickly. The lymph nodes are an important part of the body’s immune system. In Lymphoma, the lymph nodes, liver or spleen get enlarged and stop functioning normally. 

2. SOLID TUMOUR

When cancerous cells clump together they form a tumour. Tumours can grow in any part of the body. They tend to destroy the surrounding healthy organs and this is dangerous. Cells in these tumors are abnormal and divide without control or order. Tumours can also be non cancerous and are called benign. They can often be removed and, in most cases, they do not come back. Cells from benign tumors do not spread to other parts of the body. Most importantly, benign tumors are rarely life threatening.

LOOKING AFTER A CHILD WITH CANCER

Children with cancer may have a low white blood cell count(WBC) for a variety of reasons. Low WBC count may be due to chemotherapy, radiation therapy, or sometimes the cancer itself.One type of white blood cell called neutrophil, is especially important in fighting infections. A shortage of neutrophils in the blood is called Neutropenia. Neutropenia makes the patient susceptible to bacterial or fungal infections, which may at times be life-threatening.

SIGNS OF INFECTION

Fever is a sign of infection and the child has to be treated or seen in the hospital by the doctor.

Other Common indicators of Infection:

•Chills, shivering, sweating

•Loose motions

•Sore throat and / or cough

•Burning during urination

•Redness or swelling in the skin or in the genital area

•Unusual vaginal discharge or swelling

 TEMPERATURE CHECKING 

Learn the correct procedure to check the child’s temperature. For a young child take the temperature in the armpit:

1. Use a digital thermometer so that the reading can be understood clearly.2. First wipe the arm pit with a clean cloth and then put the bulb in the arm pit and have the child hold it there for

2 minutes and then check the temperature.

3. Don’t touch the bulb / tip of the thermometer, as this may result in a wrong temperature reading.

4. Keep a daily record of the child’s temperature by recording the child’s temperature at the same time everyday.

For an older child take the temperature in the mouth:

1.Use a digital thermometer so that the reading can be understood clearly.

2.Make sure the child has not eaten or drunk anything for atleast 15 minutes before taking the temperature. This can give an incorrect reading.

3.Disinfect the bulb and stem of the thermometer with a Dettol solution. Wipe it dry.

4.Insert the bulb end of the thermometer under the child’s tongue, toward the side of the mouth. Tell the child to hold the thermometer gently with lips closed, for 2 minutes. 

5.Remove the thermometer from the mouth gently and read the temperature.6.Don’t touch the bulb / tip of the thermometer, as this may result in a wrong temperature reading.

7.Keep a daily record of the child’s temperature by recording the child’s temperature at the same time everyday

If the fever is more than 99°F, sponge the child with cool tap water. Follow the doctor’s instructions and give the correct dosage of the fever reducing medication and bring the child to the hospital OPD or Casualty Ward. 

If you are far away from a hospital give the child the antibiotics prescribed by the doctor and come to the hospital as soon as possible. 

If you are outside the city where the hospital is, take your le and go to the local doctor for antibiotics and a CBC check.

There are several measures that can help to lower the risk of infections. You must follow the instructions regarding hygiene and diet.

Despite these precautions some patients will develop infection.In the vast majority of patients, infection can be controlled with either oral or injectable antibiotics, if it is diagnosed and treated early. In very few children, infections can be dangerous.

 The child must report to the hospital as early as possible if they develop fever or any other signs of infection after the administration of chemotherapy. In an emergency, the hospital will never be closed for the child.Hospital emergency departments (casualty) are always open. The doctor may call the child to check the blood counts after the 1st or subsequent cycles of chemotherapy.

DIET

Children recovering from cancer should follow a Neutropenic diet. This is a low bacteria diet, which decreases the amount of bacteria in foods and beverages and reduces the chances of infection developing in children with weakened immune systems.

THINGS TO REMEMBER

Get the child to drink more liquids.

Store food hygienically: cover everything and store food in a clean, dry place.

Boil water.Give the child cooked food rather than raw food. 

If raw fruits or vegetables are to be given, wash them in a solution of potassium permanganate and then peel all fruits and vegetables.

Keep hot foods hot and cold foods cold. 

Buy individually small packaged foods, which are better than larger portions that result in leftovers.

Do not buy or use a product if it is out of date. 

Do not expose food to large groups of people or people who have infections. 

Do not use old, mouldy or damaged fruits and vegetables. 

Do not consume food prepared in unhygienic conditions eg from roadside vendors .

Do not consume foods available in open containers. 

Do not buy or use food in cans that are swollen, dented or damaged.

INSTRUCTIONS FOR WASHING FRUITS AND VEGETABLES

Potassium Permanganate Solution: Mix enough Potassium Permanganate granules in water to make a light pink solution. Soak fruits/ vegetables in this for 5 minutes, and rinse well. This will effectively remove pesticides, bacteria and other pests. Too much potassium permanganate can be harmful, so be careful that the water is just light pink in colour, and not dark purple.

OR

Using Vinegar: Take a cup of vinegar and three cups of cooled boiled water, add a teaspoon of baking soda and store this solution in a bottle or a spray . This is useful in removing wax and bacteria, especially from ‘over-glossy’ produce such as apples, eggplant etc. For best results, use the vinegar solution to wipe / wash the fruits and vegetables. Rinse well with plain water before use

DIETARY INSTRUCTIONS DURING TREATMENT

During chemotherapy, make sure the child is drinking plenty of water and other liquids. This will help to reduce the toxic effects of the drugs and minimize the side-effects of chemotherapy (nausea, vomiting, loose motions, loss of appetite, taste alterations and food aversions). Encourage the child to eat small frequent meals. The food intake may be less during chemotherapy. Oerthe child a balanced diet with foods which are high in nutrition E.g. fruit milkshakes with protein supplements, chikkis, laddoos, vegetable / dal /parathas etc.

IDEAS TO MAKE FOOD MORE NUTRITIOUS:

Use combination of ours for making rotis. For example, to 1 kg wheat our, add 100 grams oats our, 100 grams soya our and 100 grams of chana our. Add til seeds, groundnuts, ax seeds (alsi) to the plain bhakri/ rotla ( jowar, bajra, nachni)

Use skim milk powder or any protein powder supplement to regular milk, buttermilk, milkshakes custards and puddings. Use milk instead of water in cooking whenever possible. Add cream to vegetables, soups and other dishes. Serve butter, oils, ghee with soups, sandwiches, salads and vegetables. Grate cheese in soups, sauces, sandwiches, vegetables, mashed potato, rice and noodles. Add chopped hard boiled eggs to salads, vegetables and other dishes. Sprinkle chopped nuts on fruits (banana, apple, pear), ice-cream, salads and vegetables. Include red, yellow and orange coloured fruits and vegetables in the diet

EMPHASIZE PROTEIN RICH FOODS IN THE DIET 

Milk and milk products, dals and pulses, nuts, ragi (nachni), bajra, lobia, soaked garden cress seeds (halim dana/ aliva), sesame seeds (til) and cooked soyabean and protein supplements.

TO INCREASE HEMOGLOBIN

Consume iron rich foods like ragi, wheat germ, soyabean, lentils, turnips green, spinach, jaggery, green vegetables, beetroot, dried dates which are cooked (khajoor), mint (phudina).Remember to have foods rich in vitamin C along with iron-rich foods to increase iron absorption. E.g. orange juice, limejuice, amla.

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