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Leukemia: A Childs Nightmare

A Research Paper
Presented to:
Mrs. Marilou Cezar


In Partial Fulfillment
Of The Requirements for
English 102 Advance Composition


Submitted by:
Ayra Alison Lobendino
Anton Miguel Lumeran
Heidi Manansala
Patrisha Anne Soriano

Submitted on:
February 24, 2014
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Table of Contents

I. Introduction
A. Background of the Study: Leukemia
B. Purpose of the Research
C. Statement of the Problems

II. Collection of Data
A. Presentation of Data

III. Conclusion
A. Generalization
B. Recommendation

IV. Bibliography




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I. Introduction

A. Background of the Study

According to Crowley (2007) the term leukemia refers to a neoplasm of
hematopoietic tissue. In contrast to solid tumors, which form nodular deposits,
leukemic cells diffusely infiltrate the bone marrow and lymphoid tissues, spill
over into the blood stream, and infiltrate throughout the various organs of the
body.

Patients with leukemia exhibit the general symptoms of anemia
because the white cells overwhelm the red cells. In addition, they have a
tendency to bleed easily owing to a lack of platelets. White cell failure lowers
immunity, resulting in frequent infections. The spleen is greatly enlarged, and
several other organs may be increased in size because of internal
accumulation of white cells. (Cohen, 2005)

The most common forms are acute lymphoblastic leukemia,
characterized by the abnormal growth of lymphocyte precursors; acute
myeloblastic leukemia, in which myeloid precursors rapidly accumulate; and
acute monoblastic leukemia, or Schillings type, characterized by a marked
increase in monocyte precursors. Other variants include acute
myelomonocytic leukemia and acute erythroleukemia.

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Untreated, acute leukemia is invariably fatal, usually because of
complications that result from leukemic cell infiltration of bone marrow or vital
organs. With treatment, the prognosis varies.

The types of cancers that develop in children are often different from
those that develop in adults. Childhood cancers are often the result of gene
changes inside cells that take place very early in life, sometimes even before
birth. Unlike many cancers in adults, childhood cancers are not strongly linked
to lifestyle or environmental risk factors.

There are exceptions, but childhood cancers tend to respond better to
treatments such as chemotherapy. Childrens bodies also tend to tolerate
chemotherapy better than adults bodies do. But cancer treatments such as
chemotherapy and radiation therapy can have some long-term side effects, so
children who have had cancer will need careful attention for the rest of their
lives.

B. Purpose of the Research

Leukemia is a type of cancer of the blood or bone marrow and its a
deadly disease that usually affects children and young adults. The purpose of
this study is to promote awareness of this disease; the early detection, cure
and prevention. In addition to that, this study will also showcase how afflicted
children go through physical and emotional pain including their family
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members. This study will also provide essential information that will help so
that people can properly deal with the disease.

C. Statement of the Problem

This study sought to further understand information about this cancer.
The researchers formulated questions regarding leukemia and the children
diagnosed with this disease:

1. Why is Leukemia the most common form of cancer in children?

2. How can Leukemia affect the life of the child?

3. What are the possible treatments of Leukemia?











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II. Collection of Data

The discussion below indicates the ideas relevant to the present study,
namely, Leukemia; including its effects. All gathered information, related
literature and studies are mostly foreign. In other words, the materials used
are unpublished since foreign studies are considered unpublished material
that came from other countries and the local studies came from the same
country where we live.

A. Leukemia: The Most Common Form Of Cancer In Children

Both pre-natal and post-natal exposure to ionizing
radiation (particularly X rays) can cause leukemia in children. Pre-natal
exposure to X rays has been greatly reduced with the adoption of ultrasound
for screening in pregnant women.

Several studies link pesticide exposure by both parents and children to
leukemia. The pattern of disease suggests that some damage to
chromosomes may occur before the child is born. Children born to parents
employed in certain occupations that have chemical exposures are more likely
to have leukemia. Chemicals, specifically including benzene, have been
shown to cause leukemia in adults.

A recent review of 48 epidemiological studies concluded that the
strongest evidence for a relationship between a parent's exposure to
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chemicals other than pesticides and childhood leukemia was for solvents,
paints, and employment in motor vehicle-related occupations.

These studies tend to look at the occupation of fathers more often than
those of mothers, despite the fact that exposures of mothers are likely to be at
least as important. For occupations of the mothers, the review concluded that
the most significant were employment in personal services industries, in metal
processing, and in textiles. All three categories had significantly elevated
risks. For occupations of fathers, employment in painting led to increased risk
of leukemia in a child.

Some studies show that exposure to electric and magnetic
fields (EMFs) are associated with increased risk of leukemia. There has been
some evidence for an association between leukemia and smoking by
parents, though the largest study performed to date did not find that smoking
by parents, either before birth or afterwards, increased risk of ALL or AML in
children.

B. Leukemia and The Childs Life

The child with cancer is coping concurrently with the emotional impact
of diagnosis and the physical, social, and psychological effects of the disease
and its treatment. The somatic pain, the lack of energy, and the fear of the
unknown could compromise the quality of life of the child with a diagnosis of
cancer. It is important to evaluate the psychological adaptation of children
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during the acute phase of cancer and assess if their levels of distress are
comparable with those of their healthy peers. The recognition of possible
problems in their attitude, behavior, and relationships during treatment could
guide the medical and nursing team to the appropriate intervention strategies
and a more comprehensive care. The physical symptoms of cancer and the
treatment of it can have serious social and emotional consequences for the
child. Research indicates that the negative perception of self-appearance
often found in children with cancer is associated with academic, social, and
psychological impairment, low self-esteem, and symptoms of depression.

Learning that one has cancer leads to emotional upheaval for some
time after the initial diagnosis. Personal relationships and daily routines are
disrupted. Medical treatments can be highly aversive, leading to fear and
anticipatory anxiety, which is more prominent in younger patients and those
with higher trait anxiety.

Among the personality traits most frequently attributed to cancer
patients are internalized anger and aggression. Cancer patients have higher
levels of anxiety, anger, depression, hostility, denial and repressed
emotionality. Four of these traits (depression, anxiety, anger, hostility) are
linked to other diseases such as asthma, headaches, ulcers, coronary heart
disease and arthritis. Hope, optimism, faith in a supreme power, and personal
courage should be insisted to overpower the given emotional traits.
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C. Treatment of Leukemia

Once the diagnosis has been made, a detailed, honest, and frank
discussion of the problem with parents and any other members of the family
that the parents may choose should precede initiation of therapy. The person
who will be responsible for directing the treatment, as this initial orientation is
critically important and will affect the attitude, understanding, and cooperation
of the family should present this discussion.

The treating physician should clearly state the diagnosis and the
prognosis and give the parents an understanding of the disease, including its
definition and description of different kinds of treatments and its side effects. It
is important to project optimism engendered by the hope that prolongation of
life will perhaps enable the patient to take advantage of some future advance
in therapy and the possibility of cure because pessimism is improper and
harmful to the management of the patient.

It is also important to help the parents avoid guilt feelings and to
reassure them that nothing they could have done would have prevented the
disease. It is also important to stress to the parents that the child who is in
remission should be treated like any normal child and should attend school
regularly and participate in normal peer activity.

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The aims of therapy are to induce a clinical and hematologic remission,
to maintain the remission by providing prophylactic systemic chemotherapy
and prophylactic therapy to the central nervous system, and to provide
supportive care consisting of attention to the nutrition of the patient, treatment
of complications of therapy and of the disease, and psychological support.
The aim of therapy has shifted from palliation to cure.

One of the treatments that are being used for Leukemia is Systemic
chemotherapy, it aims to eradicate leukemia cells and induce remission.
There are specific chemotherapeutic and radiation treatment so varies with
the diagnosis. One of which is for meningeal infiltration, the patient receives
an intrathecal instillation of methotrexate or cytarabine with cranial radiation.
For ALL (Acute Lymphoblastic Leukemia), the treatment is vincristine,
prednisone, high-dose cytarabine, and daunorubicin. Because ALL carries a
40% risk of meningeal infiltration! The patient also receives intrathecal
methotrexate or cytarabine. If brain or testicular infiltration has occurred, the
patient also needs radiation therapy. For AML (Acute Myeloid Leukemia),
treatment consists of a combination of I. V. daunorubicin and cytarabine. If
these fail, a combination of cyclophosphamide, vincristine, prednisone, or
methotrexate; high-dose cytarabine alone or with other drugs; amsacrine;
etoposide; and 5- azacytidine and mitoxantrone can be an alternative
treatment.

Treatment may also include antibiotic, anti fungal, and antiviral drugs
and granulocyte injections to control infection, as well as transfusions of
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platelets to prevent bleeding and of red blood cells to prevent anemia. Bone
marrow transplantation is performed in some patients. (_______, 2006)

Leukemia can be treated successfully by bone marrow transplantation.
This has also been used successfully to treat patients with multiple myeloma,
widespread lymphoma affecting the bone marrow, and Hodgkin's patient's
own marrow is infiltrated by the neoplasm. In this treatment, the patient's own
marrow is destroyed first by large doses of anticancer drugs and radiation.
Then several hundred milliliters of bone marrow are aspirated from multiple
sites in the pelvic bones of a suitable donor, filtered to break up the clusters of
marrow cells and form a homogeneous suspension of individual cells, and
injected into the patient. The marrow transplant is a foreign tissue, however,
and the patient's own immunologic defenses must be suppressed in order for
the transplanted marrow to survive.

Although marrow transplantation is an important advance, it is not
always successful. Patients may develop life-threatening infections related to
the immunosuppression required to maintain the transplant, and in some
patients, the leukemia recurs, arising form the patient's surviving leukemic
cells that were not destroyed by the prior chemotherapy and radiation. And
not all leukemic patients are suitable candidates for bone marrow
transplantations.

A newer transplantation method is being developed in which patient's own
marrow is used for transplantation, which is called an autologous bone
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marrow transplant. One approach comprises collecting the patient's own
marrow while the patient is in remission, treating the marrow to destroy any
surviving leukemic cells, and storing the marrow in liquid nitrogen for later is
should the patient develop recurrent leukemia, This is also been used to treat
patients with acute leukemia when no compatible marrow transplant donor is
available. The leukemic patient's marrow is collected in the same way as
marrow is from a donor. Then the patient is treated with chemotherapy and
radiation to destroy diseased marrow. The patient's previously collected
marrow is treated with specific antibodies that destroy the leukemic cells. And
if all goes well, the leukemia-free marrow becomes reestablished and
functions normally. (Crowley, 2007)

Immunotherapy is only useful when the leukemic burden has been
reduced to a relatively low level by chemotherapy and the exact role of
immunotherapy in the treatment of acute leukemia has not been full
established, and further studies are in progress. Meanwhile, Diffuse
meningeal leukemia is usually treated by Intrathecal Methotrexate injections
and it is continued at 3-weeks intervals until the CSF (Cerebrospinal Fluid)
returns to normal. It is possible that failure of intrathecal chemotherapy to
eradicate meningeal leukemia may be due in part to inadequate drug
distribution in the CSF and this has been shown to result in more reliable CSF
drug levels than those achieved by lumbar puncture and has the additional
advantage of allowing painless administration of the drug. (Lanzkowsky,
1980)

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III. Conclusion

A. Generalization

Based on the data presented, Leukemia is a fatal blood cancer that
affects the child and his family, emotionally. It is a type of cancer of the blood
or bone marrow and it is a deadly disease common to children and young
adults. Since its a deadly disease, it greatly affects the life of the child
diagnosed. It ruined his normal life and has to start a new and adjust with his
medications and therapies. Also, not only it affects the life of the child but the
whole family because they will witness the sufferings of the child in every
therapy. As a result of the sufferings, the family at times would give up to
lessen the childs pain. It will also result to different emotional traits that could
lead to other diseases. There is no easy way to cure the disease, so the child
suffers in every session of the treatment he must take. Everyone knows that
Leukemia is deadly but when treated early and properly, it can be cured.

B. Recommendation

The study is commended for everyone to further understand about
Leukemia and its effects. The study is also commended for parents, future
parents to open their eyes to the fact that, Leukemia affects not only the child
physically, emotionally and socially but also the life of the whole family. The
readers must also promote optimism about this form of cancer to give hope to
the diagnosed children. The research is also for future researchers to use this
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study as a guide and to know that they can improve and add more information
about Leukemia so that, the readers can have more knowledge about the said
study.



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IV. Bibliography/References
Children, Cancer, and the Environment, February 18, 2014,
http://www.envirohealthpolicy.net/kidstest/Cancer%20Pages/Individual
%20Cancers/Leukemia.htm

Crowley, Leonard V., 2007, Introduction to Human Disease: Pathology
and Pathophysiology Correlations, Sudbury, Mass, Jones and Bartlett

Cohen, Barbara J., 2005, Memmlers Human Body in Health and
Disease 10
th
Edition, Philadelphia, Lippincott Williams & Wilkins

Lanzkowsky, Philip, 1980, Pediatric Hematology-oncology: A treatise
for the clinician, New York, McGraw-Hill

Anonymous, 2006, Diseases: A Nursing Process Approach to Excellent
Care

Rice, Philip (1998). Health Psychology, United States of America:
Core Publishing Co.