Life and Work as a Pediatrician in Bangladesh: Visit to National Institute of Cancer Research and Hospital

Along with the visit to Dhaka Medical College, we visited National Institute of Cancer Research and Hospital (NICRH) to also help launch them as a satellite centre. Despite the name, this hospital is unfortunately very limited in their ability to treat children's cancer due to the fact that they have only 4 inpatient beds.

They treat mostly patients with solid tumours (as opposed to leukaemia and lymphoma) as these patients don't require hospitalization as often and can receive most of their treatment as outpatients. Secondly, this hospital has a strong team of cancer surgeons, which is vital for the appropriate treatment of solid tumours.

In general, the treatment of most solid tumours in children involves chemotherapy to shrink the tumour followed by surgery to remove as much of the tumour as possible, followed by more chemotherapy to kill any remaining cancer cells which may not have been removed by the surgery. Sometimes radiation is also used after surgery.

It's very important for physicians and surgeons to work together for the best chance for cure in these cases.

Unfortunately this doesn't always happen. t recently saw a child with neuroblastoma, a tumour of the nervous system, which is generally located in the abdomen. In this case the child's tumour had spread to the area behind the eye, which is a common place for neuroblastoma to spread. Because there was swelling and protrusion of the eye, the child went to an ophthalmologist, who mistakenly supposed the swelling to be an eye tumour and so removed it. Sadly without chemotherapy and removal of the primary tumour in the abdomen, the child will have no chance of cure. Ultimately, children with this advanced stage of neuroblastoma in Bangladesh, as it is very difficult to treat once the disease is this advanced.