Early side effects in treatment of childhood cancer

The management of childhood cancer is fraught with many paradoxes. Most of the anticancer drugs not only destroy the proliferating neoplasm but also affect normal cells. The normal tissues most affected are the bone marrow, the intestinal mucosa, and the epithelium. These tissues are most important in providing barriers to infection. Furthermore, the present approach to chemotherapy is usage of anticancer drugs at maximal tolerated doses, since the greater the concentration of drug delivered to the tumor, the greater is the chance of eradicating the malignancy. Thus, varying degrees of adverse effects must be tolerated to achieve the optimal anticancer effect. The cancer patient may need hospitalization frequently, yet the hospital environment is not the most desirable one for an immunosuppressed patient who is susceptible to nosocomial infections.