COVID19: treatment of childhood cancer can't stop

Receiving a Cancer diagnosis is a tough moment to all children and their relatives when they arrive at GRAACC´s Hospital, due to all the changes and uncertainties that lies ahead of them. Adding a Covid-19 pandemic scenario to that diagnosis, poses an extra challenge. This was the case of young Luize, who was only 6 months old when she received confirmation that had cancer, initiating the treatment during the pandemic. Luize, back then living in South of Brazil, was routed to GRAACC´s Hospital in São Paulo, a national reference in pediatric oncology for 30 years that has the mission to offer every chance of cure to children and teenagers with cancer, providing life quality and reaching an average of 70% cure cases.

In GRAACC, the patient will find a complete infrastructure, from Medicine Excellency to a humanized care performed by a multidisciplinary team of specialized professionals. The Hospital provides differentiated treatment with divided ambulatories according to the type of cancer, assuring that an experienced team specialized in that kind of tumor attends the patient. Moreover, all the resources to diagnose and treat the tumor like specialized facilities, chemotherapy, radiotherapy, Bone marrow transplant, surgery center, pediatric ICU, among others, are all centralized in one place.

During this pandemic period, GRAACC´s Hospital relied on the charity from people and companies around the world, which altogether provided Luize a specialized and complete oncologic treatment. GRAACC exists to treat Luize and the other four thousand children that arrives at the Hospital every year. As without donations this mission would not be possible, the donors are a crucial part of this story.

After more than one year of pandemic, decreed by the World Health Organization (WHO) in March last year, several sectors are experiencing difficulties. One of the segments that have suffered consequences is that of health institutions, which need donations to ensure their services to patients.

This is the case of our hospital, which is a reference in the treatment of cancer in children and adolescents and receives children from all over Brazil. “One of our main fundraising channels, i.e., events, has vanished, causing a budget deficit. Our partnerships with the retail sector that helps us making money with marketing actions related to the cause have also been impacted, since many companies have closed. That is why, right now, we strongly rely on people’s donations, regardless of the amount. One should not forget that GRAACC is supported by contributions of small recurring amounts and with the permanent support of companies. We count on society in this difficult phase,” says Tammy Allersdorfer, GRAACC’s Superintendent of Institutional Development.

Since cancer does not wait, GRAACC’s Hospital keeps its doors open. Last year alone, 390 children and adolescents came to the hospital seeking treatment and a cure for cancer. One of these children, Gabriela, was diagnosed with kidney cancer in March 2020, when she was just over one year old. She and her family moved from Primavera do Leste, a city in the state of Mato Grosso, to São Paulo to receive professional treatment at our hospital.

After some difficult months of treatment, she was discharged at the age of two. The family moved back to its hometown and Gabriela resumed playing with her cousins, just like any healthy child. Now, she only comes back to São Paulo for consultations and follow-up exams.

Every day, children like Gabriela come to our hospital in search of cancer treatment and cure. With the help of people like you, we are able to offer the most advanced treatments so that they get every chance of being cured, preserving their quality of life.

Since the pandemic began in March 2020, scientists and doctors have been dedicated to understand Covid-19 and reduce its damage. The evolution of knowledge about the new virus has already reduced the number of hospitalizations, complications and deaths.

But if there are still mysterious aspects about how the new disease manifests itself in the general population, there is less information on how it manifests itself in children and adolescents undergoing cancer treatment. This has been an extra challenge for GRAACC Hospital professionals, who are in continuous learning to prevent and treat SarsCov-2 in their patients.

With the latest technology and a qualified team, the Therapy Unit GRAACC's Intensive Care Unit was able to use in some more serious cases interleukin receptor blocker, a medication that decreases the inflammation caused by Covid-19 in the body, reducing the effects possible destructive immune response. The hospital is also one of few that uses continuous hemodialysis equipment generation, important to facilitate the renal recovery of some functioning as a filter to eliminate toxins and other blood substances, including inflammatory meters used in treatment.

In case of respiratory symptoms, blood tests are performed with inflammatory markers and clotting factors. The analysis of these information helps us assess the severity of Covid-19 and immunosuppression on the patient. In some cases, we have already indicated hospitalization until this moment on.

When the exam is positive for the new coronavirus, the patient being treated at GRAACC is also immediately submitted to chest tomography: the look of an expert in analyzing tests of immunosuppressed children like the ones we have at the hospital makes all the difference, since the radiologist knows which changes require more attention in this type of patient and his technical report will be fundamental for us to know if there are pulmonary involvement and what is the best medication for that patient.

In GRAACC’s Hospital the learning with the pandemic are continuous: the treatment of cancer cannot stop.

The advancement of the coronavirus mobilized Brazil.

At GRAACC Hospital, the concern was even greater, considering that the small patients who arrive every day in search of treatment are immunosuppressed / immunosuppressed due to treatment against childhood cancer.

Since the arrival of the virus, our focus has been on developing, among other specific actions, new protocols, reducing people in the hospital, educational campaigns and training our professionals. "One of the initiatives was the creation of a treatment unit for symptomatic respiratory cases, with external access to the hospital, to receive these patients more safely and efficiently and not expose the others", explains doctor Fabianne Carlesse, responsible for the infectologist at the hospital , which serves highly complex cases in children and follows strict infection control standards.

In addition to this new service unit, the hospital implemented actions such as reducing the number of people circulating in the spaces, rescheduling appointments with a longer interval, changing the flow of exams to avoid agglomerations, installing banners and educational folders to guide patients and companions, elaboration of a new clinical care protocol, besides the focus on permanent education. And all of these actions had a big effect. Despite the unexpected high investments for all necessary modifications in our care, our hospital has faced the pandemic with commitment and responsibility and so far there have been no deaths reported by employees or patients by COVID-19 in our hospital.

This was only possible because we have our supporters around the world, who are at our side and support us through donations, such as the one you made to our Hospital, to ensure sustainability and the possibility of continuing to provide excellent care against a disease I can't wait for: childhood cancer. Thank you for supporting us.