Totally unaware of the severe consequences of the disease, the little boy from Jhenidah, who was to enter a village primary school, was seen watching a movie on the television smilingly at the Ashic Foundation that arranged free accommodation for ten such children undergoing treatment for cancer.

Child cancer is curable in many cases but in this country 50-60 per cent patients diagnosed with cancer fail to get treatment only for financial reasons -- this is the observation made on National Child Cancer Day yesterday.

Despite increasing awareness among the parents that early diagnosis and proper treatment can cure cancer, more than 50 per cent patients cannot afford the costly treatment, said Prof Afiqul Islam of Department of Paediatric Haematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU).

"The government should provide medicine for the cancer patients free of cost. The medicines are sold in the black market over which the hospital authorities and physicians have no control," said Prof Afiqul.

He urged setting up of a medicine bank.

Sixty to 70 per cent of cancer cases are curable if the diagnosis and treatment can be started within six months but as only a few centres including the BSMMU provide treatment of cancer, especially for children, most of the cancer survivors, especially those living in remote areas of the country, are deprived of cancer treatment facilities.

Even at the National Cancer Institute, only four per cent of the total cancer patients were paediatric cancer patients in 2005 while it was 3.9 per cent in 2006.

"As there is no paediatric oncology department at the National Cancer Institute, most of the child patients go to BSMMU," said Habibullah Talukder, associate professor of the Department of Cancer Epidemiology of the institute and Director of Bangladesh Cancer Foundation.

A proposal was sent to the government in 2005 to start phase-wise paediatric Haemato- Oncology unit in older medical colleges to facilitate more cancer patients but there is no response from the government yet.

"It is very important to spread the treatment facilities of this fatal disease to the peripheral areas. It would also help to increase awareness," said Prof Afiqul.

Since the Paediatric Cancer Unit of BSMMU started working in 1993, every year around 200 to 256 newly diagnosed cancer patients have been admitted into the unit.

"Survival rate of cancer patients could decline only due to shelter problem," said Shafiqur Rahman, parent of a cancer survivor who is now completely cured after undergoing treatment staying at the shelter home of Ashic Foundation for three years.

The foundation also provides palliative care that includes physical, mental and spiritual care for the terminally ill children and their parents, which would help them to cope with the disease and die peacefully.

"As in our country early detection of cancer is not possible in 80 per cent cases, children suffering from cancer at the end stage only need palliative care," said Nezam Uddin Ahmed, associate professor of Department of Anesthesiology and Project Coordinator of Palliative Care Medicine, BSMMU and founder member of Afzalunnesa Foundation that works with the terminally ill patients.

Honest communication is important here and the problems should be shared with children considering their level of understanding, he said, adding, "Oral liquid morphine, one of the gold standard drugs for intractable pain in many of the children, is not available in this country."

The actual number of cancer patients is yet to be determined, as there is no population-based data in the country, he said.

Jan Stjernsward, former Chief of Cancer, World Health Organisation (WHO), said, "Probably Palliative Care of the patients particularly with a community oriented approach is what a developing country needs."

According to the International Union against Childhood Cancer (UICC) report, every year more than 160,000 children are diagnosed with cancer, 90,000 of whom are expected to die of the disease. Eighty per cent of the afflicted children live in the developing countries. In the developed countries three out of four cancer-afflicted children survive but in developing countries more than half of the cancer-afflicted children die of the disease.

Exposure to radiation, genetic factor and smoking in front of children increase the risk of childhood cancer, experts said.

"Intake of chemicals in food and polluted air are also contributing factors to childhood cancer," said Prof MA Mannan, chairman of Paediatric department of BSMMU.