Early detection is key to curing childhood cancer

Myths and misconceptions about childhood cancer

“Children with cancer can be cured but we need early detection,” says Dr Gita Naidu. She heads up the Paediatric Oncology Unit at Chris Hani Baragwanath Academic Hospital, the third largest hospital in the world.

“There are many myths and misconceptions about childhood cancer. Chief among these is that children do not get cancer. Or that if a child is diagnosed with cancer, they will inevitably die. Neither of these is true. Fortunately, childhood cancer is relatively rare compared with adult cancer, but it’s an important cause of childhood morbidity and mortality,” Dr Naidu says.

“In high income countries and a growing number of low and middle income countries, childhood cancer is now a leading cause of deaths in children and adolescents.”

Childhood cancer: the warning signs

“The South African Children’s Cancer Study Group has developed the early warning signs for paediatric cancer,” Dr Naidu says. “The St Siluan warning signs for childhood cancer was drawn up by our unit and are being used nationally and in some low and middle income countries.”

The warning signs are:

• S – Seek medical help early for ongoing symptoms
• I – White spot in the eye, a new squint, sudden blindness or bulging eyeball
• L – Lump on the stomach, pelvis, head, arms, legs, testicles or glands
• U – Unexplained fever present for over two weeks, weight loss, fatigue, pale appearance, easy bruising and bleeding
• A – Aching bones, joints, back and bones that break easily
• N – Neurological signs such as, abnormal movements, a change in walking, balance or speech, regression, continuous headaches with or without vomiting, and an enlarged or bulging head

Poverty a major barrier to beating childhood cancer

Dr Naidu says where you’re born plays a big role in children surviving cancer. According to estimates by the International Agency for Research on Cancer , almost 100 000 deaths annually in children younger than 15 are owing to cancer, and more than 90% of these deaths occur in low and middle income countries. “Mortality is high in developing countries – 80% of young cancer patients in Africa die. Of greater concern is how many patients die from undiagnosed cancer.”

“Presently, about 80% of children with cancer in high income countries survive. However, in low and middle income countries, cancer in children is often detected too late for effective treatment, and the treatment is complicated by co-morbidities such as malnutrition, HIV and AIDS, tuberculosis, affordability, and restricted access to treatment and care,” she explains.

“The burden and effects of childhood cancers in low and middle income countries are complex and multifactorial. Level of income, parental education, vulnerability and risk, and socio-politics are some of the factors which are recognised,” she continues.

“Poverty affects health and mortality at all ages, but particularly children. Low and middle income countries have poor healthcare provision, with few special cancer centres. Eighty percent of the African population have no access to radiotherapy, cancer surgery, basic chemotherapeutic medicine or the infrastructure needed for basic cancer care. Unfortunately, the most important determinant of outcome for a child with cancer is where he or she is born.”

Hope springs from Soweto to the world

Chris Hani Baragwanath’s paediatric oncology unit serves the residents of Soweto, a peri-urban and mostly low income township. “We are an extremely busy unit – the largest in South Africa – with a large referral base including the surrounding SADEC countries,” she says. “I work with a strong team of caring, compassionate, intelligent and industrious individuals. The entire paediatric department is one of hope and it’s an absolute honour to work here.”

The unit has two in-patient wards for children from birth to 20 years and an out-patient clinic with a day ward that can receive up to 600 patients a month. The unit has two 10 bedroom houses in Soweto for children receiving out patient therapy who cannot travel to the hospital every day.

It’s also the teaching hospital for undergraduate and postgraduate medical students from the University of the Witwatersrand. “We teach undergraduate medical students, doctors who are training to become paediatricians, and we’re an accredited unit to train paediatricians to become paediatric oncologists. We have four paediatricians who are training, one for our unit, two for the University of KwaZulu Natal and one for Zimbabwe.”

Dr Naidu’s hope for children in South Africa

Dr Naidu shares her hopes for children in South Africa:

• Improved maternity care including early diagnosis and treatment of HIV
• Improved birthing facilities
• Widespread use of immunisations
• Eradication of malnutrition
• Involvement of fathers in the upbringing of their children
• Safe living and play environments
• Early detection and referral of childhood cancer

Helping kids with cancer dream

A feather in the hospital’s cap is its two Dream Rooms – made possible by the Reach for a Dream Foundation through its partnerships with Discovery Vitality and Vukile Property Fund.

“These rooms are sanctuaries of hope and bring respite to our children diagnosed with cancer. Many of our patients are hospitalised for prolonged periods of time, miss home and find being in hospital really difficult,” Dr Naidu says.

“The beautiful rooms are havens and oases of ‘normality’ and take them out of the hospital for a few hours. It brings much comfort and solace to our little patients. The little ones have toys, books, puzzles, games, outdoor activities and they love being in the room away from the ward. The teenagers’ room has all the technology that they need: a television, computers, video games, music, lazy boys to lounge around in, and a beautiful outside area. We are very grateful for Reach for a Dream, Discovery Vitality and Vukile Property Fund for our Dream Rooms.”