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Childhood Cancer Awareness Month: Identifying early warning signs is critical

14 September 2021 | Story Dr Jan du Plessis and Dr Mampoi Jonas

Opinion article by Dr Jan du Plessis, Head of the Paediatric Oncology Unit, and Dr Mampoi Jonas, senior lecturer in the Paediatric Oncology, University of the Free State

For many years childhood cancer has remained a taboo subject in our communities, mainly because too little was or is known about it. Many have known or come across an adult with cancer but for a child to be diagnosed with cancer is totally unheard of. No parent wants to hear the news that their ‘heartbeat in human form’ has fallen ill. One moment they are OK, the next, waves of emotions flood the parents. Mixed in all this are feelings of guilt, anxiety, uncertainty, constant wondering if they could have done anything differently. Most importantly the question, often unuttered remains “Is my child dying/ how much time do I have”.

Most young cancer patients live in developing countries

Childhood cancer is rare and involves only 1% of all cancers. It is reported that globally approximately 70% of all childhood cancer cases occur in low- and middle-income countries. If diagnosed early, approximately 70-80% of childhood cancers are curable in developed countries. Unfortunately, most children with cancer live in developing countries with limited resources and the cure rate does not reflect the same success. The low survival rates can be attributed to poor diagnosis coupled with too few specially trained doctors and nurses and the misbelief that child cancer is too difficult to cure. However, even in resource-poor environments at least 50% of childhood cancers can be cured.

Numerically, childhood cancer is not a significant cause of death in sub-Saharan African countries, which leaves childhood cancer less of a priority. In Africa, the most common paediatric health problems are malnutrition, infectious diseases such as HIV and tuberculosis. Whereas in Western countries, after accidents, cancer is the second leading cause of death in children and is a burden to the health system.

A study done by Stones et al in 2014 published the survival rates for children with cancer in South Africa at two different Units (Universitas and Tygerberg Hospitals) to be around 52%. The conclusion was that the children present late and with advanced-stage disease, which obviously affects their outcome. They also concluded that strategies to improve awareness of childhood cancer should be improved. Identifying early warning signs of childhood cancer is critical for parents and healthcare workers to ensure early diagnosis and improved cure rates. We often refer to these as red flag signs that should raise suspicion of the possibility of cancer as a diagnosis for the presenting patient.

Almost 85% of childhood cancers will present with the red flag signs, which could suggest the possibility of a childhood cancer, namely:

1. Pallor and purpura (bruising)

2. Bone and joint pain

3. Lymphadenopathy

4. Unexplained masses on any body part

5. Unexplained neurological signs

6. Changes in the orbit or eye

7. Persistent unexplained fever and weight loss

The most common cancer in children is leukaemia (blood cancer). Brain tumours are the most common non-haematological cancers, followed by nephroblastomas (kidney cancers) and neuroblastomas (sympathetic chain cells, the adrenal glands the most common site of origin).

We honour the children currently battling cancer and their families

Once there is clinical suspicion of cancer, the child should be investigated or referred for the relevant investigations to be conducted to get to the right diagnosis. Treatment for childhood cancer includes chemotherapy, surgery or radiotherapy. These may be given separately or in combination depending on the diagnosis. Many models of care exist, but regardless of the outcome, children and families who receive compassionate, holistic care of symptomatology and address their non-physical needs are able to face their illness with dignity and energy.

Childhood Cancer should not remain a taboo subject in South Africa and should be a topic of conversation more often so that people can be educated regarding the early warning signs and become more aware of its occurrence amongst children. Get the word out that a cure is possible. This month, which is known as Childhood Cancer Awareness Month, and throughout the year, we honour the children currently battling cancer, the families who love them, the clinicians and other caregivers treating them, the survivors of childhood cancer and the children who lost their lives to childhood cancer.

Authors

Dr Jan du Plessis is the Head of the Paediatric Oncology Unit in the Faculty of Health Sciences at
the University of the Free State (UFS).

Dr Mampoi Jonas is a senior lecturer in the Paediatric Oncology, University of the Free State (UFS).

News Archive

UFS council elects Nwaila and Hancke

2005-03-15

Dr Charles Nwaila, Superintendent-General of Education in the Free State, was elected Vice-chairperson of the UFS Council and Judge Faan Hancke was re-elected as Chairperson today.

According to the Rector and Vice-Chancellor, Prof Frederick Fourie, the election of Dr Nwaila is an important achievement for the UFS as Dr Nwaila is a well known leader in education in the Free State.

Dr Nwaila pledged to work constructively with the UFS council and management to ensure that the UFS benefits all people of the province and the country.

The appointments are valid for a term of three years from 1 June 2005 to 31 May 2008.

The elections took place at the quarterly meeting of the UFS Council where a number of other key transformation steps were approved.

The Council approved a Strategic Plan for the UFS which reflects a renewed focus on transformation of the institution, calling it an important roadmap for the future of the UFS.

According to Prof Fourie, the Strategic Plan tried strike a balance between continuity and change, addressing the need to remain an excellent university in an ever-changing context and environment.

Prof Fourie said transformation had many aspects and dimensions and could not be reduced to an issue of numbers.

The Strategic Plan identifies five strategic priorities and corresponding challenges in the next phase of transformation.

The priorities are:

quality and excellence
equity, diversity and redress
financial sustainability
regional co-operation and engagement.
outward thrust

Prof Fourie said that besides the five strategic priorities the plan also reflected concrete actions and interventions to address them.

He said the renewed focus on transformation is embedded in the priorities and specific actions that are identified.

The Council congratulated the management for the roadmap and for the achievements that have already been achieved in terms of transformation.

In order to draft a comprehensive Transformation Plan that will give substance to certain aspects of the UFS Strategic plan – or roadmap – the Council approved the establishment of a Transformation Plan Team.

The team will consist of about 16 people, which includes the two coordinators, Prof Teuns Verschoor, Vice-Rector: Academic Operations, and Dr Ezekiel Moraka, Vice-Rector: Student Affairs.

According to Prof Verschoor, the team was chosen and approved by the Executive Management earlier for the individual contributions that they could make.

While the individuals do not represent particular constituencies on campus they are a very diverse group of persons in terms of race, gender and various sections of the campus and the satellite campuses.

Prof Fourie, said there was an urgency and importance attached to the work of the Transformation Plan Team.

He said that while the team must produce a plan within a tight deadline, the task must be carried out very well, which could mean different stages in the work of the team.

According to the Rector, the UFS must take the lead in best practice transformation, while not underestimating the complexity of the issues facing the UFS.

The full list of names will be finalized soon.

MEDIA RELEASE
Issued by: Mnr Anton Fisher
Director: Strategic Communication
Cel: 072 207 8334
Tel: (051) 401-2749
11 Maart 2005

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