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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

Multidisciplinary conference on TB control

2003-09-22

Theme: Tuberculosis control: a multidisciplinary approach to research, policy and practice Venue: CR Swart Auditorium, University of the Free State Campus, Bloemfontein Date: 11 and 12 November 2003 Time: 11 November, 19:00-20:30 AND 12 November 08:30-17:00

Tuesday, 11 November - 19:00-20:30 (registration from 18:30) and Wednesday, 12 November - 08:30-17:00 (registration from 07:30)

The Honourable MEC for Health in the Free State will officially open the Conference on the evening of 11 November, while Prof Frederick Fourie (Vice-Chancellor and Rector of the University of the Free State) will attend to the welcoming. In addition, Prof Françoise Portaels (Institute of Tropical Medicine, Belgium) and Dr Refiloe Matji (National Department of Health, South Africa) will respectively present a global and a South African perspective on TB. The majority of the presentations will follow on 12 November.

Main thrust of Conference

The main thrust of the Conference is to disseminate both research results and policy/managerial matters relevant to TB and TB control, and to facilitate discourse among researchers and health policy makers/managers/practitioners in the field of TB control. Presenters of papers, as well as delegates are, therefore, drawn from both academic/research institutions, and from health service sectors involved in TB control in all provinces and in neighbouring countries.

Topics of presentations

A variety of topics will be dealt with during presentations, such as: New challenges in the global control of MDR-TB New strategies and policies on MDR-TB in South Africa A South African perspective on TB control A provincial perspective on implementing the national TB control policy

The role of the public district hospital in TB control Tuberculosis control through DOTS Case detection strategies

TB in children Hospital to clinic: is this the missing link? Patient compliance with DOT for TB Challenges for effective health communications in a multicultural context

The economics of TB Frequency of multiple infections with M. tuberculosis in pulmonary TB patients HIV/AIDS and TB, etc.

Speakers

Among the speakers will be Dr Victor Litlhakanyane (Head of Health: Free State); Prof Françoise Portaels and Dr Leen Rigouts (Institute of Tropical Medicine, Belgium); Dr Reliloe Matji (Director: NTBC Programme); Ntsiki Jolingana (Director: HIV, AIDS, TB and Communicable Diseases, Free State) and Annatjie Peters (Free State TB Coordinator); Dr Karin Weyer (Medical Research Council); Profs Herman Meulemans, Diana De Graeve, Luc Pauwels and Christiane Timmerman (University of Anwerp, Belgium); Dr Lara Fairall (UCT Lung Institute, University of Cape Town); Prof Frikkie Booysen (Department of Economics, University of the Free State); Christo Heunis, Ega Janse van Rensburg-Bonthuyzen, Zacheus Matebesi and Kobus Meyer (CHSR&D); Dr Mary Ednington (School of Public Health, Wits); Dr Carmen Báez and Sabine Verkuijl (ISDS); Anneke Van der Spoel-Van Dijk (Medical Microbiology, University of the Free State).

Costs

There will be no registration fees. However, delegates are expected to arrange their own transport and accommodation, or arrange for sponsorships themselves.

Contact details in case of inquiries and confirmation:

Postal Address: The Director, CHSR&D, PO Box 339, University of the Free State, Bloemfontein, 9300 Fax: 051 448 0370 Tel: 051 401 2181 OR 051 401 3256 E-mail: vrensh@mail.ufs.ac.za (Dingie van Rensburg) OR neljc@mail.ufs.ac.za (Ohna Nel)

PLEASE, CONFIRM YOUR ATTENDANCE AS SOON AS POSSIBLE, BUT AT THE LATEST BEFORE 25 OCTOBER 2003 ? BY TELEPHONE, FAX OR E-MAIL.

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