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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 for web 
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).  


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

News Archive

Internationally acclaimed academic applauded on Africa Day
2011-06-02

 
 Prof. Ali Mazrui, an internationally acclaimed and renowned academic.

One of the world’s top academics was given a warm welcome in the rather cold Free State recently.

Prof. Ali Mazrui, an internationally acclaimed and renowned academic, visited us as part of our Africa Day celebrations as arranged by the Centre for Africa Studies. He delivered a keynote address, entitled ‘Pro-democracy uprisings in an African experience: from Sharpeville to Benghazi.’

A festive atmosphere and the sound of drums welcomed this intellectual giant as well as other delegates upon their arrival at the CR Swart Auditorium on our Bloemfontein Campus. Some of the delegates who attended the Africa Day Celebrations, included: Mr Tom Amolo, High Commissioner from the Republic of Kenya; Mr Dan Kgothule, MEC of Arts and Culture in the province; Prof. Jeff and Dr Carla Ramsdell, visitors from America; Dr Allan Boesak and Prof. Nicky Morgan, Vice-Rector: Operations.

Prof. Frederick Fourie, former Vice-Chancellor and Rector of our university, also attended the celebrations, as did some scholars from neighboring schools.

Welcoming Prof. Mazrui, Prof. Jonathan Jansen, Vice-Chancellor and Rector of our university, quipped that he was relieved the world had not ended the previous weekend as was predicted, because he was looking forward to listening to such a renowned intellectual.

Prof. Lucius Botes, Dean of Humanities, followed Prof. Jansen at the podium. He said the ability to go from following a bridging course to being one of the top 100 intellectuals in the world, indeed distinguishes Prof. Mazrui as an exceptional academic. This intellectual is, among others, an Albert Luthuli Professor at the University of Jos, Nigeria and Andrew D. Professor Emeritus and Senior Scholar in Africana Studies at Cornell University.

In his introduction, Prof. Mazrui said he feels honored and flattered by this opportunity. He proceeded by referring to the history of Africa Day and added that he would rather prefer an Africa Week to an Africa Day to ensure that everybody has the opportunity to celebrate the continent.

He sang the praises of South Africa, as almost every other African country which attained liberation from European colonial rule in the 20th century, has been unable to maintain its democratic order beyond its first decade of independence.

“The Republic of South Africa, on the other hand, liberated Nelson Mandela in 1990, held its first democratic election in 1994, and already has its third president. Nearly two decades after Apartheid, South Africa has not outlawed opposition parties, or experienced a military coup, or permitted the Head of State to govern the country as a dictator.”

In his speech he compared the uprisings in Sharpeville during 1960 and Soweto during 1976 with the more recent pro-democracy uprisings in North Africa, based on the role that weapons and the lack thereof, as well as the youth and women played in the respective cases.

He concluded by saying the uprisings in Tunisia and Egypt have already resulted in ousting dictators who had been entrenched in power for decades, adding that in Libya a third dictator’s future is on the line. “Never in the history of the Arabs have there been so many popular uprisings which seem to be inspired neither by Islam nor by anti-imperialism, but in the quest for liberal reforms. Half a century earlier in Sharpeville and Soweto, South Africans experienced their own political awakening.”

Prof. Kwandiwe Kondlo, Director of the Centre for Africa Studies, closed the event with a word of thanks to the American academic and his wife, guests and attendees. He said discussions prior to the event revealed that more research has to be done regarding gender issues on the continent.

Prof. Mazrui also participated in conversations at the institute and a media briefing which was hosted earlier the day.

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