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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

Dr Oprah Winfrey praises our university

2011-08-24

Dr Oprah Winfrey after receiving her honorary doctorate degree.
Photo: Rian Horn

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Video clip

Transcription (pdf document)

“I came 8 000 miles to say, thank you, Vrystaat!” and “God bless South Africa,” were the words Dr Oprah Winfrey used yesterday to respectively open and close her address to an overflowing Callie Human Centre on our Bloemfontein Campus.

Our university awarded an honorary doctorate in Education to Dr Winfrey during a stately, yet warm and cheerful affair yesterday, which saw the 4 500 seater Callie Human Centre packed to the rafters with adoring fans, staff members and students.

The honorary doctorate is in recognition of her unparalleled dedication to improving the lives and futures of so many by improving education and ensuring that it is accessible to all. Through her award-winning show, The Oprah Winfrey Show (which concluded this year after 25 years of entertainment and service), and the various charity organisations she has established, Dr Winfrey has harnessed the power of her iconic stature in the struggle to eradicate poverty and make education accessible to all.

The ceremony’s audience was entertained by South African music legend, Ms Sibongile Khumalo, the Bloemfontein Children’s Choir, Bartimea School for the Deaf and Blind’s Sign Language Choir, and several other musical performers as well as dancers.

Dr Winfrey could not hold back her tears when Mr John Samuel, interim Director of our International Institute for Studies in Race, Reconciliation and Social Justice, described her as an “honorary daughter of South Africa”. She proved just how much the country means to her when she joined in the singing of the South African national anthem, Nkosi Sikeleli, despite struggling with the words in some parts.

According to Dr Winfrey, her interest in our university began after she had read an article by Prof. Jonathan Jansen, Vice-Chancellor and Rector, in which he emphasised the need for South Africans to stop accepting mediocrity, if ever the country is to develop to its full potential.

She asked Mr Samuel to convey her message of support to Prof. Jansen and the wheels, which led to today’s great event, were set in motion.

She also expressed her admiration of the transformation process at our university and our commitment to “reconciliation, peace and harmony”. “What has happened at the University of the Free State is nothing short of a miracle and this is truly what the New South Africa is about,” she said to loud cheers from the audience.

To emphasise her point, she called the five workers from the Reitz video to the stage and used their forgiveness and acceptance of the students responsible for the video as an example of the healing achieved at the UFS.

“Having seen this forgiveness has allowed me to expand my vision of what we can be.” She also delivered a message of encouragement and reminded students that anyone, despite their circumstances and background, could become successful and grow to overcome their obstacles, as she had done.

“Anyone can be successful if they put their mind to it, work hard and are diligent,” she said. “We must all strive for more than success, though, and fulfil the highest expression of ourselves as humans by realising who you are and what you are meant to be.”

Following her address, Dr Winfrey answered several questions from our students, giving them advice on, among other things, how to choose a career that is right for them, and good characteristics to look for in leaders and peers.

She also mentioned that several learners from the Oprah Winfrey Leadership Academy, which has its very first group of Grade 12 learners this year, would be visiting our university next month in order to help them select a university to attend next year.

Media Release
25 June 2011
Issued by: Lacea Loader
Director: Strategic Communication
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: news@ufs.ac.za

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