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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 hikers to Cape Town reflect on their journey

2014-05-26

For the four volunteers from the university who are currently on their way to the Cape on foot, every hour of every day is a victory.

It is three weeks since two employees from the University of the Free State (UFS), Adéle van Aswegen and Ntokozo Nkabinde, together with two other Bloemfontein residents, Nico Piedt and Ronel Warner, left Bloemfontein on fóót for the Cape, in order to highlight the problem of food insecurity among students.

On Sunday 18 May they crossed the halfway mark at Beaufort West and will conclude their journey on Tuesday 3 June in Cape Town.

This is what the hikers have to say after three weeks on the road:

Adéle van Aswegen
It isn’t only a physical journey, but rather an emotional journey you undertake. You learn what it means to be truly thankful for basic things like clothes, a place to sleep and food.

Nico Piedt
I know what it feels like to survive on only a glass of water in your stomach – a cup of weak tea if you’re lucky – for the whole day. If I can help (through the hike) to give someone a better chance in life, then it is worthwhile.

Ronel Warner
You think and grow simultaneously. As you plan every stride ahead of you, you also plan your life ahead.

Ntokozo Nkabinde
You don’t walk for yourself. You undertake this journey, maybe because you want to help someone, but this journey is actually in honour of something bigger and you just have to endure.”

These boots are made for walking ... to Cape Town (Article of 02 May 2014)
“Aren’t auntie and them hungry yet?” Country folk worried about NSH hikers (15 May 2014)

Daily updates:
(You can also follow us on @UFSweb for daily tweets)

Day 33: 2 June 2014
13:40
20 km
Sunset Beach, Cape Town

Day 32: 1 June 2014
16:05
26 km
Mervyn and Sanet Wessels, Belville

Day 31: 31 May 2014
16:31
39.6 km
Rhonell and Gavin Julain, Paarl

Day 30: 30 May 2014
14:00
16 km
Monte Rosa, Rawsonville

Day 29: 29 May 2014
13:16
31 km
The Habit, Worcester

Day 28: 28 May 2014
11:00
22.4 km
Monte Roza, De doorns

Day 27: 27 May 2014
17:00
21.1 km
Karoo Hotel

Day 26: 26 May 2014
18:27
43.3 km
Tows river

Day 25: 25 May 2014
12:18
Lord Milner Hotel, Matjiesfontein

Day 24: 24 May 2014
16:30
42 km
Laingsburg Country Lodge

Day 23: 23 May 2014
17:32
41.8 km
Vergenoeg

Day 22: 22 May 2014
16:42
43 km
Assendelft Lodge and Bush Camp, Prins Albert

Day 21: 21 May 2014
15:09
42 km
Leeu Gamka Hotel

Day 20: 20 May 2014
13:39
20 km
Alida, Springfontein

Day 19: 19 May 2014
12:31
27.6 km
Teri Moja Game Lodge

Day 18: 18 May 2014
First rest day
Nagenoeg Guesthouse, Beaufort West

Day 17: 17 May 2014
19:30
62.3 km
Nagenoeg Guesthouse, Beaufort West

Day 16: 16 May 2014
13:00
14 km
Taaibochfontein

Day 15: 15 May 2014
16:03
32 km
Travalia, Three Sisters

Day 14: 14 May 2014
18:33
43 km
Joalani Guest Farm

Day 13: 13 May 2014
17:30
33 km
Die Rondawels

Day 12: 12 May 2014
16:49
40 km
Aandrus B&B in Richmond

Day 11: 11 May 2014
39 km
Wortelfontein (Magdel and Christiaan)

Day 10: 10 May 2014
15:44
34 km
Hanover Lodge

Day 9: 09 May 2014
40.8 km
Camping between Colesberg and Hanover

Day 8: 08 May 2014
15:25
33.7 km
Colesberg, The Lighthouse Guesthouse

Day 7: 07 May 2014
15:08
23 km
Orange River Lodge

Day 6: 06 May 2014
15:57
51.06 km
Gariep Forever Resort

Day 5: 05 May 2014
12:18
28 km
Rondefontein

Day 4: 04 May 2014
15:27
35 km
Trompsburg: Fox Den

Day 3: 03 May 2014
17:30
46.74 km
Edenburg Country Lodge (Hotel)

Day 2: 02 May 2014
11:44 am
15.3 km
Tom's Place

Day 1: 01 May 2014
32 km
Leeuwberg

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