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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 receives R13,7 Million for Research into Prehistoric Organisms

2007-03-27

Some of the guests attending the launch of the research contract are: Dr Siyabulela Ntutela (Deputy Director: Biotechnology at the Department of Science and Technology), Dr Godfrey Netswera (Manager of Thuthuka and the Support Programme at the National Research Foundation (NRF)), Dr Esta van Heerden (Platform Manager and lecturer at the Department of Microbial, Biochemical and Food Biotechnology at the UFS), Mr Butana Mboniswa (Chief Executive Officer of BioPAD), and Mr Vuyisele Phehani (Portfolio Manager for BioPAD).
Photo: Leonie Bolleurs

The University of the Free State (UFS) has been awarded a massive R13,7 million contract to conduct research into prehistoric micro-organisms which live under extreme conditions, for example in mineshafts.

This is one of the biggest research contracts awarded to the UFS in recent years.

The biotechnology research contract was awarded to the UFS by BioPAD, a South African biotechnology company that brokers partnerships between researchers, entrepreneurs, business, government and other stakeholders to promote innovation and create sustainable biotechnology businesses.

The project is endorsed by the Department of Science and Technology and the National Research Foundation (NRF), which contributes to the bursaries of the 17 postgraduate students on the programme.

The contract involves the establishment of a Platform for Metagenomics - a technique which allows researchers to extract the DNA from microbes in their natural environment and investigate it in a laboratory.

“Through this platform we will be able to understand deepmine microbial populations
and their potential application in the search for life in outer space. It is most likely
that, if life were to be found on other planets in our solar system, it would probably
resemble that which existed millions of years ago on earth. Apart from all this, these
organisms have unique properties one can exploit in biotechnological application for
South Africa and its community,” said Dr Esta van Heerden, platform manager and
lecturer at the UFS Department of Microbial, Biochemical and Food Biotechnology.
She is assisted by her collegues, Prof. Derek Litthauer and Dr Lizelle Piater.

“The platform aims to tap into the unique genetic material in South African mines
which will lead to the discovery of new genes and their products. These new and unique products will find application in the medical field (anti-cancer, anti-bacterial en anti-viral cures), the industrial sector (nanotechnology, commercial washing agents and the food industry), environmental sector (pollution management, demolition of harmful metals and other toxic waste),” said Dr Van Heerden.

According to Dr Van Heerden, the Metagenomics Platforms stems from the Life in
Extreme Environments (LExEN) programme which was started in 1994 by Princeton
University in the United States of America (USA) in South African mines with grants
from among others the National Aeronautics and Space Administration (NASA) and
the National Science Foundation (NSF) in the USA. Other international collaborators
on the project include Geosynec Consultants Inc. (USA), Oak Ridge National
Laboratory (USA), the University of Tennessee (USA) and in South Africa the
Universities of the Witwatersrand, North West and Limpopo and companies like BHP
Billiton, MINTEK and mining companies like Harmony, Gold Fields and AngloGold
Ashanti.

The research field laboratory of the Metagenomics Platform, which was situated in
Glen Harvey, was moved to the Main Campus of the UFS in Bloemfontein. “In this
way the university has become the central hub for all research programmes. We are
also the liaison between the LExEN programme and the various mining companies
involved,” said Dr Van Heerden. The new laboratory was introduced during the
launch of the research contract.

“Our decision to commit BioPAD to this project stems from the company’s commitment to advance human capacity development to strengthen South Africa’s research infrastructure. It is also part of our aim to create and protect intellectual property,” said Mr Butana Mboniswa, Chief Executive Officer of BioPAD.

Talking on behalf of the UFS senior management, Prof. Teuns Verschoor, Vice-Rector
of Academic Operations, said that the university shares the excitement to be part of
the exploration of unknown forms of life, the discovery of new genes and
their products and in applying newly gained knowledge to better understand our
universe.

Media release
Issued by: Lacea Loader
Assistant Director: Media Liaison
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl@ufs.ac.za
27 March 2007

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