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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

Getting out of the dark

2015-06-10

ESKOM is making daily announcements on the status of the power grid.

Anton Calitz, Electrical Engineer at University Estates, is in continuous contact with Eskom and Centlec in an effort to stay abreast of load shedding.

According to Anton, Eskom has recently - the week of 20 April - been focusing on the evening peak, and has announced STAGE 1 load shedding from 17:00-22:00; thus, the Bloemfontein Campus should be able to continue business as usual during the day, except for Thursdays from 18:00 and, possibly, Fridays from 17:00.

Where can I get more information about load shedding stages?

Apart from Eskom’s webpage, staff can also visit GRID WATCH. Click on "Search", then under "Schedules". Look for "Mangaung Local Municipality", and select "GROUP 4". Save this location. “This can even be loaded onto your mobile device.”

“The time slots can be seen for a couple of days in advance, to allow us to plan around the possibility of load shedding in our daily lives,” said Anton.

Please note: ESKOM can change the STAGE level at any time. Therefore, keep an eye on GRID WATCH and News24.

View the typical seven-day planner for the Bloemfontein Campus (Group 4), which indicates the STAGE 2 and 3 possibilities. Take note that, on some days, the STAGE 2 and 3 time slots are the same.

More load shedding tips: Your IT needs

The UFS Data Centre (Computer Room) is fully serviced by a generator facility, and can function without external power supply for a few days.

The generator servicing the UFS data centre does NOT provide power to the outlying facilities. This implies that all digital equipment at gates, booms, and access points will be shut down until the power is restored to these facilities. “We are now, in collaboration with Nico Janse van Rensburg, in a process to install UPS facilities at these points, which will ensure two to three hours of power supply at these points, even during load shedding,” said Dr Vic Coetzee, Senior Director: ICT Services.

No Wi-Fi will be available, as it is dependent on the power supply to the buildings where it is installed.

All servers are contained in the data centre, and will be kept running by our generators.

How to manage load shedding and your IT needs:

1. Get into the habit of saving your work regularly on computer so that you don’t lose your work/files during load shedding.
2. Back up important data. Keep to a schedule of regular back-up. Make sure your computer back-ups are safe and recoverable.
3. Keep all electronic devices charged and ready to run on battery power. Keep your cellphone charged: some old-style Telkom landlines will still operate during power outages, but others won't.
4. Remember, when power supply is restored, it sometimes happens that a power surge is sent through the network, which will damage your computer. Fortunately, laptop computers will not suffer this fate as their power is provided through an external power pack. Often, this power pack will be damaged, but not the laptop itself.
5. It makes good sense to reboot your computer daily, not only in terms of power shedding, but also in terms of updating the drivers, software, etc.
6. Switch off all computers and other electrical equipment at the wall plug overnight and on weekends.
7. Should your IT equipment not switch on after a power outage, log a call with the ICT Services. You can also call them at x2000.

More information, guidelines and contact numbers

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