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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

Researchers international leaders in satellite tracking in the wildlife environment

2015-05-29

Ground-breaking research has attracted international media attention to Francois Deacon, lecturer and researcher in the Department Animal, Wildlife and Grassland Sciences at the UFS, and Prof Nico Smit, from the same department. They are the first researchers in the world to equip giraffes with GPS collars, and to conduct research on this initiative. Recently, they have been joined by Hennie Butler from the Department of Zoology as well as Free State Nature Conservation to further this research.

“Satellite tracking is proving to be extremely valuable in the wildlife environment. The unit is based on a mobile global two-way communication platform, utilising two-way data satellite communication, complete with GPS systems.

“It allows us to track animals day and night, while we monitor their movements remotely from the computer. These systems make possible the efficient control and monitoring of wildlife in all weather conditions and in near-to-real time. We can even communicate with the animals, calling up their positions or changing the tracking schedules.

“The satellite collar allows us to use the extremely accurate data to conduct research with the best technology available. The volume of data received allows us to publish the data in scientific journals and research-related articles.

“Scientific institutions and the public sector have both shown great interest in satellite tracking, which opens up new ground for scientific research for this university. Data management can be done, using Africa Wildlife Tracking (AWT) equipment where we can access our data personally, store it, and make visual presentations. The AWT system and software architecture provide the researcher with asset tracking, GPS location reports, geo-fencing, highly-detailed custom mapping, history reports and playback, polling on demand, history plotting on maps, and a range of reporting types and functions,” Francois said.

Data can be analysed to determine home range, dispersal, or habitat preference for any specific species.

Francois has been involved in multiple research projects over the last 12 years on wildlife species and domesticated animals, including the collaring of species such as Black-backed Jackal, Caracal, African Wild Dog, Hyena, Lion, Cheetah, Cattle, Kudu, Giraffe, and Black Rhino: “Giraffe definitely being the most challenging of all,” he said.

In 2010, he started working on his PhD, entitled The spatial ecology, habitat preferences and diet selection of giraffe (Giraffa camelopardalis giraffa) in the Kalahari region of South Africa.

Since then, his work has resulted not only in more research work (supervising four Masters students) but also in a number of national and international projects. These include work in the:

Kalahari region (e.g. Khamab Nature Reserve and Kgalagadi Transfrontier Park)
Kuruman region (Collared 18 cattle to identify spatial patterns in relation to the qualities of vegetation and soil-types available. This project took place in collaboration with Born University in Germany)
Woodland Hills Wildlife Estate and Kolomella Iron Ore – ecological monitoring
A number of Free State nature reserves (e.g. Distribution of herbivores (kudu and giraffe) and predators (camera traps)

Francois is also involved with species breeding programmes and management (giraffe, buffalo, sable, roan, and rhino) in Korrannaberg, Rustenburg, Hertzogville, Douglas, and Bethlehem as well as animal and ecological monitoring in Kolomella and Beesthoek iron ore.

Besides the collaring of giraffes, Francois and his colleagues are involved in national projects, where they collect milk from lactating giraffes and DNA material, blood samples, and ecto/endo parasites from giraffes in Southern Africa.

With international projects, Francois is working to collect DNA material for the classification of the nine sub-species of giraffe in Africa. He is also involved in projects focusing on the spatial ecology and adaptation of giraffe in Uganda (Murchison Falls), and to save the last 30 giraffe in the DRC- Garamba National Park.

This project has attracted a good deal of international interest. In June 2014, a US film crew (freelancing for Discovery Channel) filmed a documentary on Francois’ research (trailer of documentary). Early in 2015, a second crew, filming for National Geographic, also visited Francois to document his work.

More information about Francois’ work is available at the GCF website.

Read Francois Deacon's PhD abstract

Direct enquiries to news@ufs.ac.za.

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