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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 for web 
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).  


DrJonas for web
Dr Mampoi Jonas is a senior lecturer in the Paediatric Oncology, University of the Free State (UFS).

News Archive

UFS venture cleans up acid mine drainage
2015-07-06

The system that puts oxygen back into the water.

Photo: Supplied

South Africa is one of the most important mining countries in the world, beginning in the 1870s. Although the mining industry has been responsible for significant development and employment, it pollutes the environment and waters sources. Through the joint effort of a well-known mining company, the University of the Free State, and the Technology Innovation Agency (UFS/TIA) SAENSE Group, a new treatment for Acid Mine Drainage (AMD) has been developed.

The system treats the major contaminants found in acid mining wastewater effectively.  
 
The UFS remediation systems use a reservoir tank into which the AMD is pumped. The water then flows passively (without using energy) to the Barium Carbonate Dispersed Alkaline Substrate (BDAS) system. The metals and anions in the AMD react chemically with the barium carbonate and precipitate (form solids). The solids stay in the tank while the clean water is released.

The efficacy and applicability of the research was demonstrated on site in Belfast, Mpumalanga where the team constructed a pilot plant in July 2014. This patented technology has treated 1 814 400 litres of Acid Mine Drainage to date with an outflow water quality that satisfies the South African National Standards (SANS) 241:2006 & 2011 regulations for drinking water.   

Rohan Posthumus from the (UFS/TIA) SAENSE Group said: “At this stage, we do not recommend that the water should be used as drinking water, but certainly it can lower water usage in mines while finding application in dust suppression of washing processes. The team would like to complete a full characterisation of the final released water. There are currently no toxic by-products formed, and even very basic filtration can make the outflow drinking water.”

Prof Esta van Heerden’s research group from the Department of Microbial, Biochemical, and Food Biotechnology has been working on AMD research for some time, but the development of the BDAS system was started in 2013 by post-doctoral student, Dr Julio Castillo, and his junior researcher, Rohan Posthumus.

The data from the BDAS system have led to two publications in peer-reviewed journals as well as a registered patent.

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