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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).

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Graduates convene with global leaders at the UFS 2015 Winter Graduation ceremonies

2015-07-07

Dr Hendrik Auret, dr Gerhard Bosman en dr Madelein Stoffberg.
Foto: Leonie Bolleurs

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The University of the Free State’s 2015 Winter Graduations, which took place from 1-2 July 2015 on the Bloemfontein Campus offered several highlights. Three global leaders received honorary doctorates. A further 2 000 degrees and diplomas were conferred to graduates in the seven faculties of the university.

For the first time in the history of the UFS, three PhDs in Architecture were awarded simultaneously. Hendrik Auret, Gerhard Bosman, and Madelein Stoffberg’s outstanding achievements are a milestone in the university’s pursuit of academic excellence.

Furthermore, three PhDs were conferred on graduates from the Department of Consumer Science in the Faculty of Natural and Agricultural Sciences. Ismari van der Merwe, Natasha Cronje, and Gloria Seiphetlheng set a precedent when they walked across the Callie Human stage to collect their doctorates at the same graduation ceremony.

This year, the university produced 66 Doctors of Philosophy in various fields of study. Six of these PhDs were awarded in the Department of Physics. Three graduates in the Department of Soil- and Crop- and Climate Sciences received PhDs at the Winter Graduation. They are Tesha Mardamootoo, Elmarie Kotzé, and David Chemei.

Dr John Samuel.
Photo: Johan Roux

Keynote speakers provide enlightenment to graduates

On Wednesday 1 July 2015, Dr John Samuel, SA’s leading education expert, addressed 707 diploma graduates from the Centre for Financial Planning Law and the School of Open Learning. For the graduates’ future reference, Samuel offered invaluable knowledge he had accumulated over the years as Chief Executive of the Nelson Mandela Foundation. “One of the lessons I have learnt was not only the importance of time, but it was in fact what being on time demonstrated,” he said. “Being on time was demonstrating respect, respect for the people you are meeting, and for the occasion.”

On the second day of graduation, Nataniël, South African singer, songwriter, and entertainer spoke to Master’s and doctoral graduates in the Faculties of Economic and Management Sciences, Humanities, Education, Health Sciences, Law, Theology, and Natural and Agricultural Sciences. His keynote spoke to the graduates’ sense of resolve in saying, “nothing is ever accidental. It is always with a purpose, it is your turn to make the world a better place.” He added that “it is important to strive for excellence and to be proud of what you are doing.”

Honorary doctorate recipients in a nutshell

Dr Samuel is one of the three exceptional global leaders to receive honorary doctorates from the university on 1 July 2015. His accolade was presented by the Faculty of Education. He has contributed to the Public Participation Education Network (PPEN) campaign as a founding member. He established the Centre for Education Policy Development, the Joint Working Group (for The National Party Government and the ANC), the National Education Conference, and the National Education and Training Forum. In addition, he made leadership contributions to the First Education and Training White Paper, the first Green Paper on Higher Education, and is the CEO of the Oprah Winfrey Leadership Academy for Girls. The WK Kellogg Foundation in the USA operates under his directorship.

Professor Heidi Hudson, Director of the Centre for Africa Studies at the UFS and Dr Lakhdar Brahimi.
Photo: Mike Rose from Mike Rose Photography

Dr Lakhdar Brahimi received an honorary doctorate from the Centre for Africa Studies. Algerian-born Brahimi was first involved with the United Nations (UN) in 1992, and has since been deployed all over the world on peacekeeping missions. Amongst many other countries, he has worked as a mediator for South Africa, Haiti, Afghanistan, Iraq, Syria, Democratic Republic of Congo, Cameroon, Burundi, Angola, Liberia, Nigeria, Sudan, and Côte d’Ivoire on behalf of the UN. He also played a direct role in South Africa’s democratic transition as a special representative in 1993/4.

Dr Mercy Amba Oduyoye received an honorary doctorate from the Faculty of Theology. Dr Oduyoye is widely regarded as one of the most influential women theologians in Africa. She was the first black woman to receive a degree in Theology in 1965 from Cambridge University in the United Kingdom. She continues to shift the paradigm of gender in theology internationally as the director of the Institute of African Women in Religion and Culture at the Trinity Theology Seminary in Ghana.

Dr Mercy Oduyoye.
Photo: Johan Roux

In closing the academic celebrations

Vice Rector: Academic, Dr Lis Lange, commended the class of 2014 for making their contribution to the educational system. Prof Jonathan Jansen, Vice Chancellor and Rector, also congratulated the graduates in closing.

“This is a day many have worked very hard towards, it is an enormous achievement as well as a development in the quality of research, and the courage to research,” he said in a vote of confidence.

Dr Khotso Mokhele, Chancellor of the UFS, applauded the university in light of the increased number of female graduates who completed their degrees with distinctions. The transcendence of demographics, both in terms of gender and race, on a postgraduate level, increases the hope of achieving gender equality in both the academic arena and South Africa.

More graduation news

A number of distinctions were also awarded during the two-day ceremony. For a list of these distinctions, follow this link.

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