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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

Tanya takes over netball reins from big sister
2016-07-04

Description: Tanya Mostert USSA SASPA Tags: Tanya Mostert USSA

Tanya Mostert will lead the University of
the Free State Netball team at the USSA
tournament in Cape Town.

Photo: SASPA

Last year, big sister led the Kovsie team, and now it is the turn of her little sister. Tanya Mostert will be filling the shoes of her big sister, Karla Mostert, when she leads the University of the Free State (UFS) team in the USSA tournament in Cape Town from Monday 4 July 2016.

Karla now helping as defence coach

Karla was captain in Johannesburg in 2015 when the UFS lost against Tuks in the USSA final by 39-48. The star of the Proteas is too old to play for the UFS again, and is now helping out as defence coach. Karla and Lauren-Lee Christians, who won’t be playing in the USSA tournament, were included in the South African Universities Netball team that will compete in the World Student Games in Miami, America, from 13 to 17 July 2016.

The Kovsie Netball team is one of seven UFS sports teams competing in USSA tournaments. The others are hockey (men and women), rugby, badminton, basketball, squash, and volleyball.

Mostert sisters are both natural leaders

Like Karla, Tanya is a natural leader. She was captain of the Zwartkop High School team, as well as the Free State U19 and U21 teams. “It is amazing that two children from the same home are both leaders, even if there is naturally a difference in their leadership style,” says Burta de Kock, the Kovsie coach.
“For me as coach, it is also wonderful to know that they (Karla and Maryka Holtzhausen, Protea captain and Kovsie assistant coach) are prepared to plough back at this young age. They are also role models for the other players.”
According to De Kock, she has a strong USSA group and wants the UFS to perform better than in 2015.

The UFS teams taking part in the USSA tournaments from Monday 4 July 2016 are:

  • Netball (Cape Town)
  • Hockey (men and women, Johannesburg)
  • Rugby (East London)
  • Badminton (Stellenbosch)
  • Basketball (Johannesburg)
  • Squash (Stellenbosch)
  • Volleyball (Pretoria)

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