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16 September 2024 | Story André Damons | Photo Supplied
Dr Mampoi Jonas and Prof Jan Du Plessis
Dr Mampoi Jonas, senior lecturer in Paediatric Oncology and Prof Jan Du Plessis, Head of the Paediatric Oncology Unit at the University of the Free State (UFS).

A campaign like Childhood Cancer Awareness Month is vital in creating awareness and educating people about the early signs and symptoms of certain cancers. This can significantly improve the survival rate of young patients. More than 50% of people diagnosed with cancer live for more than five years, and some types of cancer have survival rates as high as 90%.

This is according to Prof Jan Du Plessis, Head of the Paediatric Oncology Unit, and Dr Mampoi Jonas, senior lecturer in Paediatric Oncology, at the University of the Free State (UFS).

“Early diagnosis is crucial because early-stage cancer is more responsive to treatment and less likely to be fatal. Due to the rarity of childhood cancer, many children get misdiagnosed or diagnosed too late with advanced stage disease. The delayed detection and diagnosis diminish the chances of successful treatment.

“Cancer awareness educates families, communities, primary-care nurses and doctors about the early signs and symptoms of certain cancers. When people are aware of these, they are more likely to be on the lookout for them when children present with suspicious clinical symptoms and signs. This also gives parents the confidence to seek help early and even make people better able to support those with the disease once a diagnosis is made,” say the paediatric oncologists.

Recorded incidences on the rise

Though childhood cancer is rare, representing only 1.2% of all cancers worldwide, the recorded incidences are increasing. In the US cancer is the number one cause of death among children, while more than 100 000 children worldwide die because of cancer.

Prof Du Plessis says there are more than 12 major types of childhood cancers and multiple subtypes. The most common types are leukaemia, lymphoma (tumours that begin in the lymph glands), brain tumours, nephroblastoma (cancer of the kidneys) and soft tissue sarcomas. Most cancers in children are thought to develop as a result of mutations in genes that lead to uncontrolled cell growth and eventually cancer.

According to Dr Jonas, most cancers in children are thought to develop because of mutations in genes that lead to uncontrolled cell growth and eventually cancer. Although environmental pollutants have been implicated in some cancers, our experience has been that most paediatric cancers rather occur sporadically.

The reasons for the increase of reported incidence of cancer in children, could be to the increase in population numbers and better awareness of childhood cancers. Another reason might be that more children are being diagnosed who were previously misdiagnosed, explains Prof Du Plessis.

Treatments

Childhood cancers are treated with chemotherapy, surgery and radiation therapy under the care of a paediatric oncologist. Not much can be done about the genetic mutations, but parents can ensure that their children stay safe in the sun (slip, slop, slap campaign – slip on a shirt, slop on some suncream and slap on a hat), get their children vaccinated against HPV infection, help their children stay active and keep a healthy weight and talk to them about smoking.

Prof Du Plessis says the South African paediatric oncology community are currently busy with a few research studies regarding standardising treatment protocols for certain childhood cancers. This is to find out how our children are responding to these protocols and to see if there are different factors affecting the outcomes of South African children. These protocols are based on international treatment protocols with a few adjustments for local circumstances and resources.

They are involved with the Hodgkins lymphoma, neuroblastoma, retinoblastoma, germ cell tumour studies and contributed to a research study evaluating the nutritional status and interventions to improve the nutritional status of local patients. Registrars presented local (Bloemfontein) data at an international conference (SIOP Africa) on hepatoblastomas and osteosarcomas.

“For many childhood cancer may not be a priority or something they would like to think about. Unfortunately for many of my patient’s parents the truth is that the day before their children were diagnosed with cancer, they were also not a cancer parent. However, their lives changed for ever with these four words: ‘Your child has cancer’.

“Childhood cancer is more than chemo and no hair. It is rather about resilience, strength, hope, family, courage, cuddles, and bravery. Your life will be changed for ever if you have ever seen a child fight cancer. Their smiles will make your heart melt and make you realise the importance of the simple things in life,” declare Prof Du Plessis and Dr Jonas.

Early warning signs for parents

The Childhood Cancer Foundation South Africa (CHOC) has a campaign which emphasises the importance of recognising the early warning signs of childhood cancer. They use Siluan’s Early Warning Signs to raise awareness and promote early diagnosis which are:

• S – Seek medical help early for ongoing symptoms
• I – White spot in the eye, new squint, sudden blindness or bulging eyeball.
• L – Lump on the stomach, pelvis, head, arms, legs, testicle, or glands
• U – Unexplained fever present for over two weeks, weight loss, fatigue, pale appearance, easy bruising, and bleeding
• A – Aching bones, joints, back, and easy fractures

• N – Neurological signs, a change in walk, balance or speech, regression, continuous headaches with/without vomiting, and an enlarged head

While these symptoms can be subtle or easily attributed to other causes, it’s important to consult a doctor if they persist or worsen. If you notice any of these symptoms in a child or teen, seek professional medical help promptly. Early detection of cancer saves lives in both children and teens.

News Archive

Research by experts published in Nature
2011-06-02

 
The members of the research group are, from the left, front: Christelle van Rooyen, Mariana Erasmus, Prof. Esta van Heerden; back: Armand Bester and Prof. Derek Litthauer.
Photo: Gerhard Louw

A  research article on the work by a team of experts at our university, under the leadership of Prof. Esta van Heerden, and counterparts in Belgium and the USA has been published in the distinguished academic journal Nature today (Thursday, 2 June 2011).

The article – Nematoda from the terrestrial deep subsurface of South Africa – sheds more light on life in the form of a small worm living under extreme conditions in deep hot mines. It was discovered 1,3 km under the surface of the earth in the Beatrix Goldmine close to Welkom and is the first multi-cellular organism that was found so far beneath the surface of the earth. The worm (nematode) was found in between a rock face that is between 3 000 and 12 000 years old.

The research can shed some new light on the possibility of life on other planets, previously considered impossible under extreme conditions. It also expands the possibilities into new areas where new organisms may be found.

These small invertebrates live in terrestrial soil subjected to stress almost for 24 hours They live through sunshine, rain, scorching temperatures and freezing conditions. Through time they developed a means to cope with harsh conditions. Terrestrial nematodes (roundworms, not to be confused or related to earthworms) are among those very tough small invertebrates that deal with those conditions everywhere. After insects they are the most dominant multi-cellular (metazoan) species on the planet having a general size of 0,5 to 1 mm and are among the oldest metazoans on the planet, Nature says in a statement on the article.

They inhabit nearly every imaginable habitat form the deep seas to the acid in pitcher . Some nematodes simply eat bacteria and these are the ones we study here. Terrestrial nematodes have developed a survival stage that can take them through hard times (absence of food, extreme temperatures, too little oxygen, crowding, and more).

At the head of the research was Prof. Gaetan Borgonie of the Ghent University in Belgium and a world leader in the discipline of nematode research. He was brought into contact with the South African research leader, Prof. Esta van Heerden, who set up a cooperation agreement with the University of Ghent and Prof. Borgonie. Prof. Van Heerden manages the Extreme Biochemistry group at the UFS and the research was funded by several research grants.

The search for worms began in earnest in 2007, but it was soon clear that the sampling strategy was insufficient. A massive sampling campaign in 2008-2009 in several mines led to the discovery of several nematodes and the new nematode species Halicephalobus mephisto. It is named after the legend of Faust where the devil, also known as the lord of the underworld is called Mephistopheles.

Nature says special filters had to be designed and installed on various boreholes. Unfortunately, there is no easy way of finding a magic formula and designs had to be adapted by trial and error; improving existing designs all the time. The work of the UFS Mechanical Workshop, which manufactured, adapted and helped design it, was crucial in this respect. Filters were left on the holes for varying periods, sometimes for a few hours and sometimes for months. Prof. Derek Litthauer from the UFS played a big role in sampling, filter designs and coming up with ideas for names for the new nematode with Prof. Borgonie.

Research showed that the nematodes can live in the deep for up to 12 000 years. Three students – Armand Bester, Mariana Erasmus and Christelle van Rooyen from the UFS – did the work on this.

The importance of multi-cellular animals living in the ultra-deep subsurface is twofold: The nematodes graze on the existing bacterial population and influence their turnover. Secondly, if more complex multi-cellular organisms can survive in the deep subsurface on earth, this may be good news when looking for life on other planets where the surface is considered too inhospitable (e.g. Mars). Complex life forms can be found in ecosystems previously thought to be uninhabitable. Nature says this expands the possibilities into new areas where new organisms may be discovered.

Future research will focus on selective boreholes to look for more metazoans, so that a better idea of the complexity of the ecosystems there can be obtained. It will also look for metazoans in the deep subsurface on other continents to determine similarities and differences.

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