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#ChildhoodCancerAwarenessMonth: Early diagnosis is crucial, significantly improving survival rates

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

“To forgive is not an obligation. It’s a choice.” – Prof Minow during Reconciliation Lecture

2014-03-05

“To forgive is not an obligation. It’s a choice.” – Prof Minow during the Third Annual Reconciliation Lecture entitled Forgiveness, Law and Justice.
Photo: Johan Roux

No one could have anticipated the atmosphere in which Prof Martha Minow would visit the Bloemfontein Campus. And no one could have predicted how apt the timing of her message would be. As this formidable Dean of Harvard University’s Law School stepped behind the podium, a latent tension edged through the crowded audience.

“The issue of getting along after conflict is urgent.”

With these few words, Prof Minow exposed the essence of not only her lecture, but also the central concern of the entire university community.

As an expert on issues surrounding racial justice, Prof Minow has worked across the globe in post-conflict societies. How can we prevent atrocities from happening? she asked. Her answer was an honest, “I don’t know.” What she is certain of, on the other hand, is that the usual practice of either silence or retribution does not work. “I think that silence produces rage – understandably – and retribution produces the cycle of violence. Rather than ignoring what happens, rather than retribution, it would be good to reach for something more.” This is where reconciliation comes in.

Prof Minow put forward the idea that forgiveness should accompany reconciliation efforts. She defined forgiveness as a conscious, deliberate decision to forego rightful grounds of resentment towards those who have committed a wrong. “To forgive then, in this definition, is not an obligation. It’s a choice. And it’s held by the one who was harmed,” she explained.

Letting go of resentment cannot be forced – not even by the law. What the law can do, though, is either to encourage or discourage forgiveness. Prof Minow showed how the law can construct adversarial processes that render forgiveness less likely, when indeed its intention was the opposite. “Or, law can give people chances to meet together in spaces where they may apologise and they may forgive,” she continued. This point introduced some surprising revelations about our Truth and Reconciliation Commission (TRC).

Indeed, studies do report ambivalence, disappointment and mixed views about the TRC. Whatever our views are on its success, Prof Minow reported that people across the world wonder how South African did it. “It may not work entirely inside the country; outside the country it’s had a huge effect. It’s a touchstone for transitional justice.”

The TRC “seems to have coincided with, and maybe contributed to, the relatively peaceful political transition to democracy that is, frankly, an absolute miracle.” What came as a surprise to many is this: the fact that the TRC has affected transitional justice efforts in forty jurisdictions, including Rwanda, Sierra Leone, Cambodia and Liberia. It has even inspired the creation of a TRC in Greensborough, North Carolina, in the United States.

There are no blueprints for solving conflict, though. “But the possibility of something other than criminal trials, something other than war, something other than silence – that’s why the TRC, I think, has been such an exemplar to the world,” she commended.

Court decision cannot rebuild a society, though. Only individuals can forgive. Only individuals can start with purposeful, daily decisions to forgive and forge a common future. Forgiveness is rather like kindness, she suggested. It’s a resource without limits. It’s not scarce like water or money. It’s within our reach. But if it’s forced, it’s not forgiveness.

“It is good,” Prof Minow warned, “to be cautious about the use of law to deliberately shape or manipulate the feelings of any individual. But it is no less important to admit that law does affect human beings, not just in its results, but in its process.” And then we must take responsibility for how we use that law.

“A government can judge, but only people can forgive.” As Prof Minow’s words lingered, the air suddenly seemed a bit more buoyant.

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