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Improving childhood cancer cure

Monday November 23 2020
cancer pic

Cancer in children can occur anywhere in the body, including the blood and lymph node systems, brain and spinal cord (central nervous system), kidneys, and other organs and tissue.

Cancer begins when healthy cells grow out of control. In most types of cancer, these cells form a mass called a tumour, which can be cancerous or benign.

A cancerous tumour is malignant, meaning it can grow and spread to other parts of the body. A benign tumour means the tumour can grow but will not spread to distant parts of the body.

According to the World Health Organisation, cancer is a leading cause of death for children and adolescents around the world and approximately 300,000 children aged 0 to 19 years old are diagnosed with cancer each year.

In 2017, the International Agency for Research on Cancer revealed a global 13 per cent rise in childhood cancers.

Tanzania is one of the countries with the highest incidence of childhood cancers in Sub-Saharan Africa, with 3,501 child cancer cases, according to Cancer Country Profile 2020.

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With this, many cases are not reported as many parents are not aware that children too can suffer from cancer. Medical experts reassure that many childhood cancers are curable once they are detected early.


Common childhood cancers

Burkitt’s lymphoma is one of the most common type of cancer among children in Tanzania. This cancer, that causes swelling of the jaw or neck in a fast-growing tumour, is associated with impaired immunity and can be fatal if not treated.

“It manifests as a swelling in the jaw,” Dr Nixon Niyonzima of Uganda Cancer Institute (UCI) says, adding: “Most times, it might begin as a simple toothache that leads to a persistent swelling which some parents associate with witchcraft.”

Wilms tumour presents with keloids and swellings in the glands or neck, genitalia, and mouth. Acute Leukemia is the third commonest childhood cancer.

Others include Kaposi Sarcoma, Hodgkins Lymphoma, Lymphoblastic, Osteosarcoma (bone cancer), brain, and eye cancers.


Causes

As with adult cancers, the cause of childhood cancers is not known but some researchers have tagged Wilms tumour to poor development of kidneys during the foetal stages.

A few are linked to genetic predisposition while others are HIV/Aids related, especially Kaposi Sarcoma.


Warning signs

The warning signs of childhood cancers, according to the American Cancer Society include lumps or painless swellings without fever or other signs of infection, bruising or bleeding, general bone pain, unexplained weight loss, persistent coughs, shortness of breath, and night sweats.

Others include unexplained abdominal swelling, visual loss and bruising or swelling around the eyes.

However, the symptoms of some of the childhood cancers according to Dr Henry Ddungu, an oncologist at the UCI, mimic those of many common diseases. Therefore, parents must be vigilant and see a doctor for anything that could be suspicious.

“Many cancers are misdiagnosed as fevers and by the time the children are brought to the cancer institute, the cancer has spread to other parts of the body because the symptoms were similar to those of other illnesses such as malaria. Parents should, therefore, report anything suspicious because with early diagnosis, chances of the child recovering are higher,” says Dr Ddungu.


Treatability

‘‘Many children that we receive at the cancer institute present with cancer in the late-stages, which makes survival harder. Some are mistakenly treated for tuberculosis, brucellosis or malaria yet it is actually cancer,’’ Dr Ddungu explains, adding that children respond faster to treatment compared to adults, when diagnosed early and given social support.

The treatment of childhood cancers can be effective once there is consistency in taking the prescribed drugs.

“All childhood cancers are curable, even in Tanzania, Dr Ddungu says, but it depends on how early the cancer is detected and how the family supports the child, especially when it comes to taking their medication,” he adds.

Depending on the type and level of the cancer, a child may receive surgery, radiotherapy and chemotherapy. However, Dr Niyonzima says if there was early diagnosis, such a child may only require chemotherapy.

“Treatment of childhood cancers is not only about the availability of the drugs but the support from parents and caretakers by making sure the child takes their drugs consistently so that they can complete their treatment in the required time.”

“Burkitt’s Lymphoma is the first ever known cancer to be cured by chemotherapy, but only once detected early,” says Dr Niyonzima.

He adds that a person should have continuous checks until the cancer is ruled out.


Challenge

Several researches have been geared towards treating the cancer. The challenge, however, is that since children have not lived long enough for the signs of cancer to manifest, there is no regular screening programme for childhood cancers. Sometimes, the cancers are mistakenly treated as other illnesses.


Cost

The cost of treating a child with cancer may be hard to estimate according to Dr Ddungu because different cancer types require different drug combinations, and all this is dependent on the stage at which the child is diagnosed.

“The drugs are expensive and it is hard to estimate how much it costs to treat a child with cancer since different cancers require different drug combinations and the patients report at different stages,” he says.


Talking with your child about cancer

As you talk with your child, begin with the knowledge that you know your child best. Your child depends on you for helpful, accurate, and truthful information. Your child will learn a lot from your tone of voice and facial expressions, so stay calm when you talk with your child.

The age-related suggestions below may be helpful as you work with the health care team, so your child knows what to expect during treatment, copes well with procedures, and feels supported.

Less than one year old: Comfort your baby by holding and gently touching her. Skin to skin contact is ideal.

Bring familiar items from home, such as toys or a blanket. Talk or sing to your child, since the sound of your voice is soothing. Try to keep up feeding and bedtime routines as much as possible.

One to two years old: Very young children understand things they can see and touch. Toddlers like to play, so find safe ways to let your child play. Toddlers also like to start making choices, so let your child choose a sticker or a flavour of medicine when possible.

Prepare your child ahead of time if something will hurt. Not doing so may cause your child to become fearful and anxious.

Three to five years old: To help your child understand his treatment better, ask the doctor if he can touch the models, machines, or supplies (tubes, bandages, or ports) ahead of time.

If a procedure will hurt, prepare your child in advance. You can help to distract your child by reading a story or giving her a stuffed animal to hold.

Six to 12 years old: School-aged children understand that medicines and treatment help them get better.

They are able to cooperate with treatment but want to know what to expect. Children this age often have many questions, so be ready to answer them or to find the answers together.

Relationships are important, so help your child to stay in touch with friends and family.

If your child is a teenager: Teens often focus on how cancer changes their lives, their friendships, their appearance, and their activities.

They may be scared and angry about how cancer has isolated them from their friends. Look for ways to help your teen stay connected to friends and include them in treatment decisions.

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By Beatrice Nakibuuka & Your Health Reporter