Of the 800 to 1 000 children diagnosed with cancer in SA each year, more than half tragically go undiagnosed until their disease is at an advanced stage.
Dr Charlotte Ingram, Medical Director at the SA Bone Marrow Registry (SABMR), says SA has among the highest childhood cancer mortality rates, with two thirds of children never reaching a specialist treatment centre and, when they do, their cancer is often at an advanced stage.
“Many childhood cancers are treatable with cure rates of between 70% and 80% in well-resourced countries, while in contrast, eight in 10 African children with cancer die without access to adequate care. Despite SA having an established oncology health care service, its infrastructure is overburdened, which is further impeded by low cancer awareness in the primary health care setting and widespread service delivery challenges.”
She says unlike adult cancers, childhood cancer is difficult to prevent or screen for because the causative genetic and environmental factors are less understood. If detected early, however, most children can be treated successfully.
“Knowing what the early warning signs are is vital for treatment to commence as soon as possible. Unfortunately, among certain local ethnic groups, there is still a lot of stigma and myths that surround childhood cancer. Some of these include:
Two of the most common childhood cancers in SA are leukaemia and lymphoma.
Leukaemia is caused by a rise in the number of white blood cells in the body and accounts for a quarter of all childhood cancer cases in the country. Early symptoms include chronic fatigue, bone and joint pain, weakness, easy bleeding or bruising, recurrent nosebleeds, swollen lymph nodes, fever and unexplained weight-loss.
Lymphoma is triggered by tumours that begin in the lymph glands, the spleen, thymus gland and bone marrow and can affect other organs throughout the body as well. Look out for painless swelling of lymph nodes in the neck, armpits or groin, persistent fatigue, fever, night sweats, weight-loss and itchy skin. If any of these signs or symptoms persist, its best to make an appointment with a doctor who will be able to conduct tests to rule out the possibility of blood-related cancers.
Dr Ingram explains that in many cases, a bone marrow transplant, which is also referred to as a stem cell transplant, is used to treat leukaemia and lymphoma and other blood and immune system diseases that affect the bone marrow.
“Childhood cancers are different from those found in adults as most of them occur in developing cells such as bone marrow, blood, the kidneys and nervous system tissues. Chemotherapy kills both cancerous and healthy blood cells inside the bone marrow, which is why transferring a new, healthy set of blood stem cells by way of a bone marrow transplant, helps their immune systems to recover from the intense treatment.
“At the moment, SA’s overall childhood cancer survival rate is at an unacceptably low 52%, nearly 30% less than in developed nations. In 2018, the World Health Organisation established the Global Initiative for Childhood Cancer, which aims to achieve a global survival rate of at least 50% for all children diagnosed with cancer within the next decade.”
To deliver on that promise, policymakers need to prioritise childhood cancer by:
1. debunking the misconceptions around childhood cancer among a large percentage of the population;
2. increasing our country’s capacity to deliver quality services for children living with the illness, along with access to care;
3. while also increasing the number of bone marrow donors. Currently, only 73 000 donors are part of the national registry.”
**Do your bit by helping the SABMR spread awareness around childhood cancer this month by sharing its social media posts with family and friends:
If you are between the ages of 16 and 45 and want to become a donor, contact the SABMR on 021 447 8638 or e-mail: email@example.com. Financial donations can also be made via www.sabmr.co.za/donate to help boost funds for their Patient Assistance Programme.
**The SABMR (NPO) was established in 1991, motivated by the concern that although bone marrow transplants were a life-saving treatment option, they were only available to patients with a matching donor in their family. Today, the SABMR searches both locally and internationally for donors, thereby making collaboration with international registries and observing universal standards of practice essential.