WeeklySA_AdminVIGILANCE: Survival-rate can be higher with early detection and treatment
By Isaac Moledi
While the world of science has made huge advances in paediatric oncology and medicine, yet cancer remains a leading cause of mortality among children worldwide. Globally, childhood cancer is on the rise with health bodies estimating that one in 408 children worldwide will be diagnosed with cancer before the age of 15 years.
South Africa, like the world’s most technologically advanced countries, has advanced tertiary academic hospitals that have paediatric oncology units that provide specialised treatment. Unfortunately, says locally-based health bodies, less than half of the expected cases are being diagnosed, and, of those diagnosed, most are in stage three or four of the disease. “Yet with early detection and specialised treatment, the survival rate can be much higher,” according to Childhood Cancer Foundation SA (Choc) CEO Hedley Lewis.
As the world observes the International Childhood Cancer Awareness Month, Choc – together with two other locally-based health bodies that include the SA Children’s Cancer Study Group (SACCSG) and the Non-Communicable Diseases of National department of Health (NDOH) – believe that it is imperative that children are diagnosed early for effective treatment of early-stage disease which, the health bodies say, will translate into favourable outcomes and improved overall survival.
“But this can only be successfully done if the disease itself can only be fully understood and early warning signs be shared among parents and stakeholders involved,” said the health bodies in a statement.
Professor Gita Naidu, chair of SACCSG, Sandhya Singh, director at NDOH, were also part of the media statement.
According to Choc, cancer can be described as a group of more than 100 different diseases which are characterised by uncontrolled growth of abnormal cells occurring in multiple phases. With more than 200 different kinds of cancers, the organisation believes that the disease can develop in almost any organ or tissue such as the lung, colon, breast, skin, bones or nerve tissue.
Although more than 50% of people diagnosed with the disease can live for more than five years, Choc believes however that if diagnosed earlier, some cancer patients have survival rate of more than 90%. “Early stage cancer also does not kill. It is for this reason that early diagnosis is so important – it is during early stage cancer that treatment is likely to work best,” says Choc.
But Cancer Research UK believes that cancers can cause death in more than one way. “There is, therefore, no single answer to the question of how cancer kills. It really depends on the type of cancer one has and which parts of the body are affected,” the UK research body says.
Although the three SA health bodies warn of many factors responsible for delays in childhood cancer, including the child’s age, family’s socioeconomic status, parental educational level, distance of residence from the hospital, cancer type, site and stage, Choc also cautions families about what it calls St Siluan’s early signs of cancer.
The body tabulates Siluan’s alphabetically as:
– 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, testicles or glands;
– U – Unexplained fever present for more than 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 of speech, regression, continuous headaches with or without vomiting and enlarged head.
“These are but some of the factors which contribute to patients presenting with advanced disease and resultant poorer outcomes,” says the three health bodies. Teenagers involved in various sports and other activities were particularly warned: “Teenagers, busy with sports and other activities, often do not notice the first symptoms of their cancer, or attribute them to other parts of their lifestyle,” the three health bodies said.
According to the statement by the health organisations, many children in low- and middle-income countries have poor access to hospitals, which, in turn, lack essential diagnostic tests, experience a shortage of nursing medical and surgical personnel, inadequate and erratic supply of basic pharmaceutical and chemotherapeutic agents, including an absence of radiotherapy, surgical and intensive care facilities.
“As neonatal, infant and child health improves in South Africa, communicable diseases, such as respiratory and diarrhoeal diseases, HIV-AIDS, and tuberculosis, are better controlled. It is imperative to focus on non-communicable diseases such as childhood cancer and identify these diseases early, have access to the correct diagnostics and therapeutics and ensure the availability of supportive care to improve overall survival of our children with cancer.” The three health specialists believe that the burden of the SARS-CoV-2 is further testing our fragile African health care systems. “Many caregivers are unemployed due to national lockdowns, there are inadequate transport systems, and caregivers are afraid to venture out of the safety of their homes to seek healthcare as the ever-present danger of contracting Covid-19 lurks.
“Sadly, we may experience even further delays in the diagnosis of childhood cancer. We should endeavour to ensure children with cancer do not face further delays in the diagnosis and treatment of cancer during the global SARS-CoV-2 pandemic.”
According to the three medical specialists, the Siluan Warning Signs for childhood cancer were adopted by the South African Children’s Cancer Study Group and the national Department of Health to promote the early detection. “As Gold September is an annual campaign world-wide to raise awareness of childhood cancer, we encourage the community to be a voice of hope this September and collaborate with health care workers, non-profit organisations, and the Department of Health to spread the Siluan Warning Signs for early cancer diagnosis. This could possibly save the life of a child or teenager,” the three health bodies said.
They also warned against the myths and stigmas around childhood cancer, saying these can create a culture of silence that is not good for promoting diagnosis and accessing treatment. “Choc aims to continue to expand its reach into far-flung regions of the country whilst growing its education campaign,” Lewis said. The three medical specialists advised anyone who is concerned that his or her child or teenager may have cancer or similar symptoms to please refer the child or teenager to the following website https://choc.org.za/choc-patient-referral-pathways/ or contact the Choc helpline at 0800 333 555 immediately.
