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Rumbidzayi Zinyuke
Health Buzz
Anyone who has seen the impact that cancer, any form of cancer, has on an adult, will testify that it is no child’s play.
The disease itself can irreversibly alter one’s life and when diagnosed, the treatment will further take its toll on the same body.
The pain is unbearable.
And the thought of giving up on life often crosses their minds. Sadly, many have given up.
Now imagine this same situation for a child.
If a grown man or woman can say they have reached their limit on pain, how then will the scale of pain favour a child with the same disease?
It would definitely be catastrophic!
Many children across the world suffer a fate such as this.
They have to endure the same pain, the same rigorous treatment and the same fate as the adults once cancer invades their small bodies.
Each year, an estimated 300 000 children and adolescents aged 0-19 years across the world develop cancer, according to the World Health Organisation.
But the likelihood of surviving a diagnosis of childhood cancer depends on the country in which that child lives.
Data shows that more than 80 percent of children with cancer in high-income countries are cured, but the figure slumps to less than 30 percent in low- and middle-income countries.
This means that more children in poor countries are dying from cancer, when they could be treated and afforded a chance to lead a normal life.
According to the National Cancer Registry report, the number of children diagnosed with cancer in Zimbabwe stood at 293 (age 0-14) in 2018.
While the figure might seem low, it could have been much higher had all the children with cancer been identified.
In the same year, paediatric cancers accounted for 3,7 percent of all the cancers recorded in the country.
The most common paediatric cancers recorded in 2018 was leukaemia, accounting for 18 percent of all childhood cancers, followed by renal tumours (17 percent), retinoblastoma (15 percent), lymphoma (13 percent), soft tissue (11 percent), central nervous system (8 percent), bone tumours (6 percent) and neuroblastoma (3 percent). Other unspecified malignant tumours accounted for 9 percent of the childhood cancers.
It is so sad that many of the children with cancer die because they do not receive the proper diagnosis or simply remain undiagnosed.
September is Childhood Cancer Awareness Month and it brings our focus on this often neglected group.
While the world shifts its focus to childhood cancers for a month, the question remains: is enough being done to raise awareness of cancer in children throughout the year?
Surely with more awareness, particularly in the developing countries like Zimbabwe, children with cancer can be identified early and be able to receive life-saving treatments.
Cancer is indeed one of the leading causes of death for children and adolescents and for those in poor countries, it is compounded by inability to obtain an accurate diagnosis, inaccessible therapy, abandonment of treatment, death from side effects and avoidable relapse.
Cancer can affect any part of the body and begins with genetic change in single cells, which then grow into a mass (or tumour), that invades other parts of the body and causes harm and death if left untreated.
Like all cancers, some general signs and symptoms include fatigue, lump that can be felt or seen under the skin, weight changes, skin changes (yellowing, darkening or redness of the skin), sores that will not heal, changes in bowel or bladder habits, persistent cough or trouble breathing, difficulty swallowing, persistent unexplained muscle or joint pain and unexplained bleeding or bruising.
There are many more symptoms associated with childhood cancers.
“Unlike cancer in adults, the vast majority of childhood cancers do not have a known cause. Many studies have sought to identify the causes of childhood cancer, but very few cancers in children are caused by environmental or lifestyle factors,” says the WHO.
Available data suggest that approximately 10 percent of all children with cancer have a predisposition because of genetic factors.
The global health body also says chronic infections, such as HIV, Epstein-Barr virus and malaria, are also risk factors for childhood cancer while other infections can increase a child’s risk of developing cancer as an adult.
This is why vaccination against conditions and viruses such as hepatitis B and human papillomavirus (HPV) are important to help prevent liver cancer and cervical cancer respectively.
Since it is not possible to prevent cancer among children, experts believe that countries need to focus on prompt and correct diagnosis which is followed by effective treatment.
When identified early, cancer is more likely to respond to effective treatment and result in a greater probability of survival, less suffering, and often less expensive and less intensive treatment.
Significant improvements can be made in the lives of children with cancer by detecting cancer early, avoiding delays in care and correct diagnosis.
This is essential in the treatment of children with cancer.
For a diagnosis to be made early, it becomes important for families and caregivers to be aware of the symptoms of cancer.
But many children, particularly in marginalised areas, rarely receive the needed diagnosis on time.
Chief Government ophthalmologist and head of the Sekuru Kaguvi eye hospital Dr Boniface Macheka last year said it was unfortunate that many children with eye cancer (retinoblastoma) were only being diagnosed after the cancer had spread to both eyes.
“We are trying to put awareness messages and pictures on the next road-to-health card.
“This way we can increase awareness even from the clinics where nurses who administer routine vaccinations to children can help to identify eye cancer early. Even when the mothers see the pictures on the card, they can quickly seek assistance,” he said then.
According to studies, most children (95 percent) with eye cancer who begin treatment before the retinoblastoma has spread beyond the eye, can be cured and their vision saved.
Early diagnosis is relevant in all settings and improves survival for all cancers.
It can also help ensure that the child gets the appropriate therapy that is commensurate with the type and extent of the disease.
Therapies that can be offered include chemotherapy, surgery and or radiotherapy.
In 2018, WHO launched, with the support of St. Jude Children’s Research Hospital, the Global Initiative for Childhood Cancer, to provide leadership and technical assistance to governments to support them in building and sustaining high-quality childhood cancer programmes.
The goal is to achieve at least 60 percent survival for all children with cancer by 2030.
But it can only be through sustained awareness raising that this can happen.
Because children only rely on their parents or caregivers to determine when and where they can access health care, it is important to educate those caregivers to take any symptom seriously.
The longer they wait to seek health care, the less chances the children have to survive cancer.
It is vital for them to know that not only is cancer deadly, it will definitely be associated with catastrophic costs that most families in Zimbabwe and other African countries cannot afford.
Hence only early and correct diagnosis of cancer will save the children.
So that they can live a full and normal life.
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