Cancer is a word that evokes a spectrum of emotions, from fear and uncertainty to hope and resilience. The anxiety associated with cancer becomes even more pronounced when it comes to children.
The thought of a young life, which has barely begun to unfold its pages, facing such a daunting challenge can shake any parent or guardian to the core.
According to data from the National Cancer Registry and Statistics South Africa, every year, around 1.1 million people in Africa are diagnosed with cancer, and about 700 000 die from the disease, as reported by the World Health Organization (WHO).
Recent findings reveal a worrying trend: while the overall number of deaths in South Africa has decreased by 24.1% from 2008 to 2018, deaths from cancer have gone up by 29.3%.
In 2019, there were more than 85 000 new cases of cancer in South Africa, and in 2018, close to 44 000 cancer-related deaths were recorded.
The South African Bone Marrow Registry (SABMR) has noted an increase in referrals for children needing stem cell transplants due to blood disorders and cancers over the past four years.
Out of more than 800 patients referred since 2019, 35% were younger than 18 years old.
Cancer is more common in older people, with the average age of diagnosis being 66, and most new diagnoses occurring in adults between 65 and 74 years old. These adults usually have cancers of solid organs like the breast, lung, colon, prostate and bladder.
In contrast, young people aged 20 or under often face blood cancers. Around 30% of all cancers in children are leukaemia, while lymphomas represent about 8%.
The most frequent solid cancers in children are those of the brain and central nervous system, making up around 26%.
Other solid cancers affecting children include neuroblastoma, Wilms tumour, rhabdomyosarcoma, retinoblastoma and bone cancer.
With World Cancer Day on February 4, the SABMR is urging parents to seek medical help for any persistent symptoms or sickness in their children. Early diagnosis is crucial for successfully treating many cancers in children.
Jane Ward, the deputy director of the SABMR, said leukaemia and lymphoma were the most frequent cancers found in children all over the world.
The National Cancer Registry’s data shows that in South Africa, half of the cancer cases in children happen to those under the age of four.
Diagnosing cancer in kids can be tricky because the symptoms often look a lot like those of other common illnesses that children catch. Ward advised parents to pay attention to their children’s strange or persistent symptoms.
“Preventing or screening for cancer in children is much harder than in adults because we don’t know as much about what causes it. However, if childhood cancer is found early, there’s a very good chance of treating it successfully.“
“Sadly, in South Africa, about two-thirds of kids with cancer don't make it to a specialist in time for the treatment they need. By the time they get there, the cancer is often already at a late stage,” said Ward.
In countries where people earn little, the survival rates for children with cancer are much lower – about 20% – while in richer countries it is about 80%.
The WHO’s Global Initiative for Childhood Cancer aims to make sure that by 2030, 60% of children with cancer will survive, no matter where they live.
The overall survival rates of childhood cancer in South Africa remain low when compared to international data.
Ward said that addressing the concern required a comprehensive approach involving the government, health-care providers, international organisations and other stakeholders.
She said the stigma and misconceptions surrounding cancer, particularly in some local and ethnic communities, were major contributing reasons to the delayed diagnosis of SA children.
“Misconceptions surrounding childhood cancer need to be debunked with earnestness as this delays the treatment of the child who can often be saved and live a full life. In many cultures, Western medicine is still not trusted or the family is of the belief that they may be shunned since the disease is not properly understood.”
The warning signs of childhood cancer can encourage earlier diagnosis and lead to improved outcomes.
Childhood cancers share general symptoms with other illnesses, however, if one or more of the following symptoms persist, medical assistance should be sought immediately:
Acute Lymphoblastic Leukaemia (ALL):
Symptoms:
· Fatigue and weakness
· Frequent infections
· Pale skin (anaemia)
· Easy bruising and bleeding
· Swollen lymph nodes
· Bone and joint pain
· Loss of appetite and weight loss
· Enlarged liver or spleen
· Headaches, vomiting or visual changes (in cases where leukaemia spreads to the brain and spinal cord)
Hodgkin Lymphoma (HL):
Symptoms:
· Enlarged lymph nodes, typically in the neck, armpits or groin
· Unexplained fever
· Unexplained weight loss
· Night sweats
· Itchy skin
· Fatigue
· Loss of appetite
Non-Hodgkin Lymphoma (NHL):
Symptoms:
NHL can present with symptoms similar to those of HL, including enlarged lymph nodes, fever, weight loss, night sweats, fatigue and itching. However, the specific symptoms can vary, depending on the type and location of the lymphoma.
Ward said all three of the cancers could be cured with successful stem cell transplants.
“We have seen first-hand success stories of children who are now cancer-free and go on to live healthy and fulfilling lives because they received a timeous diagnosis and the right treatment.
“If you suspect something might be amiss with your child’s health, talk to your health-care practitioner or ask for a second opinion. Early detection is key to reducing not only childhood cancer rates but child mortality rates in the long run.”