It is impossible to imagine a loss greater than the loss of a child. Especially if, in retrospect, the parents discover the loss could have been prevented. And that’s the heart-rending discovery made by perhaps a thousand families every year in this land of ours, when they lose a child to cancer.
One thousand unnecessary deaths to cancer. Why? The cruel truth is that not enough people are aware of the early signs of childhood cancers. Parents, teachers, caregivers, even nurses and family doctors are unfamiliar with the symptoms that warn of the fact that cancer is taking hold.
Part of the reason is that childhood cancers are very different from those seen in adults. Most start in developing cells, like bone marrow, blood cells, kidneys and tissues of the nervous system. The blood disease leukaemia is the most common childhood cancer. Then there are brain tumours, and numerous other types of tumours that affect children.
Another point is that so few of us, even family doctors, ever see a case. So when a child exhibits mysterious symptoms, the chances are they will be diagnosed as something more familiar or brushed off as unimportant. The result? If the problem is finally diagnosed for what it is, the cancer has advanced too far for successful treatment.
Tragic, because modern medicine can cure the great majority of cases, if children are treated early enough. And seven in ten such children can grow up to live normal, healthy, productive, enjoyable lives.
- Around the world, one child in 600 will develop life-threatening cancer
- In South Africa, every year, 1 700 children develop cancer before the age of 15
- Of these 1 700 children, approximately 700 are diagnosed in the late stages
- 1 000 children die needlessly each year, either undiagnosed or diagnosed too late
Chemotherapy, surgery, and radiation are the usual treatments, often in combination with each other. Some cases require transplants of bone marrow or stem cells as a last solution.
What each case has in common is that it depends on early diagnosis and expert treatment at a specialised children's oncology (cancer) unit. These units are generally linked to the main teaching hospitals.
Not that the therapy is straightforward, as it brings problems of its own. For one, it generally weakens the body’s natural defences, its ‘autoimmune system.’ Children become easily infected by germs and viruses during therapy and should therefore be accommodated in a good, clean environment.
The journey between home and clinic, often using public transport, complicates most cases, adding more stress and emotional strain to the family in already overwhelming circumstances.
Caring for Our Children
Danone Clover is one company that took up the challenge, in 2004. Their 'Caring for Our Children' campaign is staged each winter, raising money for the CHOC Childhood Cancer Foundation. To date, those funds have been enough to establish four Danone Clover CHOC houses close to children's oncology units.
These sanctuaries provide a clean environment, accommodation and meals for the patient and a parent, whose presence during therapy is generally the best medicine of all.
Signs to look out for
The South African Children's Cancer Study Group has prepared a list of warning signs for distribution to primary health care centres.
The list has been adopted by the International Society of Paediatric Oncology (SIOP) for distribution throughout developing countries.
The signs are named after Saint Siluan, a Russian monk who prayed ceaselessly for all humanity:
S is for Seek medical help early for persistent symptoms.
I is for Eye, in which a white spot, new squint, blindness or bulging eyeball calls for urgent investigation.
L is for Lump, and the abdomen and pelvis, head and neck, limbs, testicles and glands must be examined often for an unexplained lump.
U is for Unexplained fever, loss of weight and appetite, pallor, fatigue, easy bruising or bleeding , each of which demands thorough investigation.
A is for Aching bones, joints, or back as well as easy fractures.
N is for Neurological signs, especially changes in behaviour, balance, gait, and milestones, headache, enlarging head.
Each of these simple signs demands investigation by an expert; delaying having the symptoms investigated and the start of treatment can lead to the unnecessary death of a child.
(Press release, CH Communications, August 2008)