The cancers that affect children are generally unique to those that affect adults and the incidence of childhood cancer is 150 in a million worldwide. In South Africa, one in 600 children are affected by cancer before the age of 16 – sadly, less than half of the children are diagnosed early enough and reach a treatment centre in time. According to Silvia Craucamp, Nurse Clinical Officer and Training Coordinator for Children’s Haematology Oncology Clinics (CHOC) in Gauteng, many children are diagnosed too late with an advanced stage of cancer for the treatment to have much chance of success and half are never diagnosed, thus receiving no treatment. “As a result, we strongly advocate and encourage all efforts that lead to the early detection of childhood cancer. As, with early detection, the prognosis for cure is very positive.”
Types of cancer prevalent amongst children
The most prevalent cancers amongst paediatric patients in South Africa is leukemia (34%), brain tumours (22%), lymphomas (11%), cancer of the kidney – also known as Wilm’s tumour (6%) and cancer of the sympathic nervous system, known as neuroblastoma.
Childhood Acute Lymphoblastic Leukemia
The most common childhood cancer is leukemia, also known as cancer of the blood. The word leukemia literally means ‘white blood’ and is used to describe a variety of cancers that begin in the blood-forming cells (lymphocytes) of the bone marrow. The bone marrow is a spongy material inside the long bones of the body, but lymph glands, spleen and thymus glands (behind the breast bone) also play a role. There are three different types of blood cells:
1. White blood cells (T-cells and B-cells) and neutrophils, which are important in fighting infections.
2. Red blood cells, which carry oxygen around the body.
3. Platelets, which help blood to clot and control bleeding.
Leukemia cells are sick immune blood cells that do not work, therefore the cancerous cell is no longer under the body’s control. These abnormal cells divide and multiply in number, taking over the bone marrow. The leukemia cells may also invade other areas of the body, like the blood and lymph glands.
Typical symptoms that should alert parents include the following:
• Fatigue (tiredness) and pale skin
• Infections and Fever
• Easy bleeding or bruising
• Bone or joint pain
Parents should definitely take these symptoms seriously.
Leukemia’s Clinical Presentation
Most common clinical presentation signs of leukemia are:
• Hepatosplenomegaly (HSM) – the simultaneous enlargement of both the liver and the spleen.
• Lymphadenopathy (LAD) – enlarged lymph nodes.
• Central Nervous System (CNS) shows similar symptoms as for a brain tumour.
• If leukemia is found, further tests will be needed to help tell what type it is and how it should be treated.
Childhood cancers require specialist paediatric treatment by a paediatric oncologist and comprise of chemo, surgery or radiation. In some cases a combination of these treatments is used while bone marrow or stem cell transplantation is done in certain situations.
For more information on childhood cancer and cancer treatment for children, visit www.choc.org.za or contact them on 086 111 2358.
Written by Elsje Beneke