Childhood cancers continue to be in the news, and for very good reasons. Approximately, there are 160,000 children diagnosed with cancers every year worldwide.
This translates into 438 children diagnosed with cancer everyday in the world. Even more staggering is the realisation that 18 children are diagnosed with cancer every hour!
Cancer does not only afflict children. It kills them too. Again, it is estimated worldwide that 90,000 children succumb to cancer every year translating to 10 deaths every hour. This estimation, undoubtedly, is grossly understated in Africa and other less endowed parts of the world.
A study done in the Cancer Unit of the children's block of the Korle Bu Teaching Hospital (KBTH) from 2006 to 2009 found that there were 386 cases of children diagnosed with cancer in Korle Bu within that period. This works up to 10 new diagnosis of children with cancer every month! This can easily be doubled or even tripled if data from other centres from the country such as Komfo Anokye Teaching Hospital, Tamale Teaching Hospital, other district hospitals and of course our ever blooming traditional healing centres countrywide are factored in.
In that study, about 40 per cent of those diagnosed were below the age of five, that vulnerable period where they may not only be able to express exactly what is wrong with them, but also have an impeccable reserve of energy to run around playfully until their last breath is exhausted. Thus, the ability for a huge number of children to be afflicted with cancers is dependent on a very high index of suspicion. Boys were more affected than girls by a ratio of 1.4:1 in that same study conducted by Prof. Renner.
Change in pattern
In addition, the study found out that compared to a study done 10 years earlier, the pattern of the cancer types had changed with more of the subtle cancers being diagnosed.
In ascribing reasons for seeing more of the subtle childhood cancers, enhanced pickup rate, be it early reporting or enhanced diagnostics, featured prominently.
The usefulness of early pickup lies in the fact that unlike adult cancers, about 90 per cent of childhood cancers are curable. Thus the earlier it is diagnosed and treatment instituted, the better the chance of curing it.
This means parents must be able to pick signs and symptoms of childhood cancers. The commonest of the cancers is present with swellings which in Akan is called "POMPO".
Thus the signs and symptoms can be remembered with this " POMPO" pneumonic.
P - representing Pain - in bones, joints, backache, easily fractured bones.
O- Ominous signs such as change in behaviour, balance or gait problems, loss of milestones, headache and increasing head circumference.
M- Masses in the body. This can be in the abdomen, head and neck, pelvis, testis and even in bones. This implies that parents should pay more than the usual attention when bathing or playing with their children. Anything suspicious must be reported for a doctor to check to exclude these cancers.
P- Pallor- If for no reason the child feels tired, lacks energy or bleeds easily from brushing of teeth to easy bruising, he/she must be checked to ensure that there is no cancer of the bone marrow predisposing him/her to easy bleeding and anaemia.
O- Once seen, report straight away. These signs include white spot in pupil of the eye (cat eye), squint, blindness or bulging eyes. Also included are unexplained weight loss and persistent fever.
Reporting early
Any of these signs must be reported to be investigated further so treatment can be started early.
There are certain specific circumstances where one must be especially vigilant on the part of health workers about possibility of childhood malignancy. Children with certain skin manifestations called neurocutaneous syndromes are at increased risk of developing cancers.
In addition, certain children with chromosomal anomalies, commonest of which is down syndrome, are at an increased risk of cancers. Children with lowered immunity such as HIV infections and other congenital immune deficiencies, those exposed to radiations, or with other siblings who have suffered from cancer are all at higher risk of developing cancers and must be paid more than the usual attention.
That is why I doff my hat to the Ghana Paediatric Oncology Society for setting aside February 16, 2015 to draw attention to childhood cancers. The theme: "Act now for children with cancers", couldn't have reflected more the need for all of us to remember the signs and symptoms. Kudos to Prof. Renner and his team for your unending efforts to throw the spotlight on childhood cancers. Let us help by spreading the news.
astom2@ yahoo.com. A member of Paediatric Society of Ghana.
