Childhood Cancer Awareness

The top 5 childhood cancers can be treated if detected early. A lack of knowledge about cancer which delays diagnosis, limited access to appropriate treatment and the need to focus on other child health priorities means that only 2 to 3 out of 10 children in under-privileged countries are cured.

Early detection makes a big difference because less advanced tumours are easier to cure and they often need less intensive treatments.

Types of childhood cancer
According to the South African Children’s Cancer Study Group (SACCSG) registry statistics, for 2009 to 2013, the 5 foremost childhood cancers in South Africa are:

• Leukaemia
• Lymphoma (tumours that begin in the lymph glands)
• Brain tumours
• Nephroblastomas or Wilms tumours – cancer of the kidneys
• Soft tissue sarcomas (tumours that begin in the connective tissue)

Children can be treated if cancer is detected early. Although childhood cancers share general symptoms with other illnesses, the early warning signs must be noted with urgency.

Warning signs
In South Africa, the St Siluan Warning Signs for Childhood Cancer are used.
(These warning signs of childhood cancer are derived from the name of St Siluan, a Russian Orthodox monk who prayed ceaselessly for humanity.)

St Siluan Warning Signs of Childhood Cancer
S – Seek medical help early for ongoing symptoms.

I – White spot in the eye, new squint, sudden blindness or bulging eyeball.

L – Lump on the stomach, pelvis, head, arms, legs, testicle or glands.

U – Unexplained fever present for over two weeks, weight loss, fatigue, pale appearance, easy bruising & bleeding.

A – Aching bones, joints, back and easy fractures.

N – Neurological signs, a change in walk, balance or speech, regression, contiguous headaches with/without vomiting & enlarged head.

Cancer treatment
There are 3 most common treatments for cancer and they are surgery, chemotherapy and radiotherapy. These treatments may be applied on their own or in combination with each other.

Risk factors
Although risk factors for childhood cancers are not well understood, some factors can increase the risk.

These include:

• Medical conditions:
  For example, children with Down’s syndrome are 10 to 20 times more likely to get leukaemia than other children.
   
• Genetics:
  Retinoblastoma is a rare type of eye cancer. Some children are born with a change (mutation) in the retinoblastoma gene, also known as the RB1 gene. This may be because they inherited the gene from one of their parents, or because a change happened to this gene during the very early stages of their development in the womb.
   
• Problems with development in the womb:
  Some childhood cancers such as Wilm’s tumours (kidney cancer in children) and retinoblastomas (eye cancer in children) begin when the baby is still inside their mother. When a baby is growing in the womb, many parts of the body, such as the kidneys and eyes, develop very early on. Sometimes something goes wrong and some of the cells that should have turned into mature cells to form a part of the body don’t. Instead, they remain as very immature cells. Usually, these immature cells don't cause any problems and mature by themselves by the time the child is 3 or 4. But if they don’t, they may begin to grow out of control and develop into a cancerous tumour.
   
• Exposure to infections:
  Epstein Barr virus (EBV) is a common infection in young children. It usually causes no symptoms. But, it can cause glandular fever (infectious mononucleosis) in teenagers and young adults. While glandular fever can be very unpleasant, it usually passes within a few weeks and it doesn’t mean that you go on to develop cancer. Once infected, a person remains a carrier of EBV for life, but the virus normally doesn’t cause any symptoms at all. In rare cases, infection with EBV can contribute to the development of cancers such as Hodgkin lymphoma and Burkitt’s lymphoma. Most people get infected with EBV as a child and stay infected for life without ever experiencing any symptoms. Because of how common it is, there is nothing you can do to prevent you, or your child, coming into contact with EBV at the moment.
   
• Exposure to radiation: 
  Radiotherapy is used as a treatment for cancer. It uses a type of radiation called ionising radiation. Children who have radiotherapy for cancer have a slightly greater risk of developing another type of cancer later on. But the risk is small compared to the risk to their health if the original cancer had not been treated with radiotherapy.
   
• Previous cancer treatments:
  Past treatment with chemotherapy can increase the risk of cancers such as acute leukaemia many years later in children and adults. 
  

Lifestyle and cancer
You can adopt a healthy lifestyle and reduce the risk of cancer. This includes making smart food choices, doing regular exercise, maintaining a healthy weight, avoiding tobacco, alcohol and other known cancer-causing agents.

Myths vs facts
Cancer is not infectious. You can’t catch it from another person and your child can’t pass it on to their siblings or other children in their school. It's unlikely for 2 children in one family to be diagnosed with childhood cancer.

We can challenge perceptions by improving our knowledge of cancer and differentiate between myths and facts so that we can reduce the negative stigma attached to those living with cancer in our communities.

Do you or your child need support?
The Western Cape Department of Health offers extensive cancer support, from early detection to diagnosis, at 2 paediatric oncology units, the Red Cross Children’s Hospital and Tygerberg Children’s Hospital.

CANSA’s Tough Living with Cancer (TLC) #CANSAtlc creates #ChildhoodCancerAwareness campaigns and they support youth and families affected by cancer. If you’re a parent in need of support, you are invited to join a TLC support group in a CANSA care centre nearest to you.

The childhood cancer charity CHOC (Children’s Haematology Clinics) established in 1979 by a parent group in Johannesburg is now a national organisation that offers a Parents Supporting Parents programme and an excellent Handbook which it makes available to parents of children diagnosed with cancer.

Professor Davidson, the head of Haematology and Oncology at Red Cross Children’s Hospital urges parents to check any material with their doctors, especially if it seems to be at odds with what their children are receiving.