Detecting early warning signs of childhood cancer is vital

Seven-year old Melina Nyoni from Blue Downs was recently diagnosed with nephroblastoma at Tygerberg Hospital. This disease is the most common renal tumour of children between the ages 2 and 5, and is also the fourth most common cancer in children in South Africa. It originates from one of the kidneys and in rare cases affects both kidneys.

Annually, Tygerberg Hospital treats six patients for this disease, with the most common presenting symptoms and signs being abdominal pain and/or distension, loss of appetite with or without weight loss, constipation and vomiting. Melina experienced these symptoms, particularly weight loss and an enlarging growth in her abdomen.

Upon presentation to Tygerberg Hospital in July 2019, Melina had a six-month history of abdominal pain, which continued to deteriorate. Upon examination, a large mass was found in the left side of her abdomen. Special investigations confirmed the presence of a large, solid mass originating from her left kidney. No signs of metastases were evident in her treatment, although tests confirmed a diagnosis of nephroblastoma. According to Melina’s father, Noel, now that the family is aware of her diagnosis, they are optimistic that she will recover well.

Dr Anel van Zyl, Paediatric Oncologist at Tygerberg Hospital, says in some cases, blood may often be present in the urine and the child may suffer from high blood pressure. “The treatment typically includes four to six weeks of pre-operative chemotherapy in order to shrink the tumour, and treat any metastatic lesions if present. A nephrectomy and complete tumour excision are then performed, after which the histological staging is determined. This staging determines the intensity and duration of post-operative chemotherapy, which can be four to 34 weeks. If it is diagnosed early before any spread has occurred, the overall survival rate is excellent (up to 90% and above). For more advanced disease, the survival is still at least 65% or higher,” explained Dr Van Zyl.

The Cancer Association of South Africa (CANSA) estimates that between 800 and 1 000 South African children are diagnosed with cancer annually. Of concern is the fact that half of the children with cancer in the country are seldom diagnosed. The Western Cape Government Health is urging parents and caregivers to familiarise themselves with the symptoms of childhood cancer and to seek appropriate medical assistance where applicable.

According to CANSA, early warning signs of childhood cancer can include:

• Aching bones, joints, and back;
• Easy fractures;
• Unexplained fever for more than two weeks;
• Unexplained weight loss, pale appearance, and fatigue;
• Easy bruising and bleeding;
• A white spot in the eye, new squint, sudden blindness, or bulging eyeball;
• A lump on the stomach, pelvis, legs, arms, glands, testicle, or head;
• A change in walk, balance, speech, or regression; or
• Continuous headaches with/without vomiting and enlarged head.

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Caption: Seven-year old Melina Nyoni from Blue Downs who was recently diagnosed with nephroblastoma.