As Friday, September 1 marks the beginning of awareness month for childhood cancer, parents have been advised to always present their children for screening and check ups, as well as early presentation for treatments, as this would help reduce the number of children living with the ailment.
Health professionals explained that there are different types of childhood cancers, which occur at different parts of the body. However, such common adult cancers as lung, breast, colon, and stomach are extremely rare in children.
Similarly, some types of cancers are almost exclusively found in children, especially embryonal tumours, which arise from cells associated with the foetus, embryo, and the developing body.
Leukaemia is the most common childhood cancer. Ordinarily, the body produces lymphocytes to protect itself from infections, but in leukaemia, these cells do not mature properly. Consequently, they become too numerous in the blood and bone marrow.
Leukaemia may be acute or chronic. The most common type is acute lymphoblastic leukaemia (ALL). There is a number of other less common acute types, which may be grouped together as acute non-lymphoblastic leukaemia (ANLL), which includes acute myeloid leukaemia (AML).
Neuroblastoma is one of the most common solid tumours of early childhood usually found in babies or young children. The disease originates in the adrenal medulla or other sites of sympathetic nervous tissue. The most common site is the abdomen (near the adrenal gland), but it can also be found in the chest, neck, pelvis, or other sites.
Pediatric hematologist/oncologist at the Lagos University Teaching Hospital (LUTH), Dr. Seye Akinsete, said childhood cancers occur in children from birth till the 18th birthday. It is not uncommon among children and it is increasingly becoming a major cause of childhood morbidity and mortality.
He advised parents to be aware of certain danger signs that may be pointers to an underlying cancer. Such occurrences like repeated fever, hospital admissions and treatment for malaria or infections, repeated blood transfusions, should not be taken lightly. Bleeding from the nostrils or gums, shining eyes like that of a cat in the dark, abdominal and leg swellings or unexplained swelling on parts of the body are reasons for parents to visit the hospital for medical screening and check ups.
He said: “Childhood cancers do not have causes like adult cancers. Most of the cancers are due to genetic mutations that occur for the first time in the child. Some cancers occur in certain families like Li-Fraumeni Syndrome.
“There are no known preventive measures in children, except for such general interventions as hepatitis and Human Papilloma Virus immunisations. “Treatment modalities include; chemotherapy, radiotherapy, surgery and immunotherapy. Bone marrow transplant is also an established mode of treatment.”
Akinsete explained that the best places to treat childhood cancers are at comprehensive cancer centres, where most modes of treatment are possible. “Lagos University Teaching Hospital is an established centre for treating children with childhood cancers. Most of the solid tumors survive, while leukemia patients do not do so well,” he said. “Most other teaching hospitals offer treatment for children, including primary healthcare centres and other recognised and registered hospitals. Treating childhood cancers is still a challenge in Nigeria because of poor awareness and late presentation, as well as inadequate infrastructure.”
The Founder of Children Living with Cancer Foundation, Dr. Nneka Nwobbi, said in developed countries, such as UK or US, cancer treatments is 80 percent because of early presentation and quality healthcare delivery, while in Nigeria, the cure rate is about 20 percent.
She explained that many parents are not aware their children can have cancer, therefore, by the time they come for treatment, the cancer would have spread, making it difficult to cure. She said: “We want Nigerians to know that cancer also occurs in children and not just in adults. Parents should do the needful and have their child properly investigated and commence treatment as soon as possible.
“Parents should be willing to open up, so that they can discuss that their children have cancer. Keeping such occurrence secret is dangerous. It is unacceptable that children die of cancer in Nigeria. So, we counsel parents about the death of their child.”
Explaining that treatment of childhood cancer is in three stages, Nwobbi listed these to include; surgery, chemotherapy and radiotherapy. After undergoing surgery, the person still needs to go for chemotherapy to kill the cells.
She stated that though there are different types of cancers in children, but the one prevalent in the country is glaucoma, which involves white blood cells in the eye, brain and nose. There is also cancer of the muscles, among others.
“Sometime before a patient goes for surgery, he/she should go for chemotherapy or radiotherapy to enable it kill and reduce the tumour to a suitable size, depending on the type of cancer.”
Nwobbi stated that children losing their hair like an old person, becoming quite dark or vomiting are early signs of childhood cancer. “Our aim is that at the end, we should have childhood cancer centre, where everybody in West Africa would have free comprehensive treatments, so that there would be no need to go abroad,” she said.
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