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Late cancer diagnosis: Stumbling block in children treatment

Local News
If childhood cancers are diagnosed early and appropriate treatment given, 80% of the cancers can be cured.

AFTER her six-year-old daughter suddenly fell sick in September last year, Lillian Kazungunye’s mind did not register that it could be a serious health challenge.

Instead, she sought spiritual healing as well as herbal medicines to no avail.

Her daughter was later diagnosed with leukaemia or cancer of the blood, the most common form of cancer in children. The cancer cells grow in bone marrow and spread into the blood.

When a child has leukaemia, the bone marrow makes abnormal blood cells that do not mature. The abnormal cells are usually white blood cells (leukocytes). The bone marrow also makes fewer healthy cells.

The abnormal cells reproduce very quickly. They don’t work the same as healthy cells.

“I visited several traditional healers, but there was no change at all. Her condition worsened," Kazungunye narrated.

She then went to hospital as a last resort where a diagnosis was made and her daughter commenced treatment.

“I went to many places looking for the cause of her illness. I went to a local hospital and was referred to Parirenyatwa (Group of Hospitals), where the diagnosis was done. I am happy with the progress my daughter has made in her path to recovery. KidzCan has been helping out with a suitable shelter and food as my daughter undergoes treatment. They have also been giving her the required medication,” she said.

Kazungunye and her daughter have been staying at the KidzCan Rainbow Village where they are sheltered, fed and assisted as they wait for treatment sessions at Parirenyatwa Hospital.

If childhood cancers are diagnosed early and appropriate treatment given, 80% of the cancers can be cured.

However, owing to various beliefs and reluctance, only 20% of children with cancer in low to middle income countries survive versus an 80% survival rate in high income countries.

Due to late diagnosis, 11-year-old Wesley Dande took long to commence treatment. The delay prompted an emergency scan which showed that he had cancer of the kidney, known as wilms tumour.

Wilms tumour is a rare kidney cancer that mainly affects children. Also known as nephroblastoma, it is the most common cancer of the kidneys in children. Wilms tumour most often affects children between ages 3 and 4.

 It becomes much less common after age 5, but it can affect older children and even adults.

“Wesley started losing weight and showing signs of being unwell, but we thought it was just a phase in his growth, but as time went on, we realised he was not feeling well and we took the hospital route to discover what was affecting him. It was after a scan was conducted that we became aware of his condition, wilms tumour,” said his mother Petunia Dande.

She said they were extremely devastated as they thought their son was going to die.

“We did not expect a child to get a cancer diagnosis. They sent us to Parirenyatwa Hospital for review after Christmas, but the condition worsened before the date of appointment, he was in excruciating pain. He underwent some tests before starting chemotherapy on the 2nd of January this year and the pain subsided.

“He could not walk, sit or eat as his condition had worsened. It was only after he finished his third dose of chemotherapy that we started witnessing noticeable changes. He is a strong child, he tries to stand and exercise on his own as we await his operation next week. With the help we are getting from the doctors, I am very grateful because there are big changes in his condition,” she said.

Dande is currently housed at KidzCan Rainbow Village as her son awaits an operation while getting the necessary treatment in the meantime.

According to bmccancer.biomedcentral.com, delay in diagnosis of cancer is defined as the interval between the onset of symptoms and confirmed diagnosis of cancer. It is one of the major health problems that contribute to decreased survival rates of children in underdeveloped nations which is associated with non-specific symptoms of childhood cancer, nature of tumour and other healthcare system factors.

“Most childhood cancers are hard to recognise, patients arrive at health centres with an advanced level of the disease and this has also contributed to the high mortality rate. Causes of delays may be patient and/or parent, nature of tumour and healthcare associated factors. Studies indicated that factors that may be related to diagnosis delay are the child’s age at diagnosis, parent level of education, type of cancer, presentation of symptoms, tumour site and first medical specialty consulted,” a bmccancer.biomedcentral.com report said.

Speaking on the sidelines of the International Childhood Cancer Day, KidzCan executive director Daniel McKenzie said there was need to bridge the gap between low to middle income countries and the developed countries as far as paediatric cancer is concerned.

“Let us try and bridge the gap. Why are we always saying in low to medium income countries the survival rate is 20% and in the developed world it is 80%? Children are children irrespective of where they are born, cancer is cancer wherever you are in the world, the treatments are the same but why then the difference?”

“In Zimbabwe we are saying let us come together as communities, they say in a village it takes a community to raise a child. This is our country we are proud of it, let's come together, let us celebrate and let's support our children and that is why we are celebrating this day that if detected early no child should die of cancer. We would like to just share with the world,  with our communities, that please in all that do just remember and know that children do get cancer.” he said.

He said it was a challenge as people, families and even clinicians, some of them do not know that children can get cancer hence children are referred too late yet mothers would have seen the symptoms earlier.

“We are saying that yes children do get cancers but if they are detected early they can be treated, they can survive.  As KidzCan, we are privileged to be in this position where we are assisting children who are suffering from cancer by supporting the main referral hospitals in Zimbabwe, namely Parirenyatwa Hospital, where we have the A4 special ward where all children are referred to and at this facility this is where we are supporting with admission packs, bus fare, diagnostic imaging, chemotherapy drugs, nutritional support and also psychosocial support.”

“We also support children at Sekuru Kaguvi Eye Hospital and also patients who are also referred for surgery at Sally Mugabe (Central Hospital) and of course we have the Kidscan Oncology wards and we support children in Matabeleland at Mpilo (Central) Hospital,” McKenzie added.

According to the Zimbabwe National Cancer Registry 2018, 293 paediatric cancers (age 0-14) were registered in 2018 and accounted for 3,7% of all cancers. The most common paediatric cancers were leukaemia (18%), renal tumours (17%). retinoblastoma (15%), lymphoma (13%), soft tissue sarcomas (11%), central nervous system tumours (8%) and bone tumours (6%).

A goal to reach 60% survival rate has been earmarked for 2030.

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