Just like adults, children are prone to many cancers

Friday, August 2nd, 2019 00:00 | By
Paediatric oncologist Doreen Mutua of Gertrude’s Children’s Hospital during the interview. Photo/JOHN OCHIENG

Pocyline Karani and Grace Wachira 

What causes cancer in children considering they are not products of lifestyle habits?

Studies have not yet revealed what causes childhood cancers. However, the cancers are categorised as resulting from familial cancer syndromes and genetic diseases.

About five-10 per cent of childhood cancers are associated with genetic syndromes, which means children from families that have certain types of cancers have certain genetic mutations that predispose them to cancers. 

The other category known to result in cancers in children are genetic diseases such as Down Syndrome, Beckwith Wiedemann Syndrome. Children with Down Syndrome are prone to Acute Myloid Leukemia, while those with Beckwith Wiedemann Syndrome are prone to kidney cancers.

Genetic diseases are caused by elements that children pick from the environment classified under risk factors.   

Which are the most common childhood cancers at Gertrude’s and Kenya in general?

Leukemia is one of the most common types of cancers we treat here, especially acute myeloid leukemia. We have quite a number of cases when it comes to lymphomas – cancers that begin in the infection-fighting cells of the human immune system.

Others are brain and kidney cancers and retinoblastoma (eye cancer). Epidemiological studies reveal that Kenya is in a lymphoma belt that cites weathers and other risk factors.

The symptoms are often misdiagnosed as malaria, anaemia or typhoid among others. Some of the rare cancers I have come across in children are ovarian cancer, skin cancer and soft tissue tumors that affect body organs.

What are the common symptoms of cancer in children that parents should look out for?

Children will present symptoms that resemble many other common childhood illness such as persistent vomiting, recurrent infections such as pneumonia, tonsillitis only for medics to later discover the persistent fever thought to be tonsillitis was actually Leukemia.

Some children will complain of bone pain at night, which could be because of Leukemia. Other subtle signs may include headaches, pale skin, swollen abdomens and general body weakness.

What are the challenges faced in tackling the cancer problem and how are you addressing them?

A lot of children present late with very advanced disease. This is because our healthcare providers have a very low index of suspicion because of symptoms similar to common childhood diseases.

Diagnostic tests are not available in our basic healthcare facilities, which means costs incurred to move children to diagnostic and treatment centres.

Our weak referral systems is a major challenge and to ease this, currently any child suspected to have cancer can be referred directly to tertiary cancer treatment centres so as to minimize resources wasted sending them from one facility to another.

These challenges are impacting hugely on positive outcomes recorded. About 80 per cent of cancers are treatable in developed countries, while in Kenya, positive outcomes range between 19-30 per cent.

Gertrude’s has partnered to with the Ministry of Health and the National Cancer Institute to raise awareness on childhood cancer to get early diagnosis.

Are there steps guardians and parents can take to prevent cancer in children?

We prevent the risk factors that can cause cancer by eating right. We ingest chemicals in processed foods and have unhealthy lifestyles. Exercising reduces the chances of having cancer and letting children play and relax gives them an upper edge.

What is Gertrude’s Hospital doing to position itself to be able to successfully tackle the growing numbers?

We have a plan in progress and we will expand our institution and come up with a cancer wing. Hopefully, it will be a reality in the next three to five years. Even then, Gertrude’s is working closely with the Ministry of Health and National Cancer Institute to raise awareness.’

We have events that just raise awareness surrounding cancer and since we cannot ask children to go for screening, we encourage adults to be screened regularly and to take the health of their children seriously.

What are the chances of cured cancer(s) in children reccurring in their later years? What may influence early relapses and how can it be prevented?

The upside of pediatric cancer is that it has very positive cure results. In high income countries, they have 80 per cent chances of cure which is something we hope to emulate. 

Our rates are however much lower with 19-30 per cent chances of being cured and that tells us that early detection goes a long way in early diagnosis and treatment that does away with the disease after remission.

The downside is that cured cancers in children have high relapse rates that occur later in life. They manifest themselves as different cancers and these relapses are the worst because the malignant cells come back bigger and well equipped to fight the modes of treatment administered and that way, they are not so easily beaten because the drugs that fight the cancer did not advance.

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