Sadly, survival rates depend on geographical location, with an 80% survival rate in most high-income countries, compared to rates as low as 20% in low and middle-Income countries.
Unfortunately, despite being defined by the World Bank as a high to middle-income country, South Africa mirrors poor survival outcomes.
“We reside in a divided landscape, with access to First World standard of healthcare and treatment reserved for those who can afford private medical care. Sadly, the vast majority of our population faces socio-economic and geographical barriers to accessing life-saving treatment,” explains Dr Johann Riedemann a clinical and radiation oncologist with a special interest in childhood cancers.
Dr Riedemann is part of a national network of more than 150 private oncologists who, under the Icon Oncology banner, are championing better access to quality cancer treatment for all South Africans. One of the ways in which they are achieving this is to invest in state-of-the-art technology which can be used to treat cancer.
In radiation oncology, specialist machines called linear accelerators (Linacs) are used to precision-target tumours, destroy cancer cells and limit unwanted toxicity to normal cells. Icon Oncology recently installed a new Linac at the Cape Gate Oncology Unit where Dr Riedemann and his colleagues from Cancercare work to treat cancer patients. These patients include children who previously had to travel great distances to receive treatment in Cape Town.
Removing this geographical barrier is a blessing to both parent and child amidst the challenge of cancer.
Dr Riedemann explains that early detection and treatment of childhood cancers are important. “If detected early, many children can be treated successfully. Research shows that the sooner a child is diagnosed, the better the outcome for the patient. Parents can equip themselves with knowing the warning signs of childhood cancers and when to consult a doctor if these symptoms persist,” says Dr Riedemann.
Cancer in children is not common, but it is important to have your child checked by a doctor if they have unusual signs or symptoms that persist. These include:
* An unusual lump or swelling
* Unexplained paleness and loss of energy; associated failure to thrive
* Easy bruising or bleeding
* An ongoing pain in one area of the body; especially when present or worse at night
* Limping without a history of injury or trauma
* Unexplained fever or illness that does not go away
* Frequent headaches, often with vomiting
* Any worsening of visual, cognitive and/or hearing abnormalities
* Unexplained weight loss – fits in with failure to thrive
Step 1: Know when to visit a medical doctor. If you're in the private sector, the first step would be to visit a General Practitioner (GP) or family doctor. If you are concerned about any persistent symptoms, or if your child is not responding to over-the-counter medication, make an appointment with your GP. Children are not mini-adults and if your GP finds reason for concern, they will refer you to a paediatrician.
Step 2: Visit a paediatrician (a medical practitioner specialising in children and their diseases). Paediatricians are trained to identify cancer symptoms in children and will arrange for tests and scans to diagnose a potential cancer.
They will also reach out to other specialists who will become part of your child’s care team in case of a cancer diagnosis.
“In oncology, multi-disciplinary teams work together to diagnose and treat our cancer patients. This means that your child will have a team of highly specialised doctors and supporting practitioners who will design a treatment plan that is tailored to the particular cancer and your child,” explains Dr Riedemann.
If you do not have medical aid, do not ignore persistent symptoms and make sure you visit your closest Department of Health clinic or, if you can afford it, a general practitioner in your area. Come prepared with a list of the symptoms which concern you, point these out to the healthcare practitioner who examines your child.
Ask for a referral to a specialist at your closest provincial hospital and make an appointment to see them.
Most tertiary provincial hospitals will have paediatric and oncology specialists who can diagnose and treat childhood cancers.
Many private specialists work in multi-disciplinary teams with their government and academic colleagues at State or university hospitals. For example, Dr Riedemann has partnered with the Paediatric Oncology Department at Tygerberg Hospital in Cape Town. “We meet regularly to discuss childhood cancer cases and to ensure we share knowledge and keep up-to-date with the latest developments in our field.
“South Africa boasts the highest level of care in public hospitals in Africa. We have centres of excellence like the Red Cross War Memorial Children’s Hospital in Cape Town, which is regarded as Africa’s leading centre for postgraduate specialist paediatric and surgical training. Children from all nine provinces are referred here by provincial clinics and hospitals,” says Dr Riedemann who was previously a member of this unit’s paediatric brain-tumour consortium.
There are also other resources and organisations that help parents of children with cancer. This includes arranging access to treatment, practical support such as transport and accommodation as well as emotional or psycho-spiritual support including counselling and psychosocial services. These are: Childhood Cancer Foundation South Africa (CHOC); Little Fighters Cancer Trust and Cancer Association of South Africa (CANSA).
