Childhood Cancer Still a Cause for Concern
By Elisha Singira
Cancer is a leading cause of death for children and adolescents, with the group being more vulnerable in low and middle-income countries where survival rates are low as a result of delay in diagnosis, an inability to obtain an accurate diagnosis, inaccessible therapy, abandonment of treatment, death from toxicity (side effects), and avoidable relapse, according to World Health Organization (WHO).
As such, Dr. Sarah Muma, Paediatric Hematologist Oncologist in the Department of Paediatrics at Kenyatta National Hospital notes that early diagnosis is very important since it will make it easy to initiate control measures.
Dr. Muma urges individuals to raise awareness once they detected signs and symptoms of the tumors which include headache, which presents an irritability, often worse in the morning, vomiting, disturbance of gait and balance, hemiparesis (weakness or the inability to move on one side of the body) cranial nerve abnormalities, impaired vision among others.
There is also increased head circumference among infants, endocrine abnormalities, seizures and mental disturbance.
She notes that there are different cancer prevalence in different regions. In the United States and Europe, Leukemia and Brain tumors are the most prevalent while in Africa, the leading tumors are Burkitt’s lymphoma, Nephroblastoma and Non-hodgkins Lymphoma.
Notwithstanding, Nephroblastoma remains the most common solid tumor in Africa exceeding 10% of total pediatric cancers in many countries. In Rwanda, it accounts for 21.3%, Senegal 22%, Ivory Coast 14.5%, Mali 17.6% and in Congo it accounts for 15.5%.
Solid tumors make up about 30% of all pediatric cancers. The most common types of solid tumors in children include Brain tumor, Wilms’ tumor, osteosarcoma, Neuroblastoma and Rhabdomyosarcoma
Tumors of the central nervous system (CNS) are the second most common group of cancers in childhood accounting for 20% of all childhood malignancies in developed countries.
Der. Muma recommends use of computed tomography (CT) scan as an important procedure in the detection of CNS malignancies and detect 95% of brain tumors as far as diagnostic and evaluation is concerned.
For tumors of the posterior fossa (small space in the skull, found near the brainstem and the part of the brain responsible for balance and coordinated movements) which are common in children, she recommends magnetic resonance imaging (MRI) for evaluation because of the advantages associated with it.
These advantages include greater sensitivity in the detection of brain tumors, especially in the temporal lobe posterior fossa, ability to directly image multiple planes which is of value to neurosurgical planning and ability to apply different pulse sequences which is useful in depicting anatomy.
On treatment, she said that most patients with high-grade brain tumors require radiotherapy to achieve local control of microscopic or macroscopic residual, adding that chemotherapy plays an important role in the management of recurrent disease and in many newly diagnosed patients.