Management Magazine
Health

Childhood cancer in Kenya

Awareness of early symptoms is a life saver

By TABITHA AREBA

The World Health Organisation (WHO) has ranked cancer as a leading cause of death in children, with 300,000 new cases diagnosed each year among children aged 0-19 years. A big percentage of patients diagnosed with this disease are likely to suffer from depression, and this makes the situation worse. This is more so in developing countries like Kenya where majority of cancer cases are diagnosed late when treatment options are limited. The children are at the centre of this suffering. In Western countries, different advocacy groups are at the frontline in pushing for treatment policies in favour of childhood cancer. Mid last year, the US Congress passed the Childhood Cancer Survivorship, Treatment, Access and Research (STAR) Act into law. 

Provisions in the Act aim at fostering more efficient drug development and improving the way childhood cancer survivors are cared for. Children are fragile, and radiation and chemotherapy on their bodies can lead to lasting damage.  An article published in the Journal of Clinical Oncology shows that by age 50 years, more than half of childhood cancer survivors have experienced a severe, disabling, or life-threatening event, including death. As such, there is a provision in the Act for government-sponsored pilot projects to develop better care models for childhood cancer survivors and their unique needs. The law also bolsters workforce development programs to ensure that health care providers are equipped with specialized skills required to provide such care.

No specialised training

Sadly, lack of specialised training, especially in developing countries, leads to late diagnosis and due to the high cost of treatment, most patients abandon treatment. The story of Keith, a 4-year-old boy who recently succumbed to leukaemia, adds to the list of cases that turn ugly due to late diagnosis. Sweating at night and a swollen abdomen are some of the initial symptoms that paediatricians could not link to cancer.  Statistics show that very few people, even doctors, know symptoms and signs to look out for. After a misdiagnosis, so much time is wasted, and the disease does lots of damage and spreads to other body organs. Diagnosis at such a stage means minimal chances of survival, and the patient requires aggressive treatment, which is very expensive. 

“Too many children have their lives cut short by cancer, and survival rates in poor countries are scandalously lower than those in wealthy countries,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. 

Cancer awareness

Early detection through diagnosing the disease in good time has been identified as one of the ways that can improve the treatment outcome in children. This is a tested and tried strategy that has worked in the management of adult cancers such as cervical, prostate and breast cancer. According to the American Cancer Society, the best way to diagnose childhood cancer early is to pay attention to the possible signs and symptoms and raise awareness. This can be achieved through media awareness campaigns, and promotions among parents. Through these campaigns, the public would be made aware of symptoms that would prompt a parent to take a child to a healthcare facility if cancer is suspected.  Some of the most common signs and symptoms listed in an article titled 2 Subtle Signs and Symptoms of Pediatric Cancer published in the Nursing2015 Journal include continued, unexplained weight loss, headaches, often with early-morning vomiting, increased swelling or persistent pain in bones, joints, back, or legs. Others include constant infections, constant tiredness or noticeable paleness, eye or vision changes that occur suddenly and persist and recurrent or persistent fevers of unknown origin. In September 2018 WHO announced a new effort – the WHO Global Initiative for Childhood Cancer – with the aim of reaching at least a 60 per cent survival rate for children with cancer by 2030. This effort is likely to save an additional one million lives. 

“The aims of the Initiative are two-fold: to increase prioritization of childhood cancer through awareness raising at global and national levels and to expand the capacity of countries to deliver best practice in childhood cancer care,” notes the WHO website in brief.  Governments need to assess capacities in cancer diagnosis and treatment within their jurisdiction. This includes availability of expertise, technologies and medicines. One of the gaps identified include lack of cancer diagnosis and treatment programmes, failure to integrate childhood cancer into national strategies and gaps social insurance schemes. 

Prevention and early treatment

There are certain interventions that have been identified by the Ministry of Health in Kenya, and which can lead to the prevention of about 40 per cent of cancers.  They include protection of the population against exposure to environmental carcinogens, creating awareness on tobacco control, physical activity and promotion of healthy diets. However, if one happens to get diagnosed, better and early treatment could prolong the live of patients. Those who survive also get an opportunity to live quality life. Key in this initiative is enhanced human capacity in all fields of cancer treatment and management, as well as better access to cancer treatment services.

Tabitha Areba is the Manager, Publications, Branding and Research at the Kenya Institute of Management. Email: tareba@kim.ac.ke

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