Childhood Cancers

To nurse one child in Nigeria with cancer, you need about N2 million on the average in a period of about two years

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By Drs. Azeezah Shopeyin and Ajayi Abass 

Childhood cancers occur in children less than 15 years. They are devastating not only to the children but their entire family. In Nigeria, it creates a huge financial burden on the family as there is no supportive treatment plan for children and the cost of treatment is very high.

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Cancer leads to abandonment of treatment and consequently death of children. Hence, prevention of childhood cancers cannot be over emphasized. It’s important to note that in most fields of medicine, pediatrics have been found to be of significant challenge, because of communication challenges, and caregiver support.

Burden to public health

The international agency for research on cancer stated in 2004 that worldwide 160,000 children under 15 years get childhood cancers and 90,000 will die from it every year. In 2007, 71.2 of every 1 million Nigerian children below 15 years had childhood cancers.

Due to the lack of data in Nigeria, and the paucity of studies on childhood cancers, it is not easy to appreciate the burden of childhood cancers, this might be due to the preoccupation with infectious diseases which are said to cause about 25% of childhood deaths.

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In an 11year retrospective study conducted in northern Nigeria, by A. Mohammed and A.U Aliyu, it was noticed that childhood cancers were 8.44% of cancers diagnosed within that period. A male: female ratio of 1.5:1.

In 2014, Consultant Paediatrician, Oncology/Haematology Unit of the Lagos University Teaching Hospital, LUTH, Dr. Adebola Akinsulirie, said about four or five cases of childhood cancer are seen monthly at the LUTH. That will give you about 50 children in a year. That is big as far as cancer in children is concerned in Nigeria. To nurse one child with cancer, you need about N2 million on the average in a period of about two years.

Types of childhood cancers

The most common childhood cancers accounting for childhood deaths in Lagos  include kidney cancer (nephroblastoma) and blood cancer (Acute lymphoblastic leukemia and Acute myeloid leukemia)

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Lymphomas (solid cancer of white blood cells) are also quite common childhood malignancies and neuroblastoma (cancer of nerve cells), others include leukemias, bone and muscle tumors.

Causal or pre-disposing factors

The cause of most childhood cancers are unknown in about 75-90% of cases, 5-15% are due to familial and genetic factors( intrauterine viral infections, parental occupational/ radiation exposures, war-torn regions and disasters, elderly maternal age above 35, parental especially maternal smoking and alcohol consumption.

 

and <5-10 % are due to known environmental exposures and exogenous factors (food, radiation, dyes, infections like intrauterine viral infection Epstein-Barr virus and leukemias/ lymphomas etc). It’s important though to note that cancers generally are caused by a variety of factors and are not limited to a single causative agent.

How to recognize childhood cancers early

Complaints about any of the following that does not go away in a child:

  • Feeling of an unusual lump or swelling
  • Unexpected paleness and loss of energy
  • Easy Bruising
  • An ongoing pain in one area of the body
  • Limping
  • Unexplained fever or illness that doesn’t go away
  • Frequent headaches, often with vomiting
  • Sudden eye or vision changes
  • Sudden unexplained weight loss

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Prevention of childhood cancers

  1. Avoidance of chewing or smoking tobacco.
  2. Protection from sunlight.
  3. Limiting fats in diet
  4. A healthy diet with at least 5 portions of fruits and vegetables per day.

Management of childhood cancers

Childhood cancers are managed by a team of specialized pediatric cancer care specialists, including pediatric oncologists, pathologists, radiologists, surgeons, radiotherapists, nurses and support staff include the nutritionist, social workers, pharmacists and other medical specialists. First, a correct diagnosis is made; depending on the stage of the disease from Investigations carried out, the child is given drugs,  and surgical intervention or radiation therapy may be necessary.

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The challenges in pediatric cancer are numerous but surmountable if there is the will. These are

  1. Recognition of symptoms by parents
  2. Time of presentation/ late presentation
  3. Lack of funds by caregivers
  4. Limited diagnostic equipment/ facilities
  5. High cost of diagnostic investigations
  6. High cost of treatment
  7. Effects of cytotoxic drugs/radiation therapy
  8. Lack of political standing of their own as such children are forgotten in most policies.

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The above challenges can be solved if

  1. Adequate awareness is provided about childhood cancers
  2. Children are exclusively included in the NHIS
  3. Funding is provided for research into childhood cancers
  4. Facilities for diagnosis and treatment are provided.
  5. Provision of psychological support and social welfare services.

In summary

Childhood cancers are a source of significant burden to the child, parents, and caregivers; as such a lot of support is needed; financial, psychological, and spiritual. The distress from the disease, the financial implications, and stress of accessing treatment including the toxicity of the cytotoxic agents is of significant concern, however, children are more likely to recover from cancers when they are detected early and commenced on therapy as quick as possible.

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Dr. Azeezah Shopeyin graduated from the University of Lagos, college of medicine.With several years experience, she also has a master degree in public health. She’s interested in health education and promotion. She’s a wife and mother of two kids and she enjoys making people happy,

Dr. Ajayi Abass Oluwaseyi graduated from Ahmadu Bello University in Zaria. Also known as Juggernaut bn Yusuf, he is also a writer, an aspiring Neurosurgeon, and a Farmer. He currently works at the federal teaching hospital in Gombe.

Author: Dr Ahmad Abdullah, MBBS, MSc Clinical Pathology

Ahmad is a father, a husband and a poet. He was born and raised in Lagos, Nigeria. He earned his medical degree from the University of Juba, currently in South Sudan. He is interested in medical research and currently practicing in Lagos, Nigeria.

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