Everything you need to know about childhood cancers

Christopher Owuor Omoro is a distraught man having lost his little boy to childhood cancer a little over three years ago. "Christopher Owuor Omoro Junior was vibrant, witty and so full of life and he will always be my son," says the senior Chris. He confesses that every time he is leading prayers at the family table, he always mentions his late son. Chris Junior had been hospitalised at only 10 months after accidentally eating mud while crawling. Chris says Junior, as he was fondly called, had stomach problems but tests revealed amoeba. "Later at four years, he developed some tiredness, which came with unhealthy looking skin," says Chris.

He further says that a diagnosis was reached when the stomach issue became a daily problem. "Junior was admitted in Nairobi Hospital when he was around five, in 2012," says Chris. "After a week, tests revealed my boy had Acute Lymphoblastic Leukemia," explains Chris Snr. "It was a big blow to us as family but we soldiered on towards his total healing that never was," says a sad Chris. "We got all sorts of discouraging words, with death as the end result," reveals Chris. The literature online was not hopeful either," he says.

It would appear like there is a rise in childhood cancers because of the number of cases being highlighted in the media in recent times. However, Prof William M Macharia, a leading Paeditrician Haemato-Oncologist and Associate Dean, Research Faculty of Health Sciences at the Aga Khan University Hopital, clarifies that this illusion of increase can be attributed to correct diagnosis and awareness of the disease today. "Childhood cancers are not new," says Prof Macharia. "Unfortunately, their occurrence in olden days was either attributed to witchcraft or an unknown strange phenomenon," he explains. The diagnosis too, wasn't accurate, so it would appear childhood cancers didn't exist, says Prof Macharia.

Are children born with the cancer?

While adult cancers are brought on by lifestyle related causes, it isn't the case for childhood cancers. Prof Macharia says that children are not born with cancer. However, he explains that something could go wrong during cell division and multiplication (cell replication) after conception. Referred to as a genetic accident, Prof Macharia says it becomes like a time bomb and can be triggered by anything in future resulting in a cancer. "It's like a landmine," he explains. "You don't even know it exists until someone steps on it and it explodes," says Prof Macharia. "A trigger could be a viral infection or anything affecting the child's health," he explains. "If nothing triggers the genetic accident, the child might even enjoy good health for a long time," he says. At one point, Chris says that Junior went into remission, which was a sigh of relief to the emotionally and financially drained family. "We were now set to move to the next stage of treatment but due to lack of finances (by now Junior has depleted the family medical cover), we changed hospitals to KNH," explains Chris. "There Junior stayed for three months without treatment as they carried out fresh diagnosis," he says. Chris believes this three month gap, was the reason his son went into a relapse. "The relapse occurred between September and December 2015 while at Kenyatta," says Chris.

He believes if it were not for financial constraints, the relapse wouldn't have occurred. "I remember one day he had eye problems and I had to carry him shoulder high to the bus stage. He was quite heavy and when I mentioned this to him "Junior wewe ni mzito", he answered immediately, "Daddy just keep walking." This response really gave me strength to soldier on. Even in death, he still remains my son.

"The peak age for childhood cancers is between three to seven years," explains Prof Macharia. "This is not enough time for anything from the environment to cause cancer seeing as it takes about 20 - 30 years to develop cancer. Thus the attribution to genetic accidents," explains Prof Macharia. And how old is the youngest patient he has come across? I prod. "A two-months-old baby who had a solid tumor," he says. "She is 18 now," he says, looking pleased. He further shares a success story of a young woman about 24, who recently graduated as a doctor, working in Nakuru. "She had cancer of the kidney at around three or four years and recovered," says Prof Macharia.

What are the chances of a full recovery for a child? "Doctors want these cancers picked very early," he explains. "When picked at stage one or two, they are easier to cure. However, in their advanced stages, stage three and four, success is low," explains Prof Macharia. He notes that the survival chances depend on the stage and type of cancer. " All advanced stages are not good," says Prof Macharia. He also cites two childhood cancers as having a low success rate; Neuroblastoma Cancer (affecting the suprarenal glands situated above the kidneys) and Acute Myeloid Leukemia (AML), a blood cancer.

What can a new parent do? Prof Macharia advises parents, especially mums, to thoroughly examine the child when bathing. "Feel the child all over and look out for any swellings or abnormalities," he advises. "Since there is no cancer screening for the young ones, a parent should be very alert," he says. "For instance, cancer of the eye can be picked early by shining a torch in your child's eye," explains Prof Macharia. "If you see a reflection from the black part of the eye (like a cat's eyes), consult a doctor immediately," he advises. Expectant mums should also avoid radiation rays as they could lead to genetic accidents.

Are some children more cancer prone than others? Children born with genetic abnormalities are at a higher risk. "Children with Down Syndrome are at a high risk of leukemia," he says. But there is hope for cancer patients. "Detecting the cancers early enough is always best as it results in less treatment and fewer side effects thus a relatively good quality of life. Today we have refined radiotherapy with a pin point focus that is confined to the affected area resulting in fewer side effects," says Prof Macharia. "Solid tumours are easy to pick if it is in an exposed part of the body. Unfortunately, cancers are generally painless unless they are pressing on other organs, causing pain and

discomfort," he continues. While costs are an inhibiting factor for many cancer patients, the load has been made easier by the recently introduced NHIF scheme that covers chemotherapy treatments.

"Cancer treatment is not affordable by the common citizen," stresses Chris who still owes Gertrude's Hospital, Muthaiga, Sh3 million which, which he has no idea how to raise and relies on well-wishers. Chris wishes the government would get a way in which those affected can access free medical services and care just like polio is given a national priority.