Early diagnosis key to treatment of childhood cancer

Most of adult cancers can be linked to lifestyle factors. [iStockphoto]

Cancer is one of the leading causes of death worldwide. According to the World Health Organisation, cancer was responsible for nearly 10 million deaths in 2020, translating to one in every six deaths.

In Kenya, cancer is the third leading cause of death after infectious and cardiovascular diseases. According to the GLOBOCAN report, 42,116 new cancer cases and 27.092 cancer deaths were reported in Kenya in 2020 alone.

Globally it is estimated that there are 400,000 new childhood cancer cases and more than 80 per cent of them in low and middle-income countries like Kenya. Although the national cancer registries for childhood cancer in Kenya have not captured all the data, it was estimated by GLOBOCAN 2018 that the country diagnosed about 3,200 new cases which was an under estimation since population statistics propose that we should be diagnosing about 6,000-7,000 new cases a year. Unfortunately, about 50 per cent of children with cancer in Kenya do not get a diagnosis at all!

Most of adult cancers can be linked to lifestyle factors like exposure to infectious agents, alcohol or cigarette smoking, unhealthy diets, obesity and possibly environmental toxins. However, most childhood cancers have no known risk factors with only about 5-10 per cent being associated with genetic or inherited syndromes like Downs Syndrome.

Screening of childhood cancer is of minimal value as most of the symptoms and signs of the diseases are shared with other infectious illnesses. It is, therefore, necessary, for parents and healthcare providers to maintain a high index of suspicion especially if patients, who do not improve on conventional therapy for infectious diseases, have symptoms that persist, or worsen while on treatment.

In high income countries, the cure rates of childhood cancers is above 80 per cent, but that of LMICs is still way below 20 per cent. A local study at the Moi Teaching and Referral Hospital found that only 20 per cent of children being treated for childhood cancer in Kenya would survive their diagnosis.

We attribute the dismal outcomes of childhood cancer in our setting to late presentation, a low level of awareness on symptoms and signs by caregivers and front-line healthcare providers, weak referral systems, inadequate diagnostic and treatment facilities, and financial challenges when parents and caregivers have to pay for their health services out of pocket.

Access to effective diagnosis and treatment is crucial to improving survival rates for childhood cancers in LMIC. It is important for childhood cancer to be diagnosed early, because it significantly improves the outcome of treatment.

Gertrude's Children's Hospital and the Gertrude's Hospital Foundation have been at the forefront of addressing some of the challenges facing diagnosis and treatment of childhood cancers. The foundation runs an annual Childhood Cancer Charity Walk that seeks to raise Sh10 million every year to improve cancer diagnosis and treatment.

-Dr Karimi is a haemato-oncologist at Gertrude's Children's Hospital