Monday February 15 2016

Signs of childhood cancer


By Gillian Nantume

Childhood cancer in our local setting has become more apparent not necessarily because of a high prevalence rate, but because of the awareness in the public.
Where once, a parent might have mistaken a tumour on their child’s body as a manifestation of witchcraft, parents now are more willing to visit hospitals for proper diagnosis.
Dr Fadhil Geriga, a child cancer specialist at Uganda Cancer Institute says, “What we are observing now is that there is more awareness among the community and the health workers. If a parent senses some unusual sickness in the child, instead of them taking the child to a Health Centre II, they now come to the hospital.”
As the world marks International Childhood Cancer Day today, there is a global campaign to raise awareness about childhood cancer.

Warning signs
Early warning signs released by the American Cancer Society include:
•Bruising or bleeding, and general bone pain.
•Lumps or swellings especially if painless and without fever or other signs of infection.
•Unexplained weight loss, persistent coughs, shortness of breath, and night sweats.
•Eye changes, visual loss and bruising or swelling around the eyes.
•Unexplained abdominal swelling.
These signs have been translated into Luganda and Swahili by Bless a Child Foundation (BCF), which offers palliative care to children suffering from cancer.
Although the Swahili signs are being used in Kenya and Tanzania, logistical arrangements have affected the use of the Luganda signs today.
“People come to hospitals when the cancer is in advanced stages because of lack of awareness,” says Brian Walusimbi, CEO, BCF, adding, “By the time they visit all the health centres and then are referred to Uganda Cancer Institute, it is often too late.”
A late diagnosis will often mean that the cost of treatment will be high and the chances of survival low.
“If a parent notices these signs, they should take the child for a checkup. It may not be cancer but it could be. What is wrong with going for a checkup and realising there is nothing wrong with the child? As a parent, you have nothing to lose.”

The commonest childhood cancers
The most common of childhood cancers in our local setting is Burkitt’s Lymphoma, a cancer of the lymphatic system.
“It manifests as a swelling in the jaw,” Dr Geriga says, adding, “Most times it begins in the form a simple toothache that leads to a swelling. But the swelling does not go down.”
Burkitt’s lymphoma is a fast-growing tumour that is associated with impaired immunity and can be fatal is left untreated.
The second commonest childhood cancer is Leukemia, which begins like any other illness with malarial signs.
“Symptoms can include unexplained weight loss, a child will cry all the time because of body pains, night sweats and lack of blood.”
With Leukemia in children, there are no known causes, although in some cases genetic predisposition puts one at risk of acquiring the disease.
Cancer of the kidney (Wilms tumour) occurs mostly in infants and toddlers.
Dr Geriga says this tumour presents as a swelling in the abdomen.
“A mother can feel it as she is bathing her baby. The tumour is painless and one can think it is just the spleen or akabaggo. Alternatively, a mother may notice blood in the baby’s urine.”
As with most cancers in children, the cause of Wilms tumour is unknown although some researchers have tagged it to poor development of the kidneys in the foetal stage.
The other common childhood cancer is caused by or is in relation to HIV/Aids presence in the body. Kaposi Sarcoma or cancer of the skin shows symptoms of keloids and swellings in the glands or neck, genitalia, and mouth.

Other cancers are cancer of the bone, brain, and eye, although these are not quite common in children.
“Most childhood cancers are curable even in Uganda,” says Dr Geriga, continuing, “It all depends on how early the cancer is detected. I encourage parents to bring their children for screening when they notice something peculiar about them.”