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HEALTH PLUS MEDICAL CORRESPONDENT

Before COVID-19 surfaced, there was another medical condition that all health care professionals disliked diagnosing – that is “CANCER”; which is also non-discriminatory, can occur at all ages and can affect any part of the body. Patients all around the world equated a diagnosis of Cancer to that of, one step closer to heaven’s gates and dreaded this diagnosis. It becomes even more upsetting when it is a child.

September marks Childhood Cancer Awareness Month

The PROBLEM:

• Cancer is the leading cause of death for children and adolescents around the world and approximately 300,000 children aged 0 to 19 years old are diagnosed with cancer each year.

• In high-income countries more than 80% of children with cancer are cured, but in many low- and middle-income countries (LMICs) only about 20% are cured.

• Avoidable deaths from childhood cancers in LMICs result from lack of diagnosis, misdiagnosis or delayed diagnosis, obstacles to accessing care, abandonment of treatment and higher rates of relapse.

According to published reports by World Health Organization, “Unlike cancer in adults, most childhood cancers do not have a known cause. It begins with genetic changes in a single cell that then grows out of control. If left untreated, cancer generally expands, invades other parts of the body and causes death.” Many studies have sought to identify the causes of childhood cancer, but very few cancers in children are caused by environmental or lifestyle factors.

Early diagnosis is KEY

The most effective strategy to reduce the burden of cancer in children is to focus on a prompt, correct diagnosis followed by effective therapy. When identified early, a correct diagnosis is essential to treating children with cancer because each cancer requires a specific treatment regimen that may include surgery, radiotherapy, and chemotherapy.

Early diagnosis consists of three components:

• Medical Literacy and awareness of warning signs by families

• Clinical evaluation, diagnosis and staging (determining the extent to which a cancer has spread)

• Access to ongoing treatment

Coping with Childhood Cancer

For any family, being informed that their child is diagnosed with cancer is devastating. Adjusting to this diagnosis and finding ways to stay strong is challenging for every single person in that family. In Trinidad and Tobago, one such family, the Josephs, turned their lost battle with Childhood Cancer into a benediction for other families coping with a similar tragedy. Health Plus interviewed the founders of The Just Because Foundation (JBF) as they commemorate their 13th Anniversary.

JBF is a non-profit organisation founded by Chevaughn and Noel Joseph in honour of their son Jabez ‘JB’ Joseph. JB was diagnosed with a rare form of childhood cancer, Alveolar Rhabdomyosarcoma (cancer of the muscle) at the age of 3 ½ and succumbed to his illness at the age of 5 ½ in March 2007. The Foundation was launched on 2nd August 2007, which would have been JB’s 6th birthday and is dedicated to improving the quality of life for children with cancer and their families in Trinidad and Tobago and around the Caribbean. JBF continues with its mission of creating greater awareness of the warning signs of Childhood Cancer.

Chevaughn said “It’s crucial that anyone who is a parent, guardian or caregiver to a child is aware of the signs of childhood cancer. It can very easily be masked as other typical childhood illnesses or injuries and therefore can easily be missed.”

Here are some of the most prevalent types of childhood cancer in Trinidad and Tobago and some of the key signs and symptoms.

Acute Lymphoblastic Leukaemia (ALL)

ALL, the most common type of childhood cancer, is cancer of the blood that starts in the bone marrow and spreads to the bloodstream. (The bone marrow is the spongy internal part of bones where new blood is made).

Leukaemia develops because of a mutation in a white blood cell that causes it to multiply uncontrollably. These mutated white blood cells, called “blasts” take over the bone marrow and crowd out normal blood cells. One blast soon generates billions of other blasts, with a total of about a trillion leukaemia cells typically present in the body at the time of diagnosis.

Signs and Symptoms:

• Fatigue and paleness

• Fever

• Bruising or bleeding – known as thrombocytopenia

• Bone pain, sometimes associated with swelling of the joints

• Weight loss or loss of appetite

• Enlarged lymph nodes

Hodgkin’s Lymphoma (Hodgkin’s disease)

Hodgkin’s Lymphoma is a cancer that affects your lymphatic system which is a part of your immune system that helps to fight infection and disease. This system includes the lymph nodes, tonsils, bone marrow, spleen, and thymus.

It has been reported in infants and young children, but it is considered rare before the age of five. Most cases are in teenagers and young adults.

Signs and Symptoms:

The most common symptom of Hodgkin lymphoma is swelling of the lymph nodes.

Lymph nodes are found in the neck or above the collarbone, as well as under the arms or in the groin. They are usually painless, firm, rubbery, and movable in the surrounding tissue.

Brain Tumours and Central Nervous System Tumours

Brain tumours in children occur in the central nervous system (CNS) and spinal cord. Together, these important organs control functions such as breathing, heart rate, movement, thinking and learning.

Signs and Symptoms:

Typical symptoms of CNS tumours are directly related to the location of the tumour.

• Headaches (frequent, recurrent)

• Vomiting – especially in the morning

• Eye movement problems and/or vision changes

• Unsteady gait or worsening balance

• Weakness in the arms or legs

• Bulging fontanel (soft spot on an infant’s head) or increased head size

• Tilting of the head or neck to one side

• Seizures/Dizziness/Loss of Consciousness

• Difficulty with speech, swallowing or drooling

• Irritability or other behavioural changes

• Hearing loss

Wilms Tumor and Neuroblastoma

Wilms tumor is the most common form of kidney cancer in children.

Neuroblastoma most often originates in the adrenal glands, which are located on top of each kidney. However, tumours can begin anywhere in the body such as the chest, neck and pelvis.

Signs and Symptoms:

• A lump or mass or pain in the abdomen

• Blood in the urine (Wilm’s Tumour)

• Fever

• Diarrhoea

• Nausea and vomiting

• Weight loss

• Anaemia, fatigue

• Shortness of breath

• Elevated blood pressure

• Weakness or paralysis if the tumour is near the spinal cord (Neuroblastoma)

The NEXT STEPS

We believe, equipped with this knowledge, the next step is seeking early medical intervention. The same way it is recommended that women have their annual pap smears and mammograms done and men their PSA’s; please ensure that your children have an annual physical exam done. Keep in mind, Chevaughn’s motherly advice to the general public, “Please be vigilant, early detection can definitely save lives.”

Look out for HEALTH PLUS every Tuesday for more informative and healthful articles. If you have any questions or concerns regarding this topic, please email [email protected]