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    Why many children are dying of cancer


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    At the Uganda Cancer Institute, at least 5,000 cancer cases in children are treated every year and worldwide 400,000 cases are recorded.

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    However, only 20 per cent of children diagnosed with cancer survive – that is, if they complete their entire treatment regime from early diagnosis to supportive care. The low survival rate is attributed largely to the high recurrence of these cancers brought on by mismanagement of treatments by caregivers.

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    Speaking at the official commissioning of Covid-19 isolation rooms at Bless the Child Foundation in Kikoni, Makerere, Ann Akullo, a pediatric oncologist, said cancers are one of the leading causes of premature deaths in children in the country yet they are curable if detected early.

    Most common cases of cancers in children recorded at the Uganda Cancer Institute include, Leukemia, kidney, lymphoma and Kaposi’s sarcoma, among others, she said. Generally speaking, unlike adult cancers, no specific cause can be attributed to child-hood cancers though a few cases recorded cases are genetic, she said.

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    The stages of cancer treatment are quite drawn out and many and can take close to three years. For leukemia, which is the most common cancer in children, the first month is always for induction, then a bone marrow test is done to rule out leukemia cells, which have to produce a 0.01% MRD to be negative for the next stage called consolidation.

    Most other cancers are treated through cycles and the first cycle of treatment is meant to suppress the bone marrow to give it opportunity to recover while the child’s blood count is monitored before the next cycle. For kidney tumors, the first cycle takes two to three months before surgery is carried out.

    But all these depend on the stage of the cancer spread, the type of cancer, histology of the cancer and genetics of the cancer.

    The many deaths in low-income countries are brought on by the lack of essential medicine and right technologies because treatments include suppressing the bone marrow, blood transfusions, other blood products like platelets, right nutrition and family support, which are really wanting.

    Parents should look out for unusual symptoms in their children, like a child having a big stomach even when well fed, lymph nodes that keep growing even after several treatments, swellings on a child’s body that can’t be attributed to anything like a child falling, prolonged fevers that don’t respond to treatments for several months.

    Leukemia presents bruises on the child’s skin and bleeding in different parts of the child’s body, for example the eyes. So, with early diagnosis of these childhood cancers, treatment and support from family members will slash the death rates by 40 per cent by 2030.

    Brian Walusimbi, the executive director of Bless the Child Foundation, said parents give up on treatment along the way constrained by the high costs of medication and other expenses like transportation of the patient throughout the treatment period.

    With a grant of 7,000 pounds gotten from the British High Commission, the foundation put up four Covid-19 isolation rooms in Mbarara and Kampala last October to provide more safety for the vulnerable children undergoing treatment at the cancer institute during the pandemic.

    The well-furnished rooms provide space for children and caregivers. With the survival rate expected to be at 60 per cent by 2030, communities need to be sensitized about early detection of cancers because most parents report to health centres late.

    Simon Tucker, the first secretary at the British High Commission, said every day about 1,000 children are diagnosed with cancer, making it the leading cause of death among children worldwide.

    The vast majority of these children live in low to medium-income households. While advances have been made in childhood cancer treatment with an 80 per cent survival rate in high income settings, there are still areas in low and middle-income countries where survival is as low as 20 per cent to 30 per cent due to inequalities in access to care.

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