'CHILD­HOOD CAN­CERS CAN­NOT BE PRE­VENTED'

Jamaica Gleaner - - FRONT PAGE - Na­dine Wil­son-Har­ris Gleaner Writer na­dine.wil­son@glean­erjm.com

MORE THAN 60 chil­dren are di­ag­nosed with can­cer an­nu­ally, but at least one ex­pert in the treat­ment of pae­di­atric can­cer be­lieves that there is very lit­tle a par­ent can do to pre­vent this.

Dr Michelle Reece-Mills, who is one of only two pae­di­atric on­col­o­gists in Ja­maica, shared that can­cer in chil­dren is of­ten re­lated to chro­mo­some and ge­netic changes more than any other fac­tor.

“With pae­di­atric can­cer, we don’t have a lot that is nec­es­sar­ily pre­ventable, so early recog­ni­tion then be­comes im­por­tant in or­der to pick up these cases re­ally early. I can’t tell a mom, ‘Ok, if you eat this, your child is not go­ing to get it, or if you feed your child this, be­cause the data is just not there to prove that these things are re­li­able in terms of mak­ing a dif­fer­ence in the out­come for kids who have can­cer,” she told The Sun­day Gleaner.

Ac­cord­ing to data from the Min­istry of Health, about 36 girls and 28 boys up to the age of 14 years were di­ag­nosed with can­cer each year be­tween 2003 and 2007. The top three can­cers among chil­dren in Ja­maica are lym­phoma, leukaemia, and brain can­cer. At least 56 chil­dren died from can­cer in 2014 based on in­for­ma­tion gleaned by the health min­istry from the Regis­trar Gen­eral De­part­ment.

Last year, both the Pan Amer­i­can Health Or­gan­i­sa­tion (PAHO) and the World Health Or­gan­i­sa­tion (WHO) launched a man­ual for health-care providers on how to di­ag­nose child­hood can­cer ear­lier based on the re­al­i­sa­tion that can­cer is a lead­ing cause of death in chil­dren over one year in many coun­tries in the Amer­i­cas. In 2012, some 29,000 chil­dren un­der 15 years old were di­ag­nosed with can­cer in the re­gion.

“Pae­di­atric can­cer is not con­sid­ered pre­ventable, but early de­tec­tion in­creases the chances it can be cured. In re­cent years, ad­vances in treat­ment and new clin­i­cal pro­to­cols and guide­lines have con­trib­uted to im­proved sur­vival rates,” a joint PAHO-WHO state­ment noted.

Reece-Mills says that there might be

chil­dren who are cur­rently liv­ing with can­cer who are yet to be di­ag­nosed. “It is said that mainly be­cause of the prob­lem with di­ag­nos­ing can­cer, the so­cio-economic sta­tus of a coun­try will in­flu­ence how many cases are ac­tu­ally tested be­cause some­times you don’t have the re­sources, or the chil­dren die be­fore they are ac­tu­ally pre­sented to a med­i­cal fa­cil­ity,” she said. “For our pop­u­la­tion, we are ba­si­cally ex­pect­ing more num­bers, so we are not record­ing the num­bers we ex­pect if you com­pare it to, let’s say, a high-in­come coun­try like the US or Canada.”

BE VIG­I­LANT

The pae­di­atric on­col­o­gist wants par­ents to be vig­i­lant and rec­om­mends annual vis­its to the pae­di­a­tri­cian. In the case of leukaemia, for ex­am­ple, symp­toms gen­er­ally in­clude per­sis­tent or in­ter­mit­tent fever, re­cur­ring in­fec­tion, bleed­ing of the nose or skin, blood in

the urine, or ex­treme fa­tigue. For can­cers, gen­er­ally, per­sis­tent vom­it­ing and headaches, espe­cially at nights, as well as the pres­ence of a lump are usual red flags.

Reece-Mills is pleased that Ja­maica has been mak­ing strides in di­ag­nos­ing and treat­ing these cases, but she be­lieves that there is much more that needs to be done to max­imise the man­age­ment of treat­ment for chil­dren with can­cer.

Among her de­sires is the es­tab­lish­ment of a pae­di­atric on­col­ogy hos­pi­tal. She be­lieves this is im­por­tant be­cause chil­dren do­ing chemo­ther­apy are gen­er­ally more sus­cep­ti­ble to in­fec­tions and should, ide­ally, be iso­lated from other sick chil­dren. She be­lieves that there is also need for more psy­choso­cial sup­port for the chil­dren af­fected and their par­ents since the di­ag­no­sis gen­er­ally af­fects fam­i­lies fi­nan­cially and psy­cho­log­i­cally.

“We are looking at the pos­si­bil­i­ties of not do­ing well and dying and these are things that can cause de­pres­sion,” she said.

The cost of treat­ment varies de­pend­ing on the type of can­cer and whether a

fam­ily is us­ing a pub­lic or pri­vate hos­pi­tal, but in any event, it can be very ex­pen­sive.

“Treat­ment of leukaemia is not short. It’s two and a half years for girls and three and half years for boys, so the ex­pense that you can gen­er­ate over that time will run you into close to $2 mil­lion. Prob­a­bly per month you are pay­ing $50,000 to $60,000, de­pend­ing on the phase of treat­ment. Af­ter a while, that be­comes bur­den­some and then there is the cost of the hos­pi­tal stay.

“You need tests, you need scans, and scans have got ex­pen­sive as well,” she said.

But the sit­u­a­tion is not hope­less for chil­dren liv­ing with can­cer. Sev­eral of Reece-Mill’s young pa­tients are now liv­ing nor­mal lives, and the Gov­ern­ment has launched a few ini­tia­tives in re­cent times to help with treat­ment and di­ag­no­sis. Among them is a part­ner­ship with Hos­pi­tal for Sick Chil­dren ‘Sick­Kids’ in Canada and Columbia Univer­sity to help strengthen pae­di­atric can­cer ser­vices at the Bus­ta­mante Hos­pi­tal for Chil­dren.

The cost of treat­ment varies de­pend­ing on the type of can­cer and whether a fam­ily is us­ing a pub­lic or pri­vate hos­pi­tal, but in any event, it can be very ex­pen­sive.

DR MICHELLE REECE-MILLS

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