Thu | Sep 21, 2017

Cancer in children cannot be prevented

Published:Sunday | November 20, 2016 | 11:00 AMNadine Wilson-Harris
Dr Michelle Reece-Mills
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.
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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 psycho-social 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.

nadine.wilson@gleanerjm.com