World Cancer Day is observed worldwide on February 4 with the theme “We Can. I Can.” Raising awareness and providing education about childhood cancers can lead to saving more lives. Joy Wanja Muraya, Health and Medicine Editor at The Conversation Africa, interviewed Jessie Githanga about the difficulties in diagnosing and treating childhood cancer in Kenya.
What are the prevalent cancers in Kenya, the region, and across Africa? What are their possible causes? Kenya lacks precise data on the most common cancers because it doesn’t maintain an up-to-date population-based cancer registry. Instead, it relies on regional registries that are mainly hospital-based, which, while not exhaustive, still provide useful data since most patients eventually visit hospitals where this information is collected. The primary childhood cancers include lymphoma, blood cancers such as leukemia, and cancers of the brain, eye, kidney, and muscle cells. Differences in prevalent cancers are seen in countries like Mozambique, Uganda, Zambia, and Malawi due to the higher incidence of childhood HIV/AIDS, which leads to AIDS-related cancers like Kaposi’s sarcoma and certain lymphomas. In areas with high malaria infections, Burkitt’s lymphoma is the leading childhood cancer, unlike in developed nations where symptoms vary.
Are childhood cancers different from those in adults? Adult cancers are often linked to lifestyle risk factors such as poor diet, obesity, lack of physical activity, and increased tobacco and alcohol consumption.
Are African children receiving proper treatment? What challenges do they face? In developed nations, children diagnosed with cancer have an over 80% survival rate, whereas in Africa, it is below 20%. This disparity is attributed to multiple interconnected reasons, including late diagnosis due to lack of awareness among guardians, healthcare workers, and the population at large, along with limited access to treatment facilities. There is also a lack of diagnostic capabilities and an alarming scarcity of treatment centers specifically designed for childhood cancer across most sub-Saharan African countries. The high cost of chemotherapy drugs, limited radiotherapy facilities, and the absence of bone marrow transplant technology exacerbate the issue, making treatments costly. Moreover, there are not enough healthcare professionals trained in pediatric cancer, including oncologists, pathologists, surgeons, nurses, pharmacists, and palliative care experts.
Treatment protocols are often not standardized, evidence-based, or tailored to the capabilities of each developing country. Furthermore, there is minimal research and clinical trials on local childhood cancers, which is concerning since the most effective treatments are often developed within clinical trials. Current data shows that even when cancer types are similar to those in developed countries, there are biological differences that significantly affect treatment choices and results. It is crucial to conduct further research, including clinical trials, to identify suitable treatments and improve outcomes.
What steps is Kenya taking to address these gaps? Kenya has recognized that cancer is a major issue. Although primary attention has been devoted to common adult cancers, such as breast, cervical, and prostate cancers, more focus is now being directed towards childhood cancers through the efforts of government agencies, non-governmental organizations, professional groups, and civil society. Initiatives include partnerships between the Ministry of Health, the National Cancer Institute in the US, the Kenya Network of Cancer Organisations, the Kenya Hospices and Palliative Care Association, the Kenya Society for Haematology and Oncology, and various independent donors and supporters. Groups specifically targeting children have been established, such as the Kenya Childhood Cancer Trust and Hope for Cancer Kids. The National Health Insurance Fund is considering financing all aspects of childhood cancer treatment. Studies in public hospitals have shown that children with health insurance have better survival chances than those without. While there is still much work to be done, these efforts are expected to bear fruit in time. Better coordination among various stakeholders is needed to prevent overlapping efforts.
What is the future direction for Africa in combating cancer? Advocacy and raising public awareness are crucial if Africa is to progress in addressing childhood cancers. International and national cancer awareness days should be complemented with ongoing awareness campaigns. Twinning programs that link centers in resource-rich countries with those in resource-limited ones have been successful in Ethiopia and Ghana, enhancing capacity and patient survival. Clinical trials that can improve survival rates and build capacity should be conducted.