The types of cancer that develop in children are often different from those that develop in adults. Most adult cancers are linked to lifestyle-related risk factors or other environmental risk factors that lead to DNA damage over time. The cause of most childhood cancers are not known.
Pearl Namuwonge happily and firmly holds her mother’s hand as they look into the camera for a photo moment. The two have reason to celebrate. Five years on, her mother, Betty Namubiru Muwonge, shares her child’s survival story from the scourge of cancer. One evening in 2013, Pearl returned home frail and unhappy. When her mother sent her to the shop to buy groceries, she could hardly move comfortably.
“As she moved, she held onto walls for support. I got concerned and asked her what had happened. She said a teacher had caned her, which triggered a lot of pain in one of her legs,” Muwonge recollects.
Scared, she took her daughter for treatment. An x-ray revealed nothing but since she still felt pain, she was referred to Uganda Cancer Institute, where a biopsy (an examination of tissue removed from someone to discover the presence, cause, or extent of a disease) confirmed she had cancer of the bones. She was immediately put on medication. Back home, Namuwonge’s father was devastated and despite her mother relentlessly seeking treatment, he discouraged her, saying cancer was incurable.
“He walked out on us. The good thing was that part of the medication was free. Many mothers would frequent the cancer institute to treat their children. Many were poor and could not sufficiently support their children through the process because at times, the drugs were for sale. We would have to buy drugs at between Shs35,000 and Shs70,000.
Some of the mothers and guardians were from upcountry, which was another cost altogether,” Muwonge further recounts.
Dr Peter Wasswa, a paediatric haematologist whose speciality is looking after children with blood diseases, including blood cancer, says: “Children are a delightful group of people to work with and I work with children up to 18 years of age. Cancer in children is a little bit rare. It is estimated that about 8,000 children develop cancer. Of these, we diagnose 10 per cent,” Dr Wasswa explains.
He observes that in developed countries, 80 per cent of children found with cancer, are cured. “Over the last two years, as the Uganda Cancer Institute, the outcomes for the treatment of cancer are improving and we still aspire to reach the same levels that the western world have reached. For children with cancer, the most important thing is to get them into care so that chances of survival are increased.
According to Jolly Kamugisha, a nutritionist with Mulago National Referral Hospital, understanding the needs for cancer patients is key. “It is important to manage eating problems related to side effects from cancer treatment,” she observes.
She singles out diarrhoea as a common ailment among children with cancer and recommends that they are given plenty of fluids to counter dehydration. It also causes loss of appetite and Kamugisha says in case children lose their desire to eat, they can be given small frequent meals of up to six times a day.
“Give the children foods that are high in sodium, for example, baked beans, bananas, Irish potatoes and apricots among others. Give them drinks at room temperature and avoid foods that make diarrhoea worse, particularly high fibre foods, sugary and fatty foods.”
In case of children developing dry mouths, the nutritionist advises thatthey are given sips of water throughout the day, in addition to sweet drinks which help in generating saliva in the mouth and easing chewing of food.
She also recommends that such children are fed on soluble and easy to swallow foods for example those with sauce, gravy or salad dressing. Soups are also good.
Ideas to help children of all ages:
• Encourage your child to express how they feel. There are specialists at many hospitals for children who know how to help children of different ages using play, artwork, or journals.
• Talk with your health care team about when your child can return to school. Some children will be able to go to school off and on during treatment.
• Talk with nurses, social workers, and other parents of children with cancer about your emotions and ways to cope. Children will cope better if their parents are getting enough support.