SOUTH AFRICA—Cancer Crayon is the first-of-its-kind cancer care initiative for paediatrics, adolescents, and young adults, that has been launched by the Cape Metropole, South Africa.
Icon Oncology and Cancercare announced the new collaboration to establish a dedicated cancer treatment unit for young people in the Western Cape and beyond.
As a specialist paediatric, adolescent and young adult oncology unit, it promises to tackle childhood cancer head-on.
The Crayon Unit will be based at Cape Gate Oncology Centre and will offer an integrated service with a multidisciplinary team of clinical, surgical and allied health professionals ready for action.
Cancer Crayon will offer a patient-centred approach that considers the unique needs of children, adolescents, young adults, and their families to ensure successful outcomes while minimising long-term risk.
The unit reports that its radiation and medical oncology team includes experts in paediatric medical and surgical care, systemic treatment planning, precision radiotherapy techniques, radiology expertise, child psychology, nutritional well-being, and rehabilitation.
The main goal of the new unit is to ensure safe and effective treatment whilst also creating a system for ongoing care and survivorship to address any potential consequences of the disease process and associated therapy.
The unit notes that its child-and-teen-friendly environment will awards privacy, reduces anxiety and creates a safe space for parents and their young patients.
Dr. Johann Riedemann, Lead Childhood and Adolescent Oncologist at Cancer Crayon Unit said, “Young people living with a cancer diagnosis require a very different approach than that used for adults.”
Dr. Riedemann also stated that the Crayon tailors support that addresses each young patient’s specific medical, emotional, social, and developmental needs.
“At its heart is our newly formed multidisciplinary team, who are devoted to delivering the best possible care for young patients. This all in a safe and welcoming environment,” explains Dr Riedemann.
Dr. Riedemann is a clinical radiation and molecular oncologist at Cancercare and a network oncologist at Icon Oncology.
This enables him and his team to deliver precision radiation therapy and radiosurgery, utilising a modern fleet of linear accelerators (linacs) across the Western and Eastern Cape.
“The radiation treatment of young children with cancer can be overwhelming for patients, parents, siblings and caretakers,” Dr. Riedemann notes.
Crayon’s reiterated that its focus is on solid tumour pathology which includes nervous system cancers, head and neck cancers, nasopharynx, lung cancers, abdominal cancers, soft tissue cancer and urogenital cancers.
“It is a dream come true, thanks to the passion and dedication of a team of exceptional humans. Together we are tackling childhood cancer. Taking the fear out of treatment and ensuring a positive journey to better health for our young patients,” capped Dr Riedemann.
Redefining a new era to tackle cancer in young people
The JCO Global Oncology journal notes that as per global estimates of diagnosed cases, the 5-year net childhood cancer survival is at 37.4%.
However, there are large regional variations ranging from 8.1% (4.4% -13.7%) in eastern Africa to 83.0% (81.6% – 84.4%) in North America in childhood cancer survival rates.
Subsequently, the differences in childhood cancer survival gaps between developing and developed countries can be as high as 70% and can be explained by gross inequities in treatment access, quality of care, and affordability.
The JCO journal also notes that childhood cancer survival rates are low in sub-Saharan Africa given factors that include late presentation at diagnosis, treatment abandonment, absence of sophisticated multidisciplinary care, and lack of adequate resources.
In addition, reasons for late presentation include limited awareness of cancer symptoms, high treatment costs, and facility-level barriers to timely access to treatment.
The 14th International Society of Paediatric Oncology (SIOP) Africa Continental Congress, held in Uganda in 2022, also heard that lack of transport to health facilities, the choice of traditional healers over clinically trained physicians, and lack of finance and information also play a part in treatment abandonment.
Moreover, global cancer statistics also show a two-to-threefold increase in paediatric cancer incidences in low-index Human Development countries.
“We estimate that more than 28,000 children died of cancer in sub-Saharan Africa in 2020,” said Dr. Jean-Marie Dangou, Noncommunicable Diseases Programme Coordinator at the WHO Regional Office.
Dr. Dangou reasoned that substantial investment in cancer prevention and care, including quality training of medical professionals, must be made if only to avert cancer deaths and cases, especially among children, in our region.
In 2018, WHO launched the Global Initiative for Childhood Cancer, with the aim of reaching a 60% survival for children with cancer aged 0–19 years by 2030.
To reach this goal the Lancet Oncology Commission recommends adapted regimens for childhood cancers, both in terms of tolerability and considering the low availability of drugs and supportive care.
Another consideration for the region is a multidisciplinary approach to addressing both childhood cancer and infectious diseases.
For example, the Epstein-Barr virus is implicated in Hodgkin lymphoma a common paediatric cancer, with Plasmodium falciparum reported as a cofactor in this association with Burkitt lymphoma.
Preliminary studies suggest a role for malaria control programmes in reducing Burkitt lymphoma incidence.
Additionally, HIV-related malignancies, such as non-Hodgkin lymphoma and Kaposi sarcoma, also point to a potential benefit of antiretroviral therapy programmes and prevention of mother-to-child HIV transmission in reducing the cancer burden.
Indeed, combating infectious diseases to reduce the cancer burden has proven effective with hepatitis B virus and human papillomavirus vaccinations in many regions globally.
The commission report in 2022 concluded that large-scale efforts to address the region’s cancer burden are already in motion, and the specific local needs of children with cancer must be targeted and prioritised.
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