AS the month of February draws to an end, it’s highly likely that the hype and noise around childhood cancer will die down as the world shifts focus towards other health issues on the calendar of events. Under normal circumstances, this should not be the case and we probably need to dedicate 365 days of each year God grants us to raise awareness and talk about childhood or pediatric cancers.
By Michael Gwarisa
It is thus imperative to remind each other that childhood cancer is real and if not detected early, could lead to severe health outcomes. In 2021 alone, Zimbabwe lost more than 60 children to various childhood cancers and the survival rate of children who are diagnosed with cancer is still very low compared to other countries. This however can change should more resources be channeled towards screening and detection of cancer in children, information dissemination and awareness raising as well as procuring medications for childhood cancer patients.
The government of Zimbabwe through the Vice President, Dr Constantino Chiwenga made a pledge at the World Cancer Day commemorations in Harare this month to set aside a fund for childhood cancer in Zimbabwe. Should this materialise, will be a positive step towards addressing the growing scourge of pediatric cancer.
Although childhood cancer is rare, it is one of the leading cause of death by disease in children between 1 and 14 years old. Childhood cancer is also expensive to treat, and puts those that survive at risk of serious illnesses later in life. Exposure to carcinogens in the environment is thought to play an important role in the development of many cancers. It is therefore prudent to know some of these environmental risk factors that may contribute to these cancers and probably find ways of ensuring the country addresses the burden.
In 2017, the then Executive Director for KidzCan, Dr Ntombi Mchuchuti highlighted that a rare type of skin cancer in children, Xerodema was being recorded the most in Epworth, raising concerns that probably there could be an environmental factor linked to the high prevalence of Xerodema in Epworth, a peri-urban settlement in Harare despite it being a cancer most prevalent in tropical regions.
Quoting her in retrospect, Dr Mchuchuti said, “…according to out statistics, we have recorded more cases of this disease in Epworth, we are not sure what could be the reason, could it be their health seeking behavior or either there is something that is in Epworth probably the environment or genetic disorder.”
According to science, Xeroderma pigmentosum and skin cancer is as a result of hypersensitivity of DNA repair deficient xeroderma pigmentosum (XP) patients to solar irradiation which results in the development of high levels of squamous and basal cell carcinomas as well as malignant melanomas in early childhood. The high levels of Ultraviolet (UV ) specific mutations, seen in oncogenes or a is a gene that has the potential to cause cancer and tumor suppressor genes, which have been characterized in Xeroderma pigmentosum tumors, clearly demonstrate the major role of the UV component of sunlight in skin cancer development.
Solar radiation is probably is just one of many environmental factors that have potential to cause or trigger development of cancer cells in a human body. Contaminated air, water, food and the environment at large can harbor harmful cancer causing material.
Speaking to HealthTimes in an interview, KidzaCan Executive Director, Mr Daniel McKenzie said “Children are exposed to the same environmental threats as the adults e.g. Cigarette smoking from adults and other lifestyle issues like exposure to carcinogens in water and air, Which cancers are largely linked to environmental factors in Zimbabwe? From the womb to old age, people around the world are exposed to countless carcinogens in their food, air, water and consumer goods.
For example, benzene, a known cause of human leukemia, is a common pollutant in vehicle exhaust. Radon, a natural radioactive gas found in many homes, raises the risk of lung cancer. Arsenic, linked to skin, liver, bladder and lung cancer, contaminates some drinking water supplies. Other known human carcinogens include asbestos, hexavalent chromium, aflatoxins and vinyl chloride.”
Epidemiologic studies worldwide have provided substantial evidence of the contributions of environmental exposures to the development of childhood cancer. Studies have shown that childhood cancer survivors are more vulnerable to the adverse effects of environmental risks such as air pollution. Fine particulate matter air pollution is a known risk factor for respiratory illness that is especially potent among persons with pre-existing pulmonary conditions.
Childhood cancer survivors have a high propensity for severe lung conditions due to the long-term toxicities of cancer treatment. They have a significantly greater risk of developing congestive heart failure, stroke, coronary artery disease, kidney failure, a second cancer, and other illnesses than their siblings who did not have cancer.
In 2021, Zimbabwe recorded 187 Childhood cancers from across the 10 provinces. In Bulawayo Seven Childhood cancers were recorded, Harare 57, Manicaland 20, Mashonaland East 24, Mash West 18, Mash Central 19, Masvingo 17, Midlands 11, Mat north Seven and Mat South five.
“Kidzcan is dealing with actual problem of a child already diagnosed with cancer by assisting Government 100% with chemotherapy medication for childhood cancer at Parirenyatwa Central Hospital ward A4 special. Issues of environment there are agencies dealing with this,” said Mr McKenzie.
According to a study by the Washington State Department of Health on the “Impact of Environmental Chemicals on Childhood Cancer,” most cancers are thought to begin with a change to the DNA of a cell, causing it to divide out of control. Many different types of DNA changes can lead to cancer and there is evidence that these changes may be caused by a variety of factors, including chemicals, radiation, and viruses. However, the exact causes of specific cases of cancer are usually difficult to determine.
Only a small percentage of childhood cancers appear to arise from damaged DNA that is directly inherited from the parents. Therefore, most cancers are thought to be due to complex interactions between genes and the environment sometime after conception. Efforts to reduce the use of these chemicals and to better control their release into the environment can improve children’s health and lower the burden of disease.
