Dr. Nneka Nwobbi is the President of Children Living with Cancer Foundation (CLWCF), one of the few non-governmental organisations in Nigeria pioneering the fight against childhood cancer. In this interview with Gabriel Ifinnwa, she gives an insight into childhood cancer in Nigeria, and why parents need to pay close attention to their children.
What is the difference between cancer in children, and adults?
Childhood cancer, of course, occurs in children. And depending on the age of the child, there are different types. For instance, cancer of the kidney is most frequent in children age between 2 and 5 years. The outcome (prognosis) of childhood cancer is quite different compared to adults. Also, adult cancer is not as responsive as childhood cancer. We do not have breast cancer in children, although there have been cases of ovarian cancer in Nigeria (although not common). Basically, the differences are the size, the organ affected, and then the cure rate. The cure rate for childhood cancer outside Nigeria is between 80 to 85 per cent, unlike here in Nigeria which is less than 20 per cent. We are having such low rate in Nigeria due to ignorance and lack of awareness in childhood cancer.
What are the symptoms of childhood cancer?
White spots in the eye, new squint, blindness, bulging eyeball; lump abdomen and pelvis, head and neck, limbs, testes, glands; unexplained fever, loss of weight and appetite, pallor, fatigue, easy bruising or bleeding from the gum or into the urine; aching bones, joints, back and easy fractures; neurological change in behaviour, balance, gait and milestones, headaches and enlarging head.
How can parents prevent childhood cancer?
The most important thing is for parents to pay attention to their children, so that they can detect the early warning signs. If there is any deviation in the norm of the child or the parents notice any of the signs of childhood cancer, the child should be quickly taken to a health care giver who will do the needful.
What are the types of cancers that occur most often in children?
At least, there are 16 types of childhood cancer. The types of cancer diagnosed in children are leukaemia, brain and other central nervous system tumours, lymphoma, rhabdomyosarcoma, neuroblastoma, Wilmstumor, bone cancer, among others. But, in Nigeria, the common types are Retinoblastoma (cancer of the eye), cancer of the kidney, leukaemia, cancer of the bone (Osteosarcoma), wilmstumour and lymphoma. These are the most frequent types of childhood cancer in Nigeria.
Is childhood cancer curable?
It is curable, if detected early. Like I said earlier, elsewhere in the world, we have a higher cure rate compared to Nigeria. Unfortunately, in Nigeria, children are never diagnosed or are diagnosed too late for effective treatment. When these children are eventually brought in by the parents, what is left is to carry out palliative care (taking care of the symptoms, until the child passes on).
How can childhood cancer be prevented?
Prevention for childhood cancer is not as easy as it is in adults. Childhood cancer is not lifestyle dependent. We have cases of children as young as 6 to 9 weeks having cancer. How do you prevent such from happening? Remember, that the child is coming from the womb. It is believed that every human being has cancer cells in them. At what stage in life this cancer will manifest remains the question.
What is the rate of childhood cancer in Nigeria?
Of course, you know that data collection is a challenge in Nigeria. The good thing is that we have a body known as Nigeria Society for Paediatric Oncologists (NISPO). The body is trying to ensure better access to data collection across the country. The Nigeria Cancer Society under Prof. Sani Malami must also be commended. They are doing a lot to ensure that data collection is a given priority in the country. Aside this, the body is trying to ensure that the treatment patterns/regiment for cancer, is the same across Nigeria.
What are the treatments for childhood cancer?
Treatment of childhood cancer is the same as those in adults. It is mainly based on the type and stage of the cancer. Some childhood cancers might be treated with chemotherapy. There is surgery and radiation therapy.
Do you think there is a supportive treatment plan for children with cancer in Nigeria?
No. I do not think so. This is not only in childhood cancer, but in other ailments too. As a mother and an advocate for childhood cancer, I think it is really appalling – the way children with terminal diseases are being treated in Nigeria. In the US for instance, 4 per cent of their budget is reserved for childhood cancer research, but still Americans are asking for more. In the case of Nigeria, there is no support at all. This is really sad. I think the Government needs to take action. As one of the foremost cancer charity organisations in Nigeria, we are mainly based in Lagos. We are finding it difficult to reach out to other parts of the country. We get requests from people in other parts of Nigeria asking us to donate chemotherapy drugs for their children, but sometimes due to the logistic and other issues, this is very difficult.
What are the challenges you face in creating awareness for childhood cancer?
The major challenge has to do with the parents. Also, there is also the lack of political will and the issue of ignorance. Parents should understand that it is nobody’s fault that a child has cancer. Childhood cancer is not contagious. So, I do not understand the stigma. We have had occasions where we go out for public outreach programmes and some parents/adults refuse to collect flyers from us. Their response is: “It is not their portion, or for their children to have cancer’’. And so “they reject it in Jesus name”. I think people must realise that childhood cancer does exist in Nigeria. Parents need to be aware that no child is immune to cancer. Our duty as an organisation is to create awareness and to ensure that the public is well informed about the dangers of childhood cancer.
We are urging parents to be open minded; the more the parents are informed the better they stand a chance of fighting this scourge. The government on its part needs to do more. Fighting cancer is a very expensive venture. And the government should get involved. Most parents spend time away from work trying to cater for their children with cancer. Some of these parents are even disillusioned, watching their children in pain. So, the Government should enforce some form of legislation to protect these parents so that they are not victimised at work or lose their livelihood. Also, lack of awareness on childhood cancer is a challenge in Nigeria. I have had conversations with people that should know, but yet, are not well informed about the dangers of childhood cancer. This is a challenge.
Do you have any affiliations with any foreign organisations in fighting childhood cancer?
No, we do not have any. But we are part of Child Cancer International (CCI). It is a group that supports what every country is doing to support families that have childhood cancer. What they do is to help cancer charities set up training programmes, where doctors in developed countries would assist to train doctors in the developing countries. We are willing to partner with any organisation that is ready to support our cause. Although, there are some individuals and companies, that have supported us over the years. But due to the economic situation in the country, it is becoming difficult.
What is your advice for parents of children with child cancer?
I know that no parent wants anything bad to happen to their child. What we are asking parents to do is to make sure they get information about childhood cancer, especially during our programmes. You can never tell, this information may be helpful to someone else. And for those who want information about childhood cancer, they can always visit our website.