Health care providers at the Queen Elizabeth Hospital have been raising concern over the number of children being diagnosed with cancer.
Addressing a recent health conference, Associate Consultant Haematologist Dr Cheryl Alexis pointed to a recent study which showed there were 38 cases of childhood cancers diagnosed between 2012 and July 2016. According to her, there have been two or three additional cases since July.
Dr Alexis noted that half of the diagnosed cases were haematological malignancies, with the most common being Acute Lymphoblastic Leukaemia (ALL) as well as Lymphomas.
“The age range was one of 14 years to 18 years, and a median of 11 years. That actually is higher than the median age that is quoted in other studies in North America and so where the median age is about six to seven years,” she said.
According to her, ALL accounted for 69 per cent of the acute leukaemias in children. The male to female ratio was 1.2 to 1 and the age range was between five to 18 years, with a median age of 10.6 years.
“Again this is a higher age, or an older child than what is really seen in other studies that have been done all over the world. Normally they quote ALL as a median age of around six to seven years. And this is bordering, in terms of age, on the poor prognostic group of patients.
“Sixty per cent of our acute leukaemias are alive and almost a third of them are dead. Interestingly enough, in terms of acute myeloid leukaemia, unfortunately we have a 100 per cent mortality rate with these kids. So we are not doing well there at all,” she said.
Chemotherapy is the most common form of treatment administered to the children, with 42 per cent of the patients still receiving treatment.
“And as you know, with childhood cancer treatment usually especially if you’re looking at leukaemias, which are the more common ones, they are long-ranging treatment, sometimes two to three years … 50 per cent of those patients relapsed, another 32 per cent were patients that died,” Dr Alexis said, adding that there was need to examine the reasons for the high relapse rate.
In terms of adverse events that were experienced by patients, 42 per cent of patients had an adverse effect, and the most were with relapses and death.
“In terms of response to treatment, 80 per cent of our kids with ALL were in remission by the end of induction therapy, whereas with acute myeloid leukaemia, only 20 per cent were in remission after induction, and 40 per cent of those kids died even before getting treatment,” she said.
She added that the time between diagnosis and treatment will impact the child’s survival rate.
“The majority of patients died after four weeks of diagnosis, so it’s a kind of late death, although we have had some early deaths with the acute myeloid leukaemias. A hundred per cent mortality from acute myeloid leukaemia. That is not acceptable,” Dr Alexis stressed.
The Caribbean SickKids Paediatric Cancer and Blood Disorder Project has also been assisting with treatment of the children, Dr Alexis said.
She also pointed for education of primary health care providers on the diagnostic processes, as well as the importance of educating parents to look for warning signs of illness, including behavioural changes.
“So all of a sudden, you have a child that is a good child, that’s getting on, not listening in class, they say he ‘hard ears’, and more so a drop in their academic performance can make you think about something that is happening.”
Dr Alexis noted that a comparison of the parishes showed that cases were higher in the lesser populated parishes of St Peter, St James and St George, compared to the larger parishes like St Michael and Christ Church where only three cases were diagnosed.