Retinoblastoma is a cancer of the pigment layer of the eye, the same layer which gives the iris its colour. Some children inherit a gene or genes which predispose to this cancer. The overall incidence is slightly greater in Africa than in the UK but it is still relatively rare compared with Burkitt’s lymphoma.
As most readers will know the treatment of Burkitt’s lymphoma has been our primary objective. Prof Peter Hesseling working with our Cameroonian colleagues and supported by BTMAT has developed and refined treatment protocols for Burkitt’s lymphoma. Prof Hesseling’s 2008 protocol which gives over 60% one year survival is now the basis of an international standard treatment for use in hospitals in a resource limited setting.
Prof Mariana Kruger, Prof Hesseling’s successor to the chair of paediatrics and child health at Stellenbosch University has developed a treatment programme for retinoblastoma together with the eye surgeons at the three Baptist Hospitals in Cameroon. The treatment involves chemotherapy and surgery. The chemotherapeutic drugs are supplied by BTMAT. If a child presents with early disease local treatment (laser) may be possible preserving the sight but unfortunately many present late, sometimes with a tumour protruding from the eye socket. Removal of the eye may be the only effective treatment option in this case. This is often unacceptable to parents who will refuse further treatment and take their child away despite our best counsel.
Prof Hesseling and I visited Cameroon in June. Prof Mariana joined us for the first week of our trip. She reviewed the case notes of every child treated under the new retinoblastoma treatment programme this year and presented her findings at a meeting of our combined teams at Mbingo on June 5th – good results so far!
Paul Wharin
Our combined teams at Mbingo, 5th June
Front row from the left:
Nurse Glenn Mbah BBH
Nurse Joel Kaah BBH(PC)
Nurse Philippa Nana MBH
Nurse Vera Larfi BBH
Prof Mariana Kruger RSA
Middle row from the left:
Dr Edouard Katayi BHM
Nurse Comfort Kimbi MBH
Nurse Mercy Santam BBH (PC)
Dr Francine Kouya MBH
Nurse Patience Nfor BHM
Nurse Judith Nji MBH(PC)
Back row from the left:
Prof Peter Hesseling RSA
Dr Paul Wharin UK
BBH: Banso Baptist Hospital
MBH: Mbingo Baptist Hospital
BHM: Baptist Hospital Mutengene
PC: palliative care