Wilms’ tumour (WT) is a childhood cancer of the kidney. It is by no means as common as Burkitt’s lymphoma, but it does occur in Africa – as it does globally – and if untreated, is fatal. BTMAT is providing the chemotherapy for this cancer. Surgery is also required; the parents have to raise the necessary fee for that; it is not easy for them. If treatment is adhered to there is a good prospect of cure, though, as with all cancers, early referral to hospital is essential. BTMAT, under the leadership of our Clinical Director Professor Hesseling, has been collecting and treating WT cases since 2009. We will in the near future have a database, with enough evidence to present our results to colleagues around the world.
Retinoblastoma(RB) is a horrific childhood cancer of the eye. It is about as common as WT, and like WT is responsive to chemotherapy and surgery. We have a fine Ophthalmology service at one of our hospitals (and other eye surgeons at the other two hospitals) where the experienced surgeon has committed his department to the management of RB children. Our senior colleague in South Africa – Professor Mariana Kruger – is an expert in this field, and is developing a protocol appropriate for RB children in Africa. BTMAT will supply the necessary chemotherapy for this disease. Plans are well advanced.
Kaposi sarcoma (KS) is a cancer of children and adults worldwide. It is an AIDS-defining condition in patients with HIV infection. As a result of the HIV’AIDS pandemic (worse in Africa than anywhere in the world) KS has become recognised much more frequently. Hitherto all cases of KS – adults and children – were treated by our HIV specialists in our Cameroonian hospitals. We have now persuaded our HIV colleagues that as KS is a cancer, it would be best treated by cancer specialists. Professor Hesseling has drawn-up a protocol for the treatment of KS children, and this is at present being reviewed by the Ethics Committee at our hospitals. It is likely to be accepted, and to be launched in the near future. Treatment of our children’s HIV will continue, and the necessary chemotherapy will be supplied by BTMAT.
Acute lyphatic leukaemia
Acute lyphatic leukaemia(ALL) is a scourge upon young people throughout the world – being the most common childhood cancer in the developed world. It occurs in Africa, though less commonly than in the developed world. Treatment in the resource-rich world is highly developed and hugely expensive. However, a simplified protocol for the treatment of ALL has been used in Malawi and claims 20% survival rates (compared with 80 – 90% in the UK). BTMAT has acquired the details of the Malawi protocol, and our Clinical Director is studying it to see if we might use it in Cameroon. It is hoped that BTMAT will be able to afford the chemotherapy – the mainstay of treatment. A major consideration will be the follow-up of any ALL child in our proposed study. The follow-up will be over several years – which presents its own problems in Africa. It is likely that we will first embark upon a Pilot Study, in order to assess whether our proposed treatment produces results commensurate with our financial input. BTMAT must ever be aware to bring the most hope of survival to most patients. We are stewards of other peoples money; we must use it wisely; we must not overstretch our resources.