At the age of 17, Xichavo Mhangani, fought and overcame not only childhood cancer but also hunger as he faced his journey alone.

Now 19, the young man can look back at a period he describes as the most difficult of his life. Not only did he fight cancer without the support of his parents, but hunger as well, as he struggled to keep his family alive. His siblings regard him as their hero given his brave efforts.

Mhangani, 15 at the time, had to step up and become both a father and mother to his two younger siblings when his mother passed away. Their mother was their only source of hope with their father out of the picture.

“I believe that I became a man at a very young age. Our mom was the only family we had and to be honest, life has never been easy for us since her death. My cancer diagnoses only made it worse,” he said.  

Rhabdomyosarcoma cancer

Prior to being diagnosed with rhabdomyosarcoma cancer, Mhangani said that he experienced severe pain in his testicles. He often visited the local clinic to seek medical assistance, but they couldn’t figure out what was the source of his suffering.

According to the Mayo Clinic, rhabdomyosarcoma (RMS) is a rare type of cancer that forms in soft tissue — specifically skeletal muscle tissue or sometimes hollow organs such as the bladder or uterus. RMS can occur at any age, but it most often affects children.

Although RMS can arise anywhere in the body, it’s more likely to start in the:

• Head and neck area
• Urinary system, such as the bladder
• Reproductive systems, such as the vagina, uterus, and testes
• Arms and legs

Unbearable pain

“For a couple of months, I had a consistent pain in my testicles which was unbearable. Although I went to the local clinic, they couldn’t detect what was wrong with me. They offered me pain block tablets to alleviate my pain. This all changed when I asked one of the nurses to write me a transfer letter so that I could seek further medical attention at Chris Hani Baragwanath hospital,” he said.

“When I got to the hospital, my testicles were swollen and painful and I struggled to walk. After my consultation with the doctor, they wanted to operate but first did a few tests to see what was wrong. Unfortunately, the tests came back positive for rhabdomyosarcoma. To be honest, the diagnosis shattered me and I felt as if it was the end of the world for me,” said Mhangani. 

The Chiawelo resident, who dreams of becoming a chartered accountant one day, feared that his cancer might not be treatable. The fact that his little sibling didn’t know what was going on with him, made it even more difficult.

“I had no idea where I’d get the money from for treatment. At that moment, I wished my mother was still alive. I had no one to talk to because my siblings didn’t understand,” he added.  

Unknown territory

Dr. Anel Van Zyl, a pediatric oncologist at Tygerberg Pediatric Hematology and oncology unit, said it’s not uncommon for young cancer survivors to not know about what kind of cancer they’ve had or the potential late effects. 

“In the past, the emphasis was on a cure and there was not a lot of attention paid to the possible late effects of childhood cancer and treatment. When the doctor talks to the parents because these children are often so young, they are unable to understand,” said van Zyl.  

“Many survivors do not realise why it is so important to continue long term follow-up treatment and many of them may not enter the programme because it was not important many years ago.” 

Van Zyl spoke during Wednesday’s webinar, under the theme, How High Does Hope Go – hosted by the Childhood Cancer Foundation South Africa. 

Survivorship care plan

She further stated that there is a survivorship care plan for survivors who finish their treatment. This provides details about cancer, treatment, and potential health programmes later in life. 

“Some survivors experience effects like obesity, depression, or learning problems and they blame themselves since they are unaware that it may be due to cancer or treatment. It’s really important for them to realise that it’s not their fault,” added Van Zyl. 

The World Health Organization (WHO) states that each year, an estimated 400 000 children and adolescents aged from 0 to 19 develop cancer. The most common types of childhood cancers include leukemias, brain cancers, lymphomas, and solid tumours. In high-income countries, where comprehensive services are generally accessible, more than 80% of children with cancer are cured.

Though Mhangani is now cancer-free, having lost one of his testicles in the process, he said his cancer journey was very stressful, both financially and emotionally. There were days when he’d go without food. And even now, he and his siblings rely on handouts and social grant money to survive.

Running a household

“Fighting childhood cancer and hunger without support from parents was the most painful thing.  I knew I was the only source of hope for my siblings.  My younger sister, who is now only 15, had to look after me. She also made sure that all the household chores are done; from cooking to cleaning and laundry,” he said. 

“As my testicles were still swollen, the doctors removed one. I also had to go to Chris Hani Baragwanath for treatment like chemotherapy and radiation. Up to this day, I still go there for check-ups. Since I couldn’t afford to travel daily from Chiawelo to Chris Hani, I had to stay at the hospital.” 

“The journey was a very stressful, painful, and emotional one for me and my siblings. I used to worry about them when I was in the hospital, their safety as well as their food. But, we received donations of food parcels from community members and organisations,” said Mhangani. 

Despite missing several weeks of school, Mhangani said that he is grateful that he managed to write his matric last year which he passed.  He is hopeful that his education will help him overcome poverty and provide for this family. 

“I am hopeful that education will open doors for me. I’d like to show other people that just because I’m a cancer survivor, I’m still able to achieve my dreams and goals,” he added. – Health-e News