Despite Wilms tumour-a cancer of the kidney that typically occurs in children and very rarely in adults-being the second most common cancer among young children in South Africa, there are several factors that still hinder early diagnosis.

Professor Janet Pool from the Department of Paediatrics and Child Health at the University of Witwatersrand (Wits), said Wilms tumour accounts for 11.9% of childhood malignancies in the country. It has a female predominance and has a higher incidence in children of African origin.

“Wilms tumour accounts for between 6-7% of all childhood cancer and between 85-90% of all renal tumours. About 70% of children are diagnosed between one and five years of age with a peak incidence at three to four years,” stated Poole.

Poole spoke during the Childhood Cancer Foundation South Africa (CHOC) webinar on Wednesday. The discussion aimed to increase disease knowledge with the hope of reducing mortality and morbidity of children with cancer.  

The World Health Organisation (WHO) states that each year, an estimated 400 000 children and adolescents aged 0-19 years old, develop cancer.  The most common types of childhood cancers include leukemias, brain cancers, lymphomas, and solid tumours such as neuroblastoma and Wilms tumours.

According to Poole, there are many factors which hinder early diagnosis including myths and beliefs. 

Childhood cancer sometimes goes undiagnosed and untreated. A lack of specialised medical services and geographic locations also plays a role, as well as a lack of awareness in the health profession. Myths and beliefs add to the challenge,” she said. 

Father’s firsthand experience

Duncan Mudau* from Thohoyandou in Limpopo, noticed his 7-year-old son’s tummy was getting bigger by the day. He never suspected that there was anything wrong with the then three-year-old and never sought medical attention.

“When my son was three, he complained of stomach cramps and refused to eat. But we never thought it was something serious even though his stomach seemed bigger. However, one day he started crying and told us that he experienced severe pain when he urinates,” said Mudau.

“It was at that moment that we decided to take him to a local clinic. The nurses told us to rush him to the Tshilidzini Hospital where a doctor immediately examined him. They told us they needed to keep him at the hospital to run some tests,” the 28-year-old father added.

Mudau, who is unemployed, said he got the shock of his life when he was told his son has Wilms tumour. The little boy was rushed to the Limpopo Provincial hospital in Polokwane for an urgent operation.

“When they broke the news to us, it broke my heart because I didn’t know anything about the condition. They told us it was common among children and that they’d have to remove the affected kidney,” Mudau explained.

He added: “Luckily they assured us that everything will be done for free as his mother and I are unemployed. Everything went well and all that’s left are some scars from the procedure. He is fully recovered and even doing well at school.” 

Varying symptoms

According to Mayo Clinic, the signs and symptoms of Wilms tumour vary and some children don’t show any obvious signs. But most experience:

  • An abdominal mass, swelling or pain
  • Fever
  • Blood in the urine
  • Nausea or vomiting
  • Constipation
  • Loss of appetite
  • Shortness of breath
  • High blood pressure

According to Poole, surgery is the vital first step during treatment and is essential for a cure. 

“The surgery needs to be performed by an experienced paediatric surgeon and no laparoscopic surgery should be done, as the whole abdomen needs to be explored. The approach should be through a large abdominal (not lumbar) incision as the kidney and the tumour should be excised widely en-bloc, together with the adjacent lymph nodes and peritoneal tissues,” she explained.

Mudau* urged fellow parents to immediately seek medical assistance when they think something is wrong with their child.

“I never took it seriously when my son told me that he doesn’t feel well. Had I taken him to a clinic sooner, he might still have had both his kidneys. But due to my ignorance, he now only has one,” he said.  – Health-e News