MEET THE CHILDHOOD CANCER CHAMP

Dr Gita Naidu, a paediatric oncologist at Wits Donald Gordon Medical Centre and Clinical Head: Paediatric Oncology at Chris Hani Baragwanath Academic Hospital, has spent 22 years helping children with cancer. She shares insights into this devastating disease.

While working as a paediatrician early in her medical career, Dr Gita Naidu realised she wanted to dedicate her life to improving children’s chances of surviving cancer. “I was really inspired by the multidisciplinary aspect of the disease,” she recalls. “Not just the scientific and clinical aspects, but also that when you’re treating a child with cancer, it’s not just the child – it’s the whole family. And the outcomes of childhood cancer in low- and medium-income countries are poor. So, I was inspired with a hope that I could make a difference by offering compassionate care to children with life-threatening diseases.”  

Most common childhood cancers

From the beginning, Dr Naidu was well positioned to be a paediatric oncologist. Her Master’s degree was in lymphoblastic leukaemia, a type of blood and bone marrow cancer that is the most common type of cancer in children. She also has a PhD in infectious complications in children with cancer.

“The most common childhood cancers by far are the leukaemias – acute lymphoblastic leukaemia and acute myeloid leukaemia,” she says. “Brain tumours are the second most common types of cancer in children. And we also see a lot of lymphomas, cancers of the eye and cancers of the kidney.”

While adults can lower their cancer risk through healthy lifestyle practices, this is not the case for childhood cancers, which are unpredictable and typically begin before birth.

Constantly developing treatment

By far the most important aspect of treatment is early diagnosis, says Dr Naidu, who helped develop a list of early warning signs that are now used throughout the country and abroad (see “Early warning signs of childhood cancer” below).

The other important factor is the biology of the disease. “Some cancers are really aggressive and some not so aggressive,” Dr Naidu explains. “So, in terms of outcome, it depends not only on what the disease is and what the stage is, but also the biology of that particular tumour.”

Cancer treatment is constantly developing. “Recently there has been a big explosion in immunotherapy and checkpoint inhibitors,” she says. This is a type of treatment where the body’s immune system is prompted to find and destroy cancer cells. Targeted therapy is also used – medication targets a specific factor that helps cancer cells grow. “But we still use the old treatment modalities [radiation, chemotherapy, surgery] because they can still cure childhood cancer – and there have been advances in these areas, too. So, it’s a combination. But the most important thing is early diagnosis.”

Hope Is a powerful thing

Dr Naidu is on the board of directors for Reach for a Dream, an organisation that makes dreams come true for children battling cancer and other life-threatening diseases. “The most important thing about this is that it gives children a feeling of hope,” she says. “So much academic and scientific work has been done on hope. The quality of life that someone has when they have hope, even if they’re going to die, is so much better.”

As for Dr Naidu herself, she draws inspiration from her colleagues, the students she teaches – and the patients who survive. “Recently, I saw a boy whose parents I counselled, saying he was going to die. And he didn’t. Now, he’s an engineer, he’s married to an engineer, and he has three children of his own. When you’re in the ward, treating children, you can feel very despondent. And then when you go to a long-term follow-up, and you see all these patients… that gives meaning to it.”

Early warning signs of childhood cancer

The earlier you catch childhood cancer, the better the chances of treating it successfully. The Saint Siluan system, developed by Dr Naidu and her team, is now in common use. “Siluan was a Greek Orthodox monk (1866-1938) who prayed for humanity – that’s how we got that acronym,” she explains.

S – Seek early diagnosis.

I – Any change in eye signs.

L – Lumps and bumps that are not responding to treatment and growing.

U – Unexplained fever.

A – Aching bones.

N – Neurological change in behaviour – “the child is maybe crawling and stops crawling, or walking and stops walking. Or they have headaches and a lot of vomiting”, Dr Naidu explains.

Coping when your child has cancer

Dr Naidu’s patients often have young parents, who must juggle the responsibilities of caring for a child with cancer and often caring for another child or two at home, as well as the responsibilities of being in the early stages of their careers. “It’s very tough for them,” she says. She encourages parents to lean on whatever support is available. “I tell parents to include the schoolteacher, the neighbour, your religious institution, your family – the more people who know, the more support you have.”