Understanding childhood cancer in Kenya
What you need to know:
- The most common type of childhood cancer is leukaemia, a blood cancer.
- Almost all childhood leukaemias are acute forms, either acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia with ALL being the more common of the two.
What is childhood cancer, and how does it differ from adult cancers?
In Kenya and globally, a child is anyone under the age of 18. Cancer is the uncontrolled growth of cells and tissues, so childhood cancer is this abnormal growth occurring in children.
According to Dr Catherine Muendo, a paediatrician haemato-oncolologist at Kenyatta National Hospital, childhood cancers are quite different from adult cancers in a number of ways she explains in the subsequent questions.
What are the most common types of childhood cancer?
Dr Muendo notes that the most common type is leukaemia, a blood cancer. Almost all childhood leukaemias are acute forms, either acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia with ALL being the more common of the two.
“After leukaemia, the next most common cancers we see are lymphomas, which are another type of blood cancer. Among solid tumours, the most common are Wilms tumour, which affects the kidney, and retinoblastoma, which affects the eye,” she says.
She notes that these cancers are not among the most common in adults, highlighting how distinct childhood cancers are.
“At Kenyatta National Hospital, the cancers we most often encounter are leukaemia, lymphomas, Wilms tumour and retinoblastoma. These four dominate the childhood cancer landscape in Kenya,” says Dr Muendo.
What are the early warning signs that parents should look out for?
Dr Muendo explains that unlike many adult cancers, childhood cancers are not caused by lifestyle or environmental factors. Children may even be born with cancer due to genetic mutations, so it is not possible to prevent them. That’s why early recognition is critical.
She says signs to watch for include persistent fever that does not respond to antibiotics, unexplained bleeding or bruising, white discolouration in the eye (cat's eye reflex), sudden loss of the ability to walk or play, a staggering gait, swelling in the neck that does not resolve with infection treatment and dark circles around the eyes caused by bleeding under the skin.
“We educate communities and healthcare workers about the signs of cancer through training sessions, the media and social media platforms because spotting it early can save lives,” she says.
What is the prevalence of childhood cancer in Kenya?
The Ministry of Health estimates there to be around 2,500 cases per year. However, this figure may be underestimated due to under-diagnosis and incomplete data reporting. Paediatric cancer cases are far fewer than adult cases, but 2,500 is still a significant number.
“We are strengthening data reporting to get a more accurate picture. The National Cancer Institute, which is part of the Ministry of Health, collects this data and maintains a cancer registry. This helps to prioritise resources for treatment and care,” says Dr Muendo.
What is the survival rate for childhood cancers in Kenya?
This depends on the type of cancer, its stage and risk category. For acute lymphoblastic leukaemia, the survival rate is around 70 to 80 per cent, compared to 90 to 95 per cent in Western countries. The survival rate for acute myeloid leukaemia is lower, at around 30 to 35 per cent, whereas in Western countries, it is around 70 per cent. Lymphoma survival rates range from 60 per cent to 90 per cent depending on the subtype.
Dr Muendo says early-stage solid tumours have better outcomes than advanced stages.
Overall, when looking at all childhood cancers in Kenya, general survival is around 20 to 30 per cent. The World Health Organization’s (WHO) Global Initiative on Childhood Cancer aims to improve this figure to 60 per cent by 2030.
Which types of childhood cancer does the WHO initiative focus on?
The initiative focuses on six index cancers that are common and highly curable with proper therapy: These are acute lymphoblastic leukaemia, Burkitt lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour and low-grade glioma. These six cancers account for around 50 to 60 per cent of all childhood cancers worldwide.
What developments or initiatives in paediatric oncology in Kenya give hope for the next five to 10 years?
“Yes, several initiatives give us hope,” says Dr Muendo. One such initiative, she explains, is the patient navigation programme, which provides holistic support for children and their families, guiding them through diagnosis, treatment and survivorship.
The programme addresses physical, emotional and financial challenges, and helps to prevent treatment abandonment, which is a major cause of poor outcomes.
Studies in Kenya have shown that treatment abandonment can be as high as 50 per cent, leading to cancer progression or relapse.
Another initiative is childhood cancer awareness and sensitisation programmes. “We train healthcare workers in counties that frequently refer patients late, helping to ensure earlier detection and timely referral. We are also streamlining referral pathways to reduce delays and improve access to treatment,” she explains.
Partnerships and collaborations are also key. Paediatric haematologists across Kenya communicate and work together in both public and private facilities. With only about 15 specialists serving the population, coordination is critical to improving care.
Advice for parents whose children have just been diagnosed with cancer
Dr Muendo says parents should not be scared by the diagnosis. There is a support system in place to guide them and their children through treatment. They should seek care promptly rather than waiting at home. “Cancer is not necessarily fatal—children can survive and thrive with proper treatment.”
