Specialist Expertise is required

Childhood cancer is fortunately fairly rare.  This means that most doctors, and even specialist paediatricians, see very few cases in their careers. 

The major improvements in success rates in the treatment of childhood cancers over the past 20 to 30 years have resulted from the cooperation of specialist centres throughout the world, who have taken part in joint trials to prove the efficacy of new treatment drugs and protocols. 

It is well established that the treatment centres that take part in the trials on an ongoing basis do achieve a higher survival rate than centres that do not. 

Childhood cancers are different from those in adults, not just in the frequency of the different types of cancer, but also in the protocols that are used to treat them.  The treatment for say leukaemia in a child is very different from that for an adult. 

While adult oncologists are expert in their fields, many of them are not familiar with the special requirements of childhood cancers; there have been cases where an oncologist has given an adult protocol of chemotherapy to a child, with highly unsatisfactory results. 

As a parent organisation, we strongly recommend that any child should be treated by a specialist in childhood cancer, ie by a paediatric oncologist. 

Specialist Treatment Centres

The standard in all major countries is that childhood cancer is treated at a few specialist referral units.  This is done throughout the world.  For example, in the UK there are some 22 such units; in New Zealand there are 3 units. 

These specialist units are normally within the public medical area, and are attached to academic teaching hospitals.  There are standards for Paediatric Cancer Units that have been established by SIOP (the International Society of Paediatric Oncology).  These can be found on the ICCCPO web site (go here), as part of the SIOP guidelines. 

Childhood cancer is one area where it is generally accepted that private medicine is not the preferred route.  In order to develop and maintain the highly specialised expertise required, the medical team must see a large number of patients.  They must also have a wide range of support services (laboratories, other medical disciplines, social workers, etc) as part of a multi-discplinary team.  This has led to almost all of childhood cancers throughout the world being treated by doctors within the specialist centres in the public sector hospitals. 

Treatment in South Africa

We are fortunate that there are some extremely good paediatric oncology units in the country.  Most of the doctors in these units are members of the SA Children's Cancer Study Group (SACCSG), which is the organisation which brings together all of the specialists in the country.  These treatment centres use well established international protocols, and achieve results comparable with those in the "developed world". 

Despite the many recent problems with the public health sector, these childhood cancer units have managed to maintain their standards.  CHOC has played its part in providing support for some of these units. 

It is our policy as an organisation that we want to see a set of specialist referral centres in the country, that are adequately resourced and run in accordance with accepted international standards. 

Where to get treatment in South Africa

We will in due course put a directory of the main centres for the treatment of childhood cancer onto this site. 

In the meantime, the local divisions of CHOC will provide referral points who can suggest doctors who should be consulted.  (See the contact page). 

Remember:  whoever makes the initial diagnosis, you have the right to a second opinion, and you are well advised to get an opinion from a specialist paediatric oncologist.  Your child deserves nothing less than this.