By Rudo Shoko

ACCORDING to the Childhood Eye Cancer Trust (CHECT), the flash from a smartphone camera can easily spot/identify retinoblastoma, a rare type of aggressive eye cancer that most exclusively affect children.
Childhood cancer affecting children under the age of five has become an emerging public health concern in Zimbabwe together with cardiovascular diseases, diabetes and chronic respiratory diseases among adults.
The World Health Organisation (WHO) says Zimbabwe is one of the countries with the highest cases of retinoblastoma in the world.
WHO describes retinoblastoma as a cancer which starts in the retina, the very back part of the eye.
The eyes develop very early as babies grow in the womb and during the early stages of development, the eyes have cells called retinoblasts that divide into new cells and fill the retina.
At a certain point, these cells stop dividing and develop into mature retinal cells.
Rarely, something goes wrong with this process.
Instead of maturing into special cells that detect light, some retinoblasts continue to divide and grow out of control, forming a cancer known as retinoblastoma.
If retinoblastoma tumours are not treated, they can grow and fill much of the eyeball.
Cells might break away from the main tumour on the retina and float through the vitreous to reach other parts of the eye, where they can form more tumours.
If these tumours block the channels that let fluid circulate within the eye, the pressure inside the eye can rise.
This can cause glaucoma, which can lead to pain and loss of vision in the affected eye.
Most retinoblastomas are found and treated before they have spread outside the eyeball, but retinoblastoma cells can occasionally spread to other parts of the body.
The cells sometimes grow along the optic nerve and reach the brain.
The International Society of Pediatric Oncology and the International Confederation of Childhood Cancer Parent Organisation, on the other hand, state that about 175 000 children are diagnosed with cancer worldwide and eventually about
19 000 die annually.
The National Cancer Prevention and Control Strategy for Zimbabwe also says: “Late detection of retinoblastoma is one of the leading causes of death of children under the age of five in Zimbabwe.”
Patriot Health, through the Cancer Association of Zimbabwe, established that there is need to dismiss the belief that childhood cancers are ‘curses’ because this has led to many families desisting from seeking medical attention.
Timely interventions are therefore compromised.
Cancer starts when cells begin to grow out of control.
Cells in nearly any part of the body can become cancerous and can spread to other areas of the body.
According to CHECT, children who have retinoblastoma often have a white glow around their pupils that shows up when photographed with a flash camera.
When a tumour grows inside a child’s eye, it can reflect back as a white pupil in flash photos, and if spotted early, it could save a child’s vision, eyes and life.
Most childhood cancers initially present with non-specific signs and symptoms, which may lead to late detection but according to WHO, there are certain signs one has to look out for which include:
– White spot in the eye, squint, blindness, bulging eyeball.
– Lump in abdomen/pelvis, head and neck, in limbs, testes and glands.
– Unexplained prolonged fever for over two weeks.
– Loss of weight, pallor, fatigue, easy bruising or bleeding.
– Aching bones, joints, back and easy fractures.
– Change or deterioration in walk, balance or speech.
– Headache for more than two weeks with or without vomiting and enlarging head.
In high-income countries, because children are usually subjected to close parental and medical surveillance, cancer has a high chance of being detected early.
In low-resourced countries, however, there are additional barriers to early detection, including poor access to health services and inadequate diagnostic facilities.
In high-income countries, approximately 80 percent of children with cancer survive five years or more after the diagnosis of cancer.
These improving outcomes result in a growing population of long-term survivors who need follow-up treatment and care.
The prognosis is much lower for children diagnosed with cancer in low and middle-income countries.
Factors explaining this include:
The late diagnosis of cancer leading to lower levels of effective treatment.
Poorly equipped hospitals without the appropriate medicines and equipment.
Other diseases that children might have and a lack of knowledge about cancer among primary health care providers.
In addition, treatment is simply not affordable for many parents in low-resource settings who would be required to pay for the costs themselves.
According to research, if cancer is detected early enough in children, there is a 70 percent chance of survival.
Up to 80 percent of children with cancer live in developing nations and more than half of these children will die because they lack access to prompt, effective treatment.
There are two forms of retinoblastoma; a heritable form and non-heritable form.
Bilateral retinoblastomas are commonly heritable, while unilateral retinoblastomas are commonly non-heritable. – Source – WHO