· Osteogenic sarcoma commonly affects children and young adults aged between nine and 19 years and affects the long bones.
· If not promptly treated, the cancer that progresses rapidly can metastasise to the spine, chest and other parts of the body
Image: Alice Waithera
@Alicewangechi
In June, 11-year-old Sharon Njeri came home from school limping and with a swelling below her right knee.
She told her mother Lydia Wairimu that she fell while playing with her schoolmates.
Naturally, her mother was not concerned and was sure the swelling would subside in a few days as is common with children.
But a week later, Wairimu was concerned that her daughter’s swelling had continued to grow despite the rubbing that she did with anti-swelling ointment. Normally, that works like magic.
Wairimu from Kairi village in Gatundu North decided to take her to a local health facility for a check-up and was given drugs which she took for two more weeks. Instead of going down, the swelling worsened.
After returning to the same health facility, she was referred to another one where an X-ray was conducted and doctors told her that her daughter had a bone tumour.
The doctor further said the child’s leg would have to be amputated to save her life.
Image: Alice Waithera
In denial, Wairimu hopped from one medical facility to another seeking alternative opinions, but all medical practitioners gave her the same answer.
But most facilities she visited asked for huge deposits to treat her daughter that she could not afford.
Both she and her husband are unemployed.
It was while she was sitting at home one day pondering what to do that she saw a doctor on a local TV station explaining such tumours.
The doctor, Stephen Ngige, is stationed at Maragua Level 4 Hospital and uses the TV segment to educate Kenyans on healthy living.
Last Monday, Wairimu travelled to Maragua where the doctor evaluated her daughter and affirmed what the others had told her. That her daughter would lose her leg.
Both mother and child were counselled and booked for treatment. Njeri is now recuperating in hospital after her leg was amputated at the knee.
“Doctors have told me that my decision to seek treatment after the swelling failed to subside has saved my daughter’s life. They say the disease is fast-spreading and could go into other parts of the body including the chest”.
She hailed Maragua Level 4 Hospital for the treatment but expressed sadness that her daughter had become physically disabled at such a young age.
She is bright in school and at the top of her class, she explained, and will require a prosthetic leg to help her continue with her studies.
“I am appealing to anybody who could help us get the artificial leg and educate us to come out and assist us”.
Image: Alice Waithera
Njeri wants to be a nurse in future to save other people's lives as the doctor has saved hers.
Dr Ngige, the deputy director of medical services at the hospital, said when she was brought in, Njeri had a painful swelling and had a septic wound that was discharging pus.
After doing an MRI, a CT Scan, and biopsy, Ngige said he discovered that the child was developing a rare case of bone cancer called osteogenic sarcoma that progresses rapidly.
It is a high-grade form of tumour with a high risk of metastasism if not treated promptly.
“We had to do an operation to remove the tumour and the child is currently recovering. We do follow up that includes occupational therapy, physiotherapy, chemo and radiotherapy after doing radionuclide scan,” he said.
Ngige underscored the need for parents to urgently take their children for a medical check-up once they notice them limping, with a swelling on their leg or arm or with a deformed limb.
The cancer, he explained, affects long bones such as humerus, radius, ulna, femur, tibia or fibula bones.
It is initially painless but due to its rapidly expanding nature and its invasion of tissues around, patients tend to develop deformities, ulcerations, sepsis and bleeding.
“If your child starts walking with an abnormal gait or experiences pain while standing, you should take them to the hospital for an evaluation so that serious conditions such as osteogenic sarcoma and ewing’s sarcoma, another form of bone cancer, can be ruled out. Don’t just assume it's trauma”.
Such symptoms could also be caused by other benign conditions such as oestemas, benign outgrowth of bones that are mainly found on the bones of the skull.
If untreated, osteogenic sarcoma can metastasise to the spinal cord and cause paralysis and or to the chest and cause dyspnea, a condition where breathing becomes difficult and painful.
Image: Alice Waithera
It can also go up to the brain cells and force the patient into convulsions or even coma.
The cancer also causes severe anaemia as it interferes with the bone marrow, which is the precursor of red blood cells.
Patients get recurrent chest infections such as pneumonia and common viral infections such as respiratory syncytial virus and are predisposed to tuberculosis.
They are also likely to develop psychosocial problems such as depression and anxiety due to the nature of the disease.
The patient is also unlikely to feed well and is prone to cachexia, a wasting syndrome and eventually die.
Ngige cautioned parents with children between nine and 19 years to be extra cautious, saying that is the peak of bone tumours in adolescents and young adults.
The cancer is quite common, he said, with a number of patients having a family history.
Ngige explained that doctors can do tumour marker tests for those predisposed to various types of cancer.
Scientists are looking into gene therapy that treats or prevents disease by altering a person's genetic makeup and stem cell therapy that promotes the repair response of diseased tissue using stem cells instead of just chemo and radiotherapy.
Ngige said the government is making efforts towards mitigating against cancer, especially with the expanded immunisation programme focussed on some viruses that can cause cancer.
He said children get routine immunisations for Hepatitis B virus to prevent hepatocellular carcinoma, the most common liver cancer, while adolescents are getting free Human Papilloma Virus vaccine that causes cervical cancer.
Antiretroviral therapy given to immunosuppressed patients has also greatly helped to deal with other types of cancer associated with HIV such as abdominal lymphomas that cause swelling and pain in the abdomen, among others.
Edited by A.N