Expert care guides little cancer fighter back to health
Posted on 3 August 2021
When four-year-old George Rafferty complained that the backs of his knees hurt, his parents had no idea of the medical journey that lay ahead. Luckily, they did exactly what paediatricians recommend: they took the little boy seriously and sought treatment. What began as knee pain led to a biopsy, a cancer diagnosis and an intensive, gruelling – and ultimately very successful – course of treatment. Just more than a year on from his first visit to paediatrician Dr Omar Jooma at Mediclinic Pietermaritzburg, George’s cancer is in remission and his oncologist, Dr Kate Bennett of the Wits University Donald Gordon Medical Centre (also a Mediclinic facility), is delighted by her young patient’s progress.
George and his parents live in the KwaZulu-Natal farming district of Muden. When he was brought in complaining of pain behind his knees, Dr Jooma conducted an examination. “There wasn’t much to find,” he explains. “I thought maybe it was a muscle inflammation or [the aftermath of] a viral infection, so I treated him with painkillers.” The pain persisted; an orthopaedic surgeon examined George and reached a similar conclusion to Dr Jooma. But by 5 August 2020, it was clear that something much more serious was happening. By then, George had developed a persistent headache and complained of pain in his abdomen.
“When I examined him, I was amazed – I found a tender mass in his abdomen,” Dr Jooma says. It was “quite moderate” in size and located in the central part of the abdomen, under George’s belly button. An ultrasound illustrated just what was going on: “There was a huge mass on the left side where the left kidney was.”
After a biopsy, George was referred to Dr Bennett at Wits Donald Gordon Medical Centre in Johannesburg. The worrying mass was a tumour in the boy’s mesentery, which attaches the intestines to the posterior abdominal wall. This important membrane holds the intestines in place, in addition to helping with fat storage and allowing the blood and lymph vessels, as well as the nerves, to supply the intestines. It also contains lymph nodes – and sometimes, as in George’s case, tumours develop in those nodes.
George was diagnosed with Burkitt lymphoma and Dr Bennett was on hand to guide him and his mom, Tordi, through the treatment process in Johannesburg.
Dr Bennett explains that Burkitt lymphoma is very aggressive. It is responsible for the fastest-growing of all cancer tumours: these can double in size in between 24 and 48 hours. The disease had also reached George’s bone marrow. He was admitted into the ward at Wits Donald Gordon Medical Centre and immediately started on a treatment protocol.
“Because the tumour grows so fast, it’s very sensitive to chemotherapy, so it breaks down really quickly,” Dr Bennett says. Doctors must keep a careful eye on the side-effects of the tumour’s dissolution and, though George experienced some negative effects, “he managed absolutely amazingly” – as did his supportive mom, who was by his side throughout. After five weeks of treatment, he was in remission. His tumour is gone, and his bone marrow is clear. He still visits Dr Bennett every six to eight weeks for blood tests, scans and a sonar. Now five years old, he’s in good health and good spirits.
Dr Bennett acknowledges that a cancer diagnosis is frightening, especially for a parent who doesn’t expect their child to fall seriously ill. But with the paediatric and oncological expertise available in South Africa, she says survival rates for childhood cancer are far superior to those in adults.
“This is not a death sentence. It’s not an easy road, but with intensive treatment, most children can be cured.”
She, like Dr Jooma, encourages parents to listen to their children – and points out that doctors must also listen carefully to parents who, after all, know their children best.
The Childhood Cancer Foundation South Africa (CHOC) uses the St Siluan warning signs of childhood cancer. If you recognise any of these in your child, see your healthcare provider immediately:
S – Seek medical help early for ongoing symptoms
I – White spot in the eye, new squint, sudden blindness or bulging eyeball
L – Lump on the stomach, pelvis, head, arms, legs, testicle or glands
U – Unexplained fever present for over two weeks, weight loss, fatigue, pale appearance, easy bruising and bleeding
A – Aching bones, joints, back and easy fractures
N – Neurological signs, a change in walk, balance or speech, regression, continuous headaches with/without vomiting, and enlarged head