SIOP PODC: Clinical Guidelines for the Management of Children With Wilms Tumour in a Low Income Setting
ABSTRACT Wilms tumour is a relatively common and curable paediatric tumour. Known challenges to cure in low income countries are late presentation with advanced disease, malnutrition, failure to complete treatment and limited facilities. In this article, management recommendations are given for a low income setting where only the minimal requirements for treatment with curative intent are available (setting 1). These include general management, supportive care, social support and registration of patients. Recommendations specific for Wilms tumour care include diagnostic procedures with emphasis on the role of ultrasonography, preoperative chemotherapy with a reduced dosage for malnourished children and postoperative chemotherapy based on surgical staging. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc.
Full-textDOI: · Available from: Kathy Pritchard-Jones, Sep 29, 2014
- SourceAvailable from: sciencedirect.com
[Show abstract] [Hide abstract]
- ". The International Society of Paediatric Oncology PODC group have recently produced a series of Guidelines for the Management of Children in low income settings for Wilms tumour , Endemic Burkitt Lymphoma , Kaposi Sarcoma , Retinoblastoma  and Supportive Care . A six country collaborative project to convert the guidelines for Wilms tumour into a specific study is being activated. "
ABSTRACT: Given the huge disparity in the chance of survival for children with cancer born in low income countries (LICs) compared with those in high income ones, there is an urgent need to assist those striving to support, palliate and offer curative treatment in resource limited settings. International twinning partnerships offer the opportunity to provide advice, expertise, support and technology transfer from established paediatric oncology units to developing ones in order to help them overcome the challenges facing them. It may help them to avoid the mistakes made over the last 50 years during which childhood cancer survival has progressed in high income countries from little expectation of cure to 75–80% long term survival. Projects must be locally driven by the team in the LIC, but volunteers and funding organisations can help to make progress possible. There is mutual benefit for all concerned.Journal of Cancer Policy 03/2013; 1(s 1–2):e8–e19. DOI:10.1016/j.jcpo.2013.06.001
- [Show abstract] [Hide abstract]
ABSTRACT: In all the major medical centers throughout the Middle East, there is a functioning pediatric hematology oncology department. In almost all countries, opioids such as morphine, oxycodone, and fentanyl are available. Pediatric palliative care services are still in their infancy and await further recognition and development. Unfortunately, there are still countries in the Middle East where children with cancer are diagnosed when the disease is already at stage III or IV, when the only option left is palliation. To decrease the incidence of late presentation, more effort is needed concerning public awareness, and concomitantly, an urgent need to develop hospital-based and community-based palliative and supportive care services. The initial step in this direction would involve more training of health care providers: Pediatricians, Pediatric Oncologists, Oncology Nurses, and Social Workers with updated pharmacological and nonpharmacological modalities of treatment.Journal of Pediatric Hematology/Oncology 03/2012; 34 Suppl 1:S1-11. DOI:10.1097/MPH.0b013e318249aa98 · 0.96 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Reduction of child mortality is one of the Millennium Development Goals; as low-income and middle-income countries (LMICs) advance toward the achievement of this goal, initiatives aimed at reducing the burden of noncommunicable diseases, including childhood cancer, need to be developed. Approximately 200 000 children and adolescents are diagnosed with cancer every year worldwide; of those, 80% live in LMICs, which account for 90% of the deaths. Lack of quality population-based cancer registries in LMICs limits our knowledge of the epidemiology of pediatric cancer; however, available information showing variations in incidence may indicate unique interactions between environmental and genetic factors that could provide clues to cause. Outcome of children with cancer in LMICs is dictated by late presentation and underdiagnosis, high abandonment rates, high prevalence of malnutrition and other comorbidities, suboptimal supportive and palliative care, and limited access to curative therapies. Initiatives integrating program building with education of healthcare providers and research have proven to be successful in the development of regional capacity. Intensity-graduated treatments adjusted to the local capacity have been developed. Childhood cancer burden is shifted toward LMICs; global initiatives directed at pediatric cancer care and control are urgently needed. International partnerships facilitating stepwise processes that build capacity while incorporating epidemiology and health services research and implementing intensity-graduated treatments have been shown to be effective.Current opinion in pediatrics 02/2013; 25(1):3-15. DOI:10.1097/MOP.0b013e32835c1cbe · 2.74 Impact Factor