Beryl Thyer
Memorial Africa Trust
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Burkitt's Lymphoma: Professor Hesseling
Dear reader,
I shall start by introducing myself. My fulltime occupation until my retirement 4 years ago was that of Professor in Paediatrics and Child Health at Stellenbosch University and Tygerberg Academic Hospital in South Africa, where I started a children’s cancer service in 1974. I have been an active member of the International Society for Cancer in Children (SIOP) for many years, and while serving as the first African SIOP continental president, organized the first SIOP African Continental meeting in 1994. At that meeting the enormous differences in available human and other resources, and the huge differences in survival in children with cancer between western countries and poor developing countries was painfully evident.
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Myself and Eucalia;
a survivor of Burkitt’s lymphoma.
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We drafted a resolution to attempt to develop affordable and effective treatment for the most common of all central African childhood cancers, known as Burkitt Lymphoma (BL).The reported cure rate for BL in many African countries at that time was only 25%, compared to a cure rate of >75% in South Africa and in western countries with intensive modern treatment. In 1996 SIOP called a special board meeting in London to discuss the needs of children with cancer in developing countries, and agreed to sponsor a BL Pilot study in Malawi. This was followed by several other BL treatment studies in Malawi.
At a SIOP conference in Porto in 2003, a paediatric oncologist called Dr Barry Pizer (Alder Hey Children’s Hospital, Liverpool, UK) - an acquaintance of Peter McCormick (better known as Dr Peter) - met me after I had presented a paper on the Malawi BL programmes, and asked if I would be willing to correspond with Peter Mc, who as a volunteer worker in Cameroon had encountered many patients with BL, and was anxious to treat them in the best possible way. At that time I was looking for other hospital sites in Central Africa at which to implement and evaluate the Malawi BL programmes. Dr Peter already had all the prerequisites for a sound working partnership in place at Banso Baptist Hospital in the Northwest province of Cameroon.
I obtained a grant from the Lisa Thaxter Trust, UK; the Institutional Review Board approved the implementation of the 2002 Malawi BL protocol, and a very fruitful partnership commenced that resulted in the treatment of children with BL at the Cameroon Baptist Hospitals at Banso, Mbingo and lastly Mutengene. I planned new studies and wrote research grants. Dr Peter used his personal resources, until a bequest from his late sister Beryl made it possible for him to establish the Beryl Thyer Memorial Africa Trust. This enabled him to do fundraising on a bigger scale, and to obtain essential drug donations from pharmaceutical companies.
Teams consisting of a doctor, research nurse and ward sister were trained at each hospital to counsel parents, to treat patients strictly according to protocol, and to keep detailed treatment records. An essential strategic component of our programs is to do home visits one year after completion of treatment in order to assess the final outcome, and to promote the early recognition and referral of childhood cancer in the villages. During the past year additional funding has been obtained to commence a formal parent support programme at each hospital. At the time of writing a tumour registry and computer linked workstation has also been developed at 2 of our three hospitals.
New programmes only attract funding if previous programs have been properly reported at international scientific meetings, and if sponsors are satisfied that their money is spent in a responsible and accountable way. One of my main tasks has been to develop new programs, coordinate their implementation, train staff during biannual visits, and to assist Cameroonian doctors and nurses to present our work at international meetings. This, and the ongoing training of the different teams, is our method to develop the capacity for Cameroonian CBC health workers to treat children with cancer. A successful program has also been developed for a less common but potentially curable cancer of the kidney, known as Wilms’ tumour.
The combination of Dr Peter’s philanthropic efforts and medical supervision, and of my scientific input, has resulted in the annual treatment of at least 100 children with BL every year, with an ultimate cure rate of 60%. A very gratifying development has been that many childhood cancer treatment centres in Francophone Africa have now adopted our inexpensive treatment approaches. We are hopeful that the most recent 2008 BL Cameroon treatment strategy that has been implemented in CBC hospitals, will cure even more children at low cost.
The invitation to help Dr Peter in Cameroon, the subsequent establishment of the BTMAT together with ongoing scientifically planned well controlled programmes, has had a significant impact on the chances of survival for children of poor families in Africa who develop BL. It is unlikely that the public health service of Cameroon will support this cancer treatment programme in the near future. The BTMAT therefore has an essential role to play to facilitate the ongoing treatment of childhood cancer in the Northwest and Southwest provinces of Cameroon.
I wish to acknowledge the dedication of my fellow health workers in Cameroon, the trust of the guardians of our patients, and the support of the Health Board of the Cameroon Baptist Convention.
Peter Hesseling
(Emeritus Professor in Paediatrics and Child Health at Stellenbosch University, South Africa)
(Burkitt's: Professor Hesseling)
Beryl Thyer Memorial Africa Trust, a UK registered charity ~ 1112603