Paediatric Cancer

In 2019 we partnered with Uganda Cancer Institute (UCI), located in Kampala, to establish the Paediatric Cancer Partnership. Patients from across Uganda, and surrounding East African countries access the paediatric oncology services provided at UCI. This partnership is part of the Uganda Cambridge Cancer Initiative, with partners including Cambridge Africa, Uganda Cancer Institute (UCI), CRUK Cambridge Centre, and the University of Cambridge Department of Pathology.

• Each year, an estimated 400,000 children and adolescents  aged 0-19  develop cancer ^{(1, 2).}
• In high-income countries, five-year survival rates for children with cancer exceed 80%, but in low-and middle-income countries the survival rate drops to  less than 30%. ^(2,3).
• Avoidable deaths from childhood cancers in LMICs result from lack of diagnosis, misdiagnosis or delayed diagnosis, obstacles to accessing care, abandonment of treatment, death from toxicity, and relapse. ^{(2, 3)}

This partnership is focusing on improving care for children with cancer with the ultimate aim of supporting the World Health Organisation’s (WHO) objective of achieving at least 60% survival for all children with cancer by 2030.

In order to meet this aim, our  partnership is working on supporting pathology and the diagnostic pathways, improving the safety of prescription and administration of chemotherapy and strengthening aspects of supportive care.

Over the past two years the team have worked to implement emergency chemotherapy protocols to:

• Ensure early treatment is given to the sickest children.
• Time limiting emergency treatment to ensure each child receives the correct treatment as soon as the diagnosis is finalised.
• Ensure chemotherapy, fluids and supportive medicine is given in the right way.

The partnership is hybrid, compromising fortnightly meetings and learning sessions as well as in person visits to Uganda and to the UK, where necessary. We hope that linking Pathologists in UCI and CUH will allow training, mentorship and support around the diagnosis of often complex paediatric tumours

Recently the partnership has published the first in a series of information leaflets developed by the partnership teams and Cambridge University students. Lack of understanding about childhood cancer diagnosis and treatment by patients and their families was identified as a reason for high rates of treatment abandonment. Max Tagg and Jess Knight undertook their medical elective in the partnership in June – July 2022 and developed the information leaflets for children  and their families at UCI. The first of these were printed  and given to patients and their families in February 2023. Until now, no patient and family education resources have existed with explanation and guidance on childhood cancer diagnosis and treatment.

The on-site charitable foundation, Bless a Child Foundation (BACF), which provides accommodation and support services for children undergoing treatment, is an essential part of the paediatric oncology pathway. We hope to continue developing links with the foundation.

“I also hope that we can continue to build on our friendships, based on honesty and mutual respect. In turn, ensuring we get the best from each other by recognising our strengths and weaknesses, and using them to achieve our goal, irrespective of cadre. And most importantly I would like to think that we can work together in the partnership to really makes a difference to the lives of children with cancer."

Dr Denise Williams, co-lead of the Paediatric Cancer Health Partnership

1. Steliarova-Foucher E, Colombet M, Ries LAG, et al. International incidence of childhood cancer, 2001-10: a population-based registry study. Lancet Oncol. 2017;18(6):719-731.
2. World Health Organization. (‎2021)‎. CureAll framework: WHO global initiative for childhood cancer: increasing access, advancing quality, saving lives. World Health Organization. https://apps.who.int/iris/handle/10665/347370
3. Lam CG, Howard SC, Bouffet E, Pritchard-Jones K. Science and health for all children with cancer. Science. 2019 Mar 15;363(6432):1182-1186. doi: 10.1126/science.aaw4892. PMID: 30872518.