Report 2010 Pediatric Oncology

The goal of the Pediatric Oncology Program is to improve the quality of care for children and adolescents with cancer in LMIC. The specific aims of the program are to provide education and training in pediatric cancer and its management, including supportive care, psychosocial support and palliative care, to establish relevant programs addressing aspects of pediatric cancer care within institutions or settings where there are identified needs and to establish centers of excellence in the delivery of pediatric cancer care.

  • Establishment of a Comprehensive Pediatric Oncology Program for Tikur Anbessa Hospital (Black Lion Hospital) in Addis Ababa, Ethiopia

INCTR USA, in collaboration with the Division of Pediatric Hematology/Oncology, Blood and Marrow Transplantation Program at the Lombardi Cancer Center, Georgetown University launched a 3 year pilot program to improve pediatric cancer survival rates at Tikur Anbessa Hospital through the training of health care professionals to deliver protocol-based treatment for children with highly curable cancers. The program will include the development of appropriate palliative care and pain management services for these patients. Tikur Anbessa Hospital sees 400 to 600 new cases of pediatric cancer each year.

In late 2010, plans were made to hold a meeting entitled, "1st International Symposium in Pediatric and Adolescent Oncology in Ethiopia". The meeting is intended to be a four day symposium and is being organized in partnership with the Addis Ababa University, Tikur Anbessa Hospital, Georgetown University Hospital and INCTR, USA. Pediatricians, medical residents and interns, nurses and pharmacists from Ethiopia have been invited to attend this meeting. An international faculty, including other LMIC that have faced similar challenges confronting Ethiopia when establishing pediatric cancer care programs have been invited along with Ethiopian physicians to provide the lectures for the symposium. An educational workshop for Ethiopian nurses caring for children with cancer was planned to be held during the initial two days of the symposium.

A formal curriculum for a pediatric oncology fellowship for residents interested in specializing in pediatric oncology is in the process of being drafted and has entailed discussions with the University of Addis Ababa.

  • Establishment of Centers of Excellence in Pediatric Oncology

The Ocean Road Cancer Institute (ORCI) has been expanding and developing its comprehensive pediatric oncology program through the efforts of Dr. Trish Scanlan, who is INCTR's Coordinator for East Africa. Many more pediatric patients (in excess of 300) were referred to ORCI in 2010 for treatment than in years past. Treatment protocols for curable childhood cancers have been introduced gradually such that the approach to treatment has been standardized and made as uniform as possible. ORCI continues to participate in the INCTR study of the treatment and characterization of BL in Africa. A ward at the Muhimbili National Hospital was renovated for the children at ORCI to serve as their base while new facilities are being constructed at ORCI and their move was planned for early 2011.

  • Retinoblastoma

Because retinoblastoma is one of the more common malignancies seen at ORCI, it was considered essential to try to educate health professionals about the early signs of retinoblastoma and where to refer children with a possible diagnosis of this disease. Plans to develop an early diagnosis program are being developed, with input from other elements of INCTR with experience in this area.

Other services for children and their families have been secured through a partnership with Children in Crossfire, an Irish charity. By combining forces, funds have been developed to support the costs of treatment, the salary of a teacher so that children can undergo schooling during treatment and in-between treatments when distances prevent them from returning home, the provision of food for children and their families, and the development of a parents' support group. Facilities for a "hostel" for children and families not requiring "in-patient" care have been identified and plans for the renovation of this building have been made with the ensurance of sustainability a high priority.

In addition to these activities, Dr Scanlan and Dr Udo Bode who is one of the directors of the Pediatric Oncology Program have developed a formal curriculum to train pediatricians in pediatric oncology. This curriculum is designed to be relevant to the setting in which the doctors will practice pediatric oncology. In addition to this, they have worked in collaboration with nurses from Crumlin Hospital on a training program for pediatric oncology nurses.

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