September is childhood cancer awareness month and parents have been advised to take their children for regular eye check-ups for early detection of retinoblastoma (cancer of the eye).
Festus Njuguna, a paediatric oncologist at Moi Teaching and Referral Hospital (MTRH) explains that retinoblastoma is a cancer of the eye affecting children mostly below five years of age, leading to loss of vision or life if not treated well.
During diagnosis, a doctor examines the back of the eye, through the pupil and retina, for any tumours. Retinoblastoma arises from the retina.
Dr Hillary Rono, an ophthalmologist based in Trans Nzoia County, notes that retinoblastoma is either hereditary or sporadic. Unlike inherited cancer, sporadic cancer tends to be more aggressive and requires early attention.
“A number of children inherit from their parents, but in some the case is unknown,” said Rono.
Dr Njuguna adds that children diagnosed with retinoblastoma can undergo laser therapy, whereby high-energy lights are shown on the cancer, which freezes and kills cancer cells.
Laser therapy is done when the tumour is small. Chemotherapy is also another treatment that can be used together with laser therapy.
However, when the tumour is bigger and the eye is bulging with white reflects, a patient has to undergo surgery (removal of the entire eye) which is combined with therapy.
“If the cancer is not removed at an advanced stage, even if patients are given chemotherapy alone, it will not kill all the cancer cells,” said the oncologist.
If a tumour is not removed, cancer spreads to the brain, and since the brain is within limited space, as the tumour grows, pressure increases causing death.
An enlarged tumour is dangerous to a patient if it is not removed. Most of the time, patients at such a stage will have already lost their vision, and the eye is not useful to them, and it is dangerous because it can cause cancer cells to continue spreading, risking their lives,” explains Dr Njuguna.
He adds, “I encourage parents to be very keen on their children’s eyes, and when they notice anything abnormal, they should raise an alarm and visit a specialist,” said Dr Rono.
Though the country experiences a shortage of eye specialists, the expert said there is continuous medical education of healthcare workers through seminars, to help identify and create an easier referral pathway.
He said lack of awareness by parents and healthcare providers has been the main hitch in the diagnosis of the disease.
“The goal of any cancer treatment is to save a life, save the eye, and save sight. This can only be attained with early identification, referral and treatment,” said Dr Rono.
Among measures adopted by the Ministry of Health in the diagnosis of retinoblastoma is enhancing collaboration between the maternity and child-friendly departments through the National Guidelines for Retinoblastoma developed in 2019.
“It is so traumatising to witness a child’s eye removed when it can be treated,” said Dr Rono.
According to data from the Ministry of Health, at least 100 cases of retinoblastoma are reported in Kenya every year.