Development & Aid, Headlines, Health, Latin America & the Caribbean, Population

CHILDREN-MEXICO: Cancer and Poverty a Lethal Mix

Adrián Reyes

MEXICO CITY, Mar 21 2005 (IPS) - María Concepción, an eight-year-old Mexican girl, is dying of cancer. Her life might have been saved by early treatment, but this was not an option in her case. She is one of thousands of Mexican children whose lives are cut short every year by the lethal mix of illness and poverty.

With 7,000 new cases reported every year, cancer is now the second leading cause of death for children between the ages of four and 14 in Mexico, outstripped only by accidents. It ranked in 14th place 28 years ago, according to statistics from the Ministry of Health.

Specialists say this change has as much to do with improved diagnostic methods, which allow for more cases to be detected than in the past, as with an actual rise in the incidence of cancer.

Late last year, María became listless and stopped playing with her friends. She complained about a sharp pain in her throat and head. Her parents, who live in an impoverished rural area, took her to the Moctezuma Pedriatic Hospital, a public health care facility in Mexico City.

María was subjected to a battery of tests, and when the results came back, she was diagnosed with tongue cancer. The doctor was informed, so that he could have her brought in immediately for treatment. At that point, María and her family had already returned to the countryside.

But María could not be found: for some unknown reason, her parents had given the hospital a false address. And they never returned to the hospital on their own.

“That little girl is probably suffering terribly right now, and could be close to death, because she didn’t receive the treatment she needed in time,” Héctor Sánchez, a pathologist who worked on María’s case, told IPS.

In some cases, tragedies like these could be avoided.

Children with cancer have between a 70 and 80 percent chance of surviving if the disease is detected early and they undergo the proper treatment, according to Roberto Rivera, the assistant director of haemato-oncology at the state-run National Paediatric Institute (INP).

Parents should be alert to any changes in their children’s health and behaviour, such as a fever, recurring infections, frequent unexplained tiredness, aches and pains, or unusual physical changes. Every day, even every minute counts in the fight against cancer, Rivera commented to IPS.

Children who live in cities have a better chance of surviving the disease than those who live in rural areas, where “between 30 to 35 percent of cases diagnosed are not followed up with treatment, and the children die,” he said.

Alejandro is three and has leukaemia, but there is every likelihood that he will be cured.

During a visit by IPS to the state-run Federico Gómez Children’s Hospital in Mexico City, Alejandro enthusiastically recounted a visit he and other children on the cancer ward had received several weeks earlier from a group of masked wrestlers, who enjoy cult-like popularity in Mexico.

“I touched their masks, and I told them I’m strong too,” said Alejandro, who courageously endures a three-hour-long chemotherapy session, and its gruelling after-effects, every single week.

Alex, as the other children and the psychologists at the hospital call him, is making excellent progress. His doctors believe he will recover from the disease without the need for a bone marrow transplant, a more invasive form of treatment called for in some cases of leukaemia.

Rivera noted that leukaemia is more common among children who live in the oil-producing regions of Mexico, like the states of Veracruz and Tobasco, which have coasts on the Gulf of Mexico.

In rural areas, where there is heavy use of insecticides and fertilisers, there is also a high incidence of retinoblastoma, a tumours that forms in the retina, or lining of the eye. This condition affects one in every 18,000 children, and in some cases it is hereditary.

If it is not treated early enough, it can spread to the brain or other parts of the body, and eventually lead to death.

The most common forms of cancer found in Mexican children are leukaemia, retinoblastoma, kidney cancer and neuroblastoma, a tumour that targets nerve cells.

The INP and the Federico Gómez Children’s Hospital are the country’s leading institutions in the fight against paediatric cancer, in terms of advanced treatment methods, research and the training of doctors and nurses in this field.

The INP is promoting a campaign to encourage paediatricians and oncologists throughout the country to keep up to date in terms of training and knowledge, adopt unified treatment methods and develop better awareness of the early warning signs of cancer in children, so that treatment can begin as early as possible.

Rivera, who has also developed a specific campaign for early diagnosis of retinoblastoma, said that a network of fully equipped oncological centres will be in place throughout Mexico within the next two to three years, allowing for more effective coverage.

These facilities have already been established in all but 12 of the country’s 31 states, he noted.

There are also programmes being developed to help patients who live in more remote regions, so that they can receive the specialised treatment they require without the need to travel to large cities.

Of the close to 7,000 Mexican children initially diagnosed with cancer every year, only 1,500 are covered by private medical insurance; the rest depend on public health care services.

The costs involved are enormous. The country’s health care authorities spend around 30,000 dollars annually on every child who receives cancer treatment in a public hospital.

In the private health care system, the costs can be double that amount or more.

The price of a bone marrow transplant to treat leukaemia can exceed 181,000 dollars.

Since January, paediatric cancer patients without social security coverage have been helped through the newly created People’s Insurance plan – a government programme for low-income families that guarantees free access to treatment and medicines.

Other patients with limited resources are assisted by non-profit organisations whose only requirement is that parents commit themselves to carrying through with their children’s treatment.

Intensive cancer treatment can take up to five years. Once the critical phase has been overcome, regular follow-up is essential to detect a possible relapse or complication.

Rivera said techniques and knowledge exist for every kind of cancer, to save children’s lives, if the diagnosis is made early enough.

The treatments used include chemotherapy, linear acceleration radiotherapy, bone marrow transplants and other surgical procedures.

Paediatric cancer is a challenge facing many countries today. The annual incidence rate is 120 new cases per one million children in Mexico, 150 in the United States, and 139 in Europe, according to statistics from the World Health Organisation’s International Agency for Research on Cancer.