Ghanaian health professionals validate national childhood cancer treatment guidelines

The Childhood Cancer Society of Ghana (CCSG), with support from World Child Cancer, has developed comprehensive National Guidelines for Childhood Cancer Treatment aimed at improving care and survival outcomes for children living with cancer in Ghana.

The guidelines were developed through a collaborative, multidisciplinary process involving paediatric oncologists, oncology nurses, pharmacists, pathologists, palliative care specialists, public health professionals, and other technical experts to ensure evidence-based and nationally relevant treatment protocols.

A stakeholder validation meeting was held in Accra to review, refine, and endorse the draft guidelines ahead of national adoption and nationwide dissemination.

Ministry of Health Commends Initiative

Speaking at the meeting, on behalf of the Minister of Health the Director of Technical Coordination at the Ministry of Health, Dr Hafez Adam Taher, said the initiative reflects Ghana’s strong commitment to addressing childhood cancer as a major non-communicable disease.

He noted that the guidelines align with Ghana’s National Cancer Control Strategy, the National Non-Communicable Diseases Policy, and the World Health Organization’s Global Initiative for Childhood Cancer, which prioritise early detection, equitable access to treatment, decentralised service delivery, and the integration of palliative care.

According to him, the guidelines will help standardise treatment protocols nationwide, strengthen coordination across health facilities, and contribute to reducing childhood cancer-related deaths.

He also highlighted Ghana’s participation in the Global Platform for Access to Childhood Cancer Medicines, supported by the WHO and its partners, to ensure sustainable access to essential medicines for treatment centres across the country.

Dr. Taher praised CCSG for organizing the validation meeting and bringing together key stakeholders from across the health sector.

Paediatric Oncology Specialists Outline Guideline Benefits

The Head of the Paediatric Oncology Unit at the Korle Bu Teaching Hospital, Prof Lorna Awo Renner, said the guidelines mark a major milestone in ensuring safe, standardised, and equitable childhood cancer care nationwide.

She explained that the initiative produced both a comprehensive guideline and an abridged version. The abridged document is designed for nationwide use by the Ministry of Health and the Ghana Health Service across all designated treatment centres.

According to her, the comprehensive version, which contains detailed treatment regimens, chemotherapy drugs, and dosages, will be made available electronically to trained specialists only, to prevent misuse by unqualified persons.

She noted that the abridged version also includes simplified guidance and flow charts to support early detection and appropriate referral of suspected childhood cancer cases.

Prof Renner shared that Ghana has been part of the WHO’s Global Initiative for Childhood Cancer since 2019, making it one of the first countries to join. Creating national treatment plans is a major step in meeting a key goal of the WHO’s CureAll framework.

She also confirmed that Ghana is among only 12 countries globally selected for the Global Platform for Access to Childhood Cancer Medicines, supported by the WHO and St Jude Global, with medicine supplies expected to commence by the end of the first quarter of the year.

Prof Renner lauded the National Health Insurance Scheme and the Ghana Medical Trust Fund for helping reduce the financial strain on families and making healthcare more accessible.

Role of Primary Healthcare in Childhood Cancer Survival

The Paediatric Oncologist at the Greater Accra Regional Hospital, Dr Nihad Salifu , stated that primary health care facilities are central to childhood cancer survival, as most children first present at that level before being referred to specialised centres.

She described primary health care as the foundation, pointing out that children often return to community-level facilities after treatment, making it vital to strengthen supportive care systems at that level.

Dr Salifu explained that the guidelines include simplified supportive care protocols for primary health care facilities, developed using the Integrated Management of Childhood Illnesses framework to ensure ease of use by frontline health workers.

She said supportive care, covering all interventions apart from chemotherapy, surgery, and radiotherapy, is critical in preventing complications, reducing treatment-related deaths, and improving survival outcomes, noting that strong supportive care systems have driven improved survival rates in high-income countries.

Dr. Salifu says the guidelines cover important childhood cancer emergencies like tumour lysis syndrome, chemotherapy-related nausea and vomiting, drug extravasation, mouth sores, diarrhoea, constipation, febrile neutropenia, anaemia, bleeding, and managing pain.

Referral Pathways and Early Detection

Dr Salifu emphasised that the protocols prioritise early stabilisation and immediate referral to paediatric oncology centres, with clear red-flag indicators to prompt urgent action.

She raised concerns about ambulance accessibility and costs, calling for strengthened emergency transport systems to ensure timely referrals, particularly for families who cannot afford transport fees.

On referral pathways, Dr Salifu disclosed that new provisions now allow suspected childhood cancer cases to be referred directly from CHPS compounds to specialist treatment centres without jeopardising NHIS coverage.

She emphasized that health workers no longer need to delay referring children to specialist care while waiting for expensive scans, stressing that no child should be denied timely treatment because of the cost of optional investigations.

Dr Salifu added that early detection, prompt supportive care, and timely referral to specialised centres are critical determinants of survival, urging sustained investment in strengthening Ghana’s health system at all levels to improve outcomes for children with cancer.

Progress in Childhood Cancer Detection and Treatment

Dr Koku Amegan-Aho, Paediatric Oncologist at the Ho Teaching Hospital, said Ghana is making steady progress in childhood cancer detection and survival, despite persistent challenges.

He explained that based on Ghana’s population, the country is expected to record over 1,000 new childhood cancer cases annually, yet only about 513 new cases were diagnosed last year, indicating that many cases still go undetected.

Dr Amegan-Aho noted that while global estimates suggest that up to 70 per cent of children with cancer in low- and middle-income countries may die, Ghana’s outcomes show improved survival compared to previous years.

“We have come a long way. We are seeing more survivors today than before,” he said, attributing the improvement to better training, early detection, and increased awareness.

He clarified that the rise in reported childhood cancer cases does not necessarily mean more children are developing cancer, but rather that more cases are being identified early due to improved training of health workers, including doctors, nurses, and laboratory staff, as well as community sensitisation.

According to him, parents are now reporting earlier to health facilities, while frontline health workers are better equipped to recognise early warning signs and refer suspected cases promptly to specialised centres.

Financial and Systemic Challenges in Childhood Cancer Care

On challenges, Dr Amegan-Aho identified financial constraints as a major barrier to childhood cancer care, noting that even in high-income countries, governments absorb most cancer-related costs due to the high expense involved.

He explained that advanced diagnostic tools required for childhood cancer are costly and often beyond the reach of individual families, stressing the need for stronger government investment in diagnostic infrastructure.

He further noted that treatment costs go beyond chemotherapy, as children also require supportive care to manage complications such as infections, mouth sores, and other side effects resulting from cancer treatment.

Dr Amegan-Aho said while government support, faith-based organisations, and charitable partners have played critical roles, families still face indirect costs such as transportation, loss of income, and long hospital stays, which affect treatment continuity.

He stressed that addressing childhood cancer effectively requires sustained support from diagnosis through treatment and post-treatment care to ensure children remain in care and achieve better outcomes.

Specialist Advice on Leukemia and Lymphoma

A Paediatric Oncologist at the Korle Bu Teaching Hospital, Dr Lily Gloria Tagoe, also urged health workers to prioritise early detection and referral to improve survival rates for children with leukemia and lymphoma in Ghana.

She noted that childhood leukemia accounts for about one-third of paediatric cancers in the country, with acute lymphoblastic leukemia and acute myeloid leukemia being the most common types.

Dr Tagoe said delayed diagnosis remains a challenge, as symptoms often mimic common illnesses such as malaria and typhoid.

Key warning signs include persistent fever, anemia, unexplained bleeding, bone pain, weight loss, swollen lymph nodes, and enlarged organs.

She stressed that basic tests like full blood counts should trigger early referral, even when results appear inconclusive.

Dr Tagoe also highlighted Burkitt lymphoma as one of the fastest-growing childhood cancers in Ghana but noted that it is highly curable with timely chemotherapy.

She emphasized that prompt diagnosis and treatment are critical to preventing complications and saving lives.

World Child Cancer Supports National Guidelines

The Country Coordinator for World Child Cancer Ghana, Adwoa Pinamang Boateng Desu, however  affirmed the organization’s support for the newly validated childhood cancer treatment and care guidelines in Ghana.

According to her , the guidelines aim to standardise care across all treatment and shared care centers, ensuring children diagnosed with cancer receive timely and quality treatment.

READ ALSO: MTN Ghana Foundation Supports New Mothers with Baby Hampers at Korle Bu

She explained that WCC’s support goes beyond funding, extending to the training of healthcare professionals on the new guidelines to ensure effective implementation.

“The guidelines are not just documents they are hope for children and their families,” she said, noting that referral pathways allow even suspected cases from primary healthcare facilities to be directed straight to major treatment centers.

The training of healthcare professionals on the validated guidelines is scheduled to begin next month, paving the way for nationwide adoption and improved childhood cancer survival rates.

She  also highlighted that nutrition and pediatric radiology guidelines are under review, signaling further progress in strengthening childhood cancer care in Ghana.

Source: Isaac Kofi Dzokpo