For families navigating childhood cancer, the end of intensive treatment can mark a significant change in daily life, but it does not necessarily signal the end of medical care.
Follow-up treatment, monitoring and attention to a child’s development can continue for months or years after cancer enters remission.
That message is being highlighted during Childhood Cancer Awareness Month through the experience of 12-year-old Chánterie van Rensburg from Monte Vista, who was diagnosed with rhabdomyosarcoma earlier this year.
Her case has also prompted her oncologist, Dr Johann Riedemann, founder of Cape Town-based Crayon, to emphasise the importance of planning for survivorship from the point of diagnosis.
Chánterie was admitted to hospital in January after developing severe back pain and struggling to walk. She was subsequently diagnosed with rhabdomyosarcoma, a rare cancer affecting soft tissue such as muscle.
Her treatment included nine rounds of intensive chemotherapy and 20 radiation treatments.
On 27 August, her family was told that a scan showed no evidence of the cancer. She has since returned to Panorama Primary School, where she is head girl, and has resumed activities including hockey.
Her parents, Divan and Clarissa van Rensburg, described seeing her back on the hockey field as an important moment in her recovery.
‘Seeing her there with her team on the hockey field, after everything her body has been through, was one of those moments we will never forget,’ they said.
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Remission does not mean follow-up ends
Riedemann says survivorship needs to be considered from the beginning of a child’s cancer treatment rather than only after therapy has finished.
‘Survivorship does not start on the last day of treatment. It starts on the day a child is diagnosed,’ he said. ‘From our very first conversation with a family, we are already planning for the life we want that child to live afterwards.’
For Chánterie, treatment is continuing in a different form, as she is expected to take a daily chemotherapy medicine for the next year while doctors monitor her progress.
Her mother, Clarissa, said the family remains aware that further treatment and monitoring are still ahead.
‘We know the road is not completely over yet,’ she said. ‘But today she is in remission, and we are incredibly grateful for that.’
Long-term monitoring is particularly relevant in childhood cancer because children are still growing and developing while undergoing treatment.
‘Children’s bodies are still growing and developing,’ Riedemann explained. ‘Sometimes the effects of treatment only show up months or even years later. For example, it can affect growth, learning or fertility. That is why follow-up care does not simply stop. We walk with our young patients and their families for the long term.’
Crayon, which stands for Childhood, Radiation, Adolescent, Young Adult, Oncology Network, operates in Cape Town’s Northern Suburbs and treats patients from birth to 39 years old.
The specialist unit brings together oncologists, surgeons, psychologists, dietitians and other healthcare professionals as part of an integrated approach to treatment and longer-term care.
Riedemann says the model is designed around the needs of each young patient and their family rather than relying on a single specialist.
‘No single doctor can give a young person everything they need,’ he said. ‘At Crayon, our specialists work as one team. We discuss every patient together and build each plan around that child and their family. This means families never have to find their way through it alone.’
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Knowing the early warning signs
The National Cancer Registry estimates that between 800 and 1 000 children are diagnosed with cancer in South Africa each year. It notes that fewer than half of children with cancer are estimated to be diagnosed.
Riedemann is encouraging parents and caregivers to seek medical attention when symptoms persist or do not appear to have an obvious explanation.
‘You know your child better than anyone. If something does not seem right and it does not go away, please see a doctor and ask questions,’ he said. ‘Childhood cancer is rare. But finding it early can make a real difference to a child’s treatment and their future.’
The Saint Siluan warning signs, also used by the Childhood Cancer Foundation South Africa (CHOC), provide a way for parents and caregivers to remember symptoms that warrant medical attention.
CHOC and the South African Department of Health have promoted the signs as part of efforts to improve early recognition and referral.
They include:
- S – Seek: Medical help early when symptoms persist.
- I – Eye: A white spot in the eye, a new squint, sudden loss of sight or a bulging eyeball.
- L – Lumps: Swelling or a lump involving the abdomen, pelvis, head, arms, legs, testicles or glands.
- U – Unexplained: A fever lasting more than two weeks, weight loss, fatigue, paleness, or unusual bruising or bleeding.
- A – Aches: Persistent pain in the bones, joints or back, or bones that fracture easily.
- N – Neurological signs: Changes in walking, balance or speech, loss of previously acquired skills, persistent headaches, or an enlarging head.
These signs do not by themselves mean that a child has cancer, but persistent or unexplained symptoms should be assessed by a healthcare professional. CHOC’s helpline is available on 0800 333 555.
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