Patients

Patients

Information about our Patients

Child Cancer Patients

Paediatric cancers are different to adult cancers in the following ways:
[1] They are much less common

[2] There’s a different spectrum of cancers consisting mainly of: Brain tumours (25%), Acute leukaemia (30%), Tumours arising from primitive cells in deep-seated organs such as liver, kidney and adrenal gland which are hard to detect when small.

[3] They are fast-growing – which does mean that they are usually more sensitive to chemotherapy.

The following symptoms, if persistent, could be danger signs for childhood cancer:

      White spot in the eye, new squint, blindness or a bulging eyeball.
      Lumps in the abdomen/pelvis, head and neck, in limbs, testes or lymph glands.
      Pallor and easy bruising or bleeding.
      Aching bones, joint pains, backache, and easy fractures.
      Neurological signs: Change or deterioration in walk, balance, or speech; Regression of Developmental Milestones
      Headache for more than two weeks with or without vomiting; Enlarging head.
      Unexplained prolonged fever over 2 weeks, loss of weight and fatigue can also be signs of cancer but there are other diseases like TB and HIV that need to be excluded first.

The warning signs of cancer can be mistaken for common childhood ailments. We would advise parents to take their child to a physician or a qualified healthcare provider for further consultation if any of these symptoms persist, and we try hard to educate doctors and nurses about these warning signs to improve early detection.

While 70-80% of children with cancer survive in wealthier countries where cancer is the second leading cause of death, the reality is vastly different for those living in poor countries. A combination of lack of knowledge about cancer which delays diagnosis, limited access to appropriate treatment and the need to focus on other child health priorities means that only 2 to 3 out of 10 children in these countries are cured. Early detection makes a big difference because less advanced tumours are easier to cure and often need less intensive treatments.

Knee and Hip Replacements

Knee and hip replacements, or arthroplasty, are surgical procedures in which the diseased parts of the joints are removed and replaced with new, artificial parts. These artificial parts are called the prosthesis. The goals of knee or hip replacement surgery include increasing mobility, improving the function of the hip joint, and relieving pain.

Many state patients wait for long periods of time for joint replacement surgery, which causes great discomfort and pain on a daily basis. In addition, the backlogs increase faster than Government can address, since more patients are added weekly to the operating waiting list.

Dialysis

Dialysis is the clinical purification of blood by removing waste products and excess fluid from the body. Dialysis serves as a substitute for the normal function of the kidneys and is necessary when the kidneys are not able to adequately filter blood. Dialysis allows patients with kidney failure a chance to live productive lives.

The true incidence of end-stage kidney failure (ESKF) is unknown. The major obstacle to the widespread use of this treatment, which has to be offered lifelong, is its high cost. Currently, the annual cost of treating an ESKF patient with dialysis is conservatively estimated at R100 000. Because of this, access to treatment for patients in the public sector has to be governed and a rationing model has been endorsed which is in line with national guidelines.

According to this policy, all patients accepted for renal replacement therapy must eventually be suitable for transplantation.

Patients are categorized into 3 priority groups.

      Patients with priority rating 1 must be accommodated on the dialysis and transplant programme.
      Patients with priority rating 2 will be accommodated on the programme if resources allow. Of overriding importance, is that patients in both these categories must be suitable for kidney transplantation.
      Patients in the 3rd rating category will be offered optimal conservative treatment but not renal replacement therapy.

Patient has no Category 2 or 3 factors and satisfies all the following factors:

      Age under 50 years
      BMI less than 30 kg/m2
      Gainfully employed
      HIV negative
      Hepatitis B Surface Antigen (HBsAG) negative
      South African citizen

.

The accrual of the combination of these factors listed below will progressively reduce the priority rating within this category.

Social Factors

      Poor home circumstances, including lack of access to storage space, running water, sanitation and electricity[5]
      BMI less than 30 kg/m2
      Conviction of serious criminal offence
      HIV negative
      Poor social network/support
      No proximity/geographic accessibility to dialysis unit

Medical Factors

      Age 50 to 60 years
      BMI 30-35 kg/m2.
      Hypertension with severe left ventricular dysfunction or other severe target organ damage
      HBsAg/HCV positive with no cirrhosis[6]
      Smoking
      Diabetes mellitus
      HIV+ providing CD4 count ≥ 200/ml and an undetectable viral load; if on antiretroviral (ARV) treatment, First presentation with ESKF requiring urgent dialysis
      Comorbid disease e.g. stable ischaemic heart disease
      Previous kidney transplant

Kidneys are a very scarce resource and should be allocated to patients who will derive most benefit from the transplant. Any condition or circumstance which compromises the medium-long term survival of a patient or the graft will exclude the patient from transplantation and hence dialysis.
Any one of the following factors excludes patients:

      Renal transplantation is contraindicated or carries
      acceptable risks
      AIDS or HIV infection other than patients described in category 2
      Age ≥ 60 years
      Active substance abuse or dependency
      Morbid obesity (BMI ≥ 35 kg/m2)
      HBeAg positive or cirrhosis
      Diabetes mellitus and aged >50 years
      Active, uncontrollable malignancy with short life expectancy
      Advanced, irreversible progressive disease of vital organs such as:
      cardiac, cerebrovascular or peripheral vascular disease
      liver disease
      lung disease

[5] Peritoneal dialysis is precluded as a treatment option, restricting patients to haemodialysis which is limited.[6] Patients with HBsAg infection especially with cirrhosis have a poorer prognosis following transplantation because immunosuppression stimulates viral replication. Patients are also at risk of developing liver-related complications as well an increased risk of sepsis.

Unresponsive infections
Psychological Exclusion Criteria

Any form of serious mental illness which results in diminished capacity for patients to take responsibility for their actions.

Habitual Non-Adherence

Patients with habitual non-adherence to any medical treatment

Testimonials


“Thank you for your efforts and all of the good work that your foundation does.” - Adrian Nasson, son of a hip replacement patient

“This is an incredible cause that many people are completely unaware of.” - Donna Parekh, daughter of Avril Parekh, a beneficiary of The Joint Project 6 – 20 April 2018

“I would like to say a special thank you to you for Jeremy’s surgery. We are so grateful to have it done after all this time. I can’t believe it’s done! We appreciate how quickly it happened and the cost that we as retired dancers could afford. Bless you!” - Dominique Hodges, wife of Jeremy Hodges, a beneficiary of The Joint Project 5 – 23 March 2018

“Everything went so well.The hospital was great. The doctors, physios and all concerned were amazing.” - Jeremy Hodges, beneficiary of The Joint Project 5 – 23 March 2018

“On behalf of my Mother and the rest of the family, let me firstly express our deep gratitude and heartfelt thanks for making this sorely needed operation a reality. Please extend our thanks to all concerned.” - Mawadah Omar, daughter of Sharifa Adonis, beneficiary of The Joint Project 3 – 28 January 2018

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