What most people do not realise, is that Cancer is a Business!! This is the ugly fact that parents are not told on the fateful day that their child is diagnosed with cancer.
Finding out that your child has cancer is devastating enough in itself, but what is even worse are the months and years that follow… the fight against this monstrous disease, the toll it takes on your child with cancer, your other children, your spouse, your marriage/relationship, your familial relationships, your friendships, your work, your own health, and your finances.
When we talk about The Business of Cancer, we are not only talking about the financial costs of Childhood Cancer Treatment, although they are high, but everything that it takes to deal with a diagnosis of Childhood Cancer…
A typical cancer patient’s treatment can easily cost hundreds of thousands of rands per year:
Depending on the kind of cancer and the complexity of a case, treatment per year can cost less than R10 000, or way over R1 million,” according to Dr Ernst Marais, Operations Executive at the Independent Clinical Oncology Network (ICON).
Even those who are lucky enough to have a medical aid are not free of financial stress when one looks at the limits imposed, for example:
Sub-limit = R500 000 per family. Limited to 1 x PET scan per annum for ’staging’ and subject to annual Specialised Radiology benefit.
For those who’ve never had to deal with cancer, staging is the process whereby they check if the cancer has developed and spread, or alternatively, if it’s been checked and shrunk. Obviously you need a base scan at the start of treatment, so that you have something with which to compare the scan you have when the treatment ends.
Now that might sound like a lot, but once one gets into the nitty gritty of cancer costs, let me tell you, it really isn’t!
There are also other limits to look out for, such as the limit imposed for “biological entities” which can include some very expensive cancer medication, and the limits for other types of scans such as MRIs which can cost anything up to around R12 000 per… or a CT scan @ around R5 000 per…


The Cost of Nephroblastoma Treatment in South Africa

Nephroblastoma or Wilms’ tumour is one of the most common childhood malignancies in Africa (up to 26% in some African countries), but with a survival rate significantly lower than in developed countries. In African countries with a small gross domestic product (GDP) per capita, the cost of treating nephroblastoma may be prohibitive.
Data from 2000 to 2010 from two SA paediatric oncology units were retrospectively analysed. The costs included investigations, chemotherapy and radiotherapy, comparing early- v. advanced-stage disease. In both units, the nephroblastoma International Society of Paediatric Oncology (SIOP) protocol was used.
Stage I disease was the most common, followed by stage IV:

  • The total cost of diagnosis, staging and treatment of stage I disease was ZAR9 304.97 (EUR882.80 or USD1 093.40)
  • The total cost of diagnosis, staging and treatment of stage IV disease was ZAR48 293.62 (EUR4 581.9 or USD5 674.9)

While this may still sound affordable to some, remember that:

  1. The majority of South Africans are not on medical aid, many are unemployed and poor and struggling with the day-to-day cost of living as it is;
  2. These costs are from 2010 – things have gotten a LOT more expensive since. Most parents of Children with Cancer will tell you that the financial costs run into the hundreds of thousands pre year;
  3. Even if both parents are working, one of them (usually the mother) will have to give up in order to care for the Child with Cancer;
  4. These are only the hospital/medical costs – there are a myriad of other costs to take into account such as:
  • Transport costs to clinics/hospital (sometimes for deep rural areas)
  • Accommodations costs for the parent/caregiver while the child is in hospital, sometimes for months on end;
  • Lost Wages
  • child care expenses
  • Special dietary needs;
  • Special equipment such as walkers, wheelchairs, nebulisers, etc.
  1. Some other cancers cost a LOT more to diagnose and treat than the example given above

The BUSINESS of Cancer

The Business of Cancer does not only include the costs of the diagnosis/treatment though, it encompasses much more.
Apart from the financial costs, dealing with Childhood Cancer also involves dealing with:

  • Appointment schedules
  • Lab results
  • Prescriptions
  • School – time out, homework, assignments, exams, special needs/medications etc.
  • Accommodation
  • Travel Plans
  • Emergency Strategies
  • Organising carers for other children (sometimes on the fly)
  • Cooking special meals; and much more

The Business of Cancer also has no “Office Hours” and parents of Children with Cancer have no time to relax, generally get very little sleep, function under immense stress and guilt for not being able to give their other children enough attention, and forget about vacation-time.
In other words, parents of Children with Cancer are constantly running a small company in crisis mode!
So, the next time you come into contact with a family in which there is a Child with Cancer, spare a thought for them and what they are going through… Cancer is NOT a Business anyone wants to be part of!
The quoted costs of Nephroblastoma were taken from the 2012 report:
The cost of nephroblastoma treatment in South Africa: A very cost-effective investment with guidelines for the rest of Africa
D C Stefan,1,2 MD, PhD; D K Stones,3 MD; A van Zyl,1 MD; R Uys,1 MD
1 Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Tygerberg, Cape Town, South Africa
2 South African Medical Research Council, Cape Town, South Africa
3 Department of Paediatrics and Child Health, Universitas Hospital Academic Complex, University of the Free State, Bloemfontein, South Africa
Corresponding author: D C Stefan (cristina.stefan@mrc.ac.za)

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