CANSA's Tough Living with Cancer (TLC) Programme

Type E – Dr Tanya Schickerling

Type E – Dr Tanya Schickerling

A travel grant was awarded to Dr Tanya Schickerling of Charlotte Maxeke Johannesburg Academic Hospital, Division of Paediatric Haematology and Oncology to attend the SIOP 2016, 48th Congress of International Society of Paediatric Oncology in Dublin, Ireland from 18 to 22 October 2016.

Abstract

The Necessity for a Paediatric Transplant Programme in a Developing Country

Background/Objectives

In a country still grappling with a legacy of inequality, haemopoeitic stem cell transplant (HSCT) programmes have not been prioritised. In preparation for the opening of a custom-built cellular therapies unit at the Nelson Mandela Children’s Hospital in Johannesburg, an audit of past practices was conducted.

Design/Methods

A retrospective analysis of children undergoing HSCT at a state-academic and a private-academic hospital was performed. Descriptive statistics, Kaplan-Meier survival curves and Cox regression analysis were calculated.

Results

From January 1980 to December 2015, 39 stem cell transplants were performed on patients diagnosed in our unit, including 19 autologous and 20 allogeneic transplants. The majority of patients (31/39) came from Gauteng Province while six were referred from other provinces and two patients came from Zimbabwe for treatment. Median age was 4.6 years (range 2.8 months to 16 years) and no patients were HIV positive.  Indications for transplant included haematolymphoid malignancies (13), solid tumours (15) and non-malignant haematological conditions (11). Twenty-three procedures were performed in our combined unit while 16 patients were referred elsewhere. Sixteen patients (41%) are alive and disease-free, four are alive with disease, 15 died from relapsed disease and four (10.3%) died of treatment-related mortality (TRM). Three patients developed second malignant neoplasms, one of whom demised. The median follow-up period was 624 days (range 44 days to 15.6 years). Five year overall survival (OS) from transplant was 52.7% with no difference detected between indication for transplant (p=0.79) or geographical location of transplant (p= 0.38).

Conclusion

Limited resources and expertise have resulted in poor access to a life-saving and achievable treatment modality. Despite the lack of a dedicated programme, OS and TRM rates are considered acceptable for the historical period under study. Implementation of a dedicated HSCT programme will increase access for children with high risk malignancies, both locally and country-wide.

The major areas of study and how the visit may contribute to the understanding and/or management of cancer.

“As I am a paediatric oncology fellow, I still have a lot to learn with regards to research.  Attending this congress gave me the opportunity to attend the Young Investigator workshop with excellent topics with regards to how to, why to and when to conduct research.  During this session there where three lectures that stood out.

The first one was on “How to write a grant proposal”.  Prof Glaser is a specialist from Leeds that is currently doing research in multiple fields of paediatric oncology and has received over 10 million dollars of grants. He pointed out that preparing for writing a grant proposal is a lot like preparing for an exam.  You should know the syllabus, study the work, read the question, look at past papers (previous successful applications) and spend enough time completing it.  This approach is very structured and I find it very helpful.

The second lecture that really stood out was that on “How to write a Scientific Paper”.  Dr Gross gave us an excellent step by step guide from what to do and what not to do when writing an abstract and a manuscript.  He explained exactly what needed to be included in the introduction all the way through to the discussion.  I have written a manuscript before for my MMed and I found it to be very challenging.  I am sure that if I knew then what I know now it would have been much easier.

The last lecture was on “How to present research”.  This lecture I found extremely interesting because I do believe that it doesn’t matter how good your study is, if you cannot get people to listen to you while presenting your research, it gets lost and all the work would have been for nothing.  He suggested that presenting is like telling a story and that there are several different types of stories that can be told e.g. overcoming the monster, a quest, a comedy, a tragedy etc.  He also said that you should use tools to assist you in telling the story and not drown your slides with information, a mistake a lot of us make.

Apart from the Young Investigators Workshop, I also had the opportunity to attend multiple other interesting lectures ranging from nutrition in patients with cancer, the late effects of childhood cancer, the most recent research done in Retinoblastoma, Hodgkin lymphoma, liver and Germ cell tumours, just to mention a few.

I had the opportunity to meet some world famous oncologists that are experts in their fields.  I was fortunate enough to have lunch with Professor Marry van den Heuvel-Eibrink, who is an oncologist in the Netherlands with special interest in renal tumours and I could discuss a very rare case of bilateral renal cell carcinoma with her.  After presenting the case to her she offered to do mutational testing on the patient for us in the Netherlands.  These tests are not available to us in South Africa and would probably not have been done if I didn’t have the opportunity to go to SIOP and present this patient to her.

Overall the conference was extremely inspiring.  I really feel motivated to do research, I feel extremely lucky to have met all these great people and I can’t wait to get started on my next research project.  Thank you so much for giving me this opportunity.”

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