Drawing on a half-century's worth of medical advances, doctors in affluent countries like the United States can save four out of five children afflicted with cancer. But it’s a whole different world where Sean Kenney works.
In the refugee camps of the Middle East and remote villages of Africa where Kenney has assisted with relief efforts, many cases of childhood cancer go untreated or even undiagnosed. As a former brain-tumor patient at St. Jude Children's Research Hospital and current aid worker with Catholic Relief Services, Kenney, 32, thinks he understands the reasons.
"It's a function of both a lack of knowledge on the subject and also a lack of treatment options," says Kenney, who endured two surgeries, radiation therapy and extensive rehabilitation as a child patient.
The global challenges presented by pediatric cancer drew into sharper focus Thursday with the publication of a series of articles by U.S. News & World Report. The coverage, encompassing nine stories, dozens of photos and some 18,000 words, highlights the central role played by St. Jude in the increasingly urgent effort to extend and enhance the care provided in the low- and middle-income countries where 90 percent of kids with cancer live.
The news outlet's editors said they traced their decision to send reporters and photographers around the world for the project to recent findings by researchers that "challenged long-held assumptions" about the impact of childhood cancer.
The study led by Drs. Lisa Force and Nickhill Bhakta of the St. Jude Department of Global Pediatric Medicine estimated that some 400,000 cases of pediatric cancer occur worldwide each year – roughly twice the number actually diagnosed – and that childhood malignancies create a greater overall burden, when measured by the years of healthy life lost, than most adult cancers.
The U.S. News & World Report coverage, which also features the work of such other groups as the Boston-based nonprofit Partners in Health, comes more than a year after St. Jude launched a $100 million initiative called St. Jude Global to bring cancer care within reach of more of the world's children. It also follows the announcement last September of a five-year collaboration between St. Jude and the World Health Organization to raise the survival rate worldwide to 60 percent for six common pediatric cancers.
The series in U.S. News & World Report includes commentary by Dr. Carlos Rodriguez-Galindo, director of the global initiative, who wrote that while St. Jude has helped boost childhood cancer survival rates to about 80 percent in wealthy nations, the picture is grim elsewhere. Worldwide, he said, more than 80 percent of kids stricken with cancer die, and yet the disease isn't a priority in many countries.
"However, every single child with cancer is a priority to us at St. Jude Children's Research Hospital," he wrote. "We cannot let this sad reality discourage us. Our mission – that no child should die in the dawn of life – means no child anywhere in the world, period."
St. Jude's initial steps to extend its care internationally were spurred in part by a child's simple plea, Rodriguez-Galindo said. On Christmas Eve 1986, Dr. Fernando Silva, director of a children's hospital in Managua, Nicaragua, was walking through the wards when he came upon a young war orphan who had been diagnosed with leukemia, a disease the hospital had no resources to treat. "Please tell someone that I am here," the youngster told Silva.
In the decades that followed, St. Jude established partnerships with 24 programs in 17 countries, mostly in Latin America and the Middle East, but also in China and the Philippines. The initiative was working, producing significant improvements in survival rates, but hospital officials eventually realized it couldn't be feasibly expanded to serve enough of the world's children.
The new global program will train clinical staffs, provide research and help health systems worldwide expand their capacity to treat pediatric cancer. Last December, Rodriguez-Galindo wrote, more than 160 people from 52 countries gathered in Memphis to launch the St. Jude Global Alliance, which forms a structure to provide advanced care across seven regions of the world.
In addition to its coverage of the new global initiative, U.S. News & World Report chronicled St. Jude's past work to cure kids in places like Lebanon, Jordan and China.
China, in particular, has seen survival rates soar as a result of a shift in government spending priorities and decisions to partner with out-of-country institutions such as St. Jude, which the news outlet calls a "pioneer in collaborating with Chinese hospitals in childhood cancer research." The report notes that Dr. Ching-Hon Pui, chair of St. Jude's Department of Oncology, has worked for more than two decades with the leading hospitals in Beijing and Shanghai.
Through those and other efforts, the Chinese government in 2010 included acute lymphoblastic leukemia in the national insurance scheme. Today, the estimated 15,000 kids in China diagnosed with ALL each year are fully covered, and the survival rate has risen to 70-80 percent, according to the government. Pui gets considerable credit, with U.S. News & World Report noting that former health minister Zhu Chen described the St. Jude physician as "the doctor who introduced the most advanced leukemia treatment protocols to China."
One of the next steps for Pui and his team at St. Jude is to help doctors in mainland China and Hong Kong develop research and treatment protocols for other types of childhood cancer, the news outlet says.
In its coverage of childhood cancer in the Middle East, U.S. News & World Report details St. Jude's affiliation with institutions like the Children's Cancer Center of Lebanon in Beirut. It also reports on how the network of cancer care centers that St. Jude helped establish in the region have responded to the refugee crisis stemming from the Syrian civil war and other conflicts.
"When we started this we had no idea, and no one was wishing for this crisis to happen," Dr. Sima Jeha, director of the Eastern Mediterranean Region for St. Jude Global, told the news outlet. She said the refugee influx was "really a test for the strengths of the system."
With the refugee crisis threatening to overwhelm cancer-care facilities, St. Jude gave substantial support to fundraising efforts by the institutions to pay for expansion and treatment initiatives, U.S. News & World Report said. In a sign that the work paid off, survival rates for refugee children with cancer in some of the facilities have been similar to those of patients from local populations.
The Children's Cancer Center can't treat all the kids who need its services in the area. But U.S. News cites a report published by St. Jude stating that 575 non-Lebanese children suspected of having cancer were evaluated at the Children's Cancer Center between 2011 and 2017, with 311 of them receiving treatment and the remainder referred elsewhere after consultations.
Jeha told the news outlet that the response to the refugee crisis could serve as a model for treating patients in future conflicts.
"It's very rewarding to see that this was done, but it's also heartbreaking to think that those kids would have died if no intervention was done, and probably they are dying in other places because of no intervention," she said.