PEDIATRIC CANCEROLOGY IN MADAGASCAR - RES ULTS OF EFFORTS UNDERTAKEN FOR MORE INFORMATION AND AWARENESS LEADING TO BETTER GENERALIZED CARE

Pediatric cancerology in Madagascar is not yet structured. For five ye ars, the pediatric ward of Soavinandriana has been striving to take in children suffering from cancerous affections and to create a study gr oup in the discipline for the following reasons: it is possible to tre at children suffering from cancer in Madagascar: Children can recover and tolerate chemiotherapy better than adults. It is thus advisable to group together the children in the same ward and not to hospitalize t hem in a ward of general cancerology with adults. The diagnosis and ba lance of extension can be carried out with the means already disposed of. Decisions regarding treatment are taken in agreement among the dif ferent specialists: pediatricians, surgeons, anatomopathologists, biol ogists, cancerologists. One can refer to the protocols used in large c enters of cancerology (Institut Gustave Roussy: Institut P. et M. CURI E...). Cancerology in a pediatric ward is an excellent discipline for teaching medical students and paramedical personel alike. There remain however sometimes insurmountable difficulties linked to local conditi ons: delays in diagnosis, supplies in expensive medicines, iatrogenic risks particularly of hematological and infectious character. In four years and a half, we have been able to hospitalize some fifty children in regularly growing numbers. We have seen as many children come to c onsult for an opinion and whom we could not take on for lack of means or medicine. The most encouraging results are related to lymphomas, le ucemia and nephroblastomas. Tumors of neurological origin can not yet be treated with the means we dispose of. The first step is to create a study group and make the medical corps aware of the need for a strate gy of generalized care and minimum delay in the diagnosis procedure.