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Once you have identified the early warning signs of childhood cancer, the next step is to follow the correct referral pathways for childhood cancer.

After a young person with suspected cancer has been identified, the next step is to follow the correct referral pathways for the nearest paediatric oncology unit (POU) where multidisciplinary, comprehensive care across specialties can be offered. This is to enable children to reach the specialised treatment centres in time to ensure e­ffective treatment, as well as have access to essential medicine and care.

The pathway from the first point of entry at Primary Health Care level to specialised POUs is theoretically a clear and uncomplicated one.

For most young people who have a possible diagnosis of cancer, the point of entry into the health system is through primary health care (PHC) services either at the local PHC Clinic, Community Health Centre, local General Practitioner (GP) and/or traditional healer.

At CHOC, we advocate for emphasis to be placed on increasing capacity in community-based and primary health services to facilitate prompt referral to specialist centres without having to go through convoluted pathways. Provincial Referral Policies should outline clear referral pathways for patients with a cancer diagnosis and institutions should have local standard operating procedures (SOPs) with contact details of the nearest POUs to ensure appropriate, timely and reliable transport of the patient to the treatment facility after liaising with the POU and after stabilising the patient.

CHOC Cancer Info | Referral Pathways

The centres will have the necessary human resources available namely; paediatric oncologists, paediatric oncology-trained nursing staff, radiation oncologists, surgeons, histopathologists, radiologists, supportive care and intensive care unit facilities. Laboratory facilities for the processing of biopsy material for morphological diagnosis as well as cytogenetic and molecular analysis of the tumour tissue are required. Limited availability for these tests is currently available within the National Health Laboratory Service (NHLS) attached to large tertiary facilities. It is imperative that the young patient with suspected cancer be referred for imaging and diagnostic investigations to be done at the referral centre to avoid delay in referral and to ensure that the appropriate investigations are performed, thus preventing further delay and waste of money.

What do I need to bring with me?

For a list of Paediatric Oncology Units in South Africa, visit: