Angry Man Pictures has had the privilege of collaborating with Stephanie Hampton co-founder of The Scott Hampton Foundation, Professor Beverly Griffin from Imperial College London and Dr Yusuf  Hamied director of Cipla International in India on the documentary Surviving Burkitts.  We felt a documentary on this aggressive childhood cancer would be an appropriate way to provide doctors, universities, health workers, NGO’s and regional medical centres with a resource to further advance understanding, therefore enabling earlier diagnosis and treatment of the disease.

Background.

Some 50 years ago, the British surgeon, Denis Burkitt, described a tumour in children living at low altitude areas in Equatorial Africa, in a belt lying 15 degrees either side of the Equator, the so-called ‘Great Lakes Region’ of Africa. Since then, much has been written about this tumour, the fastest growing of all known malignancies. It still exists, as in Burkitt’s time, but is now known as Burkitt’s Lymphoma. It is the most common tumour of children in this region of Africa, and it still kills about half of its victims, those that do not respond to basic chemotherapy.

A new version of this tumour has evolved in association with HIV-infections, but this is neither restricted to children nor to sub-Saharan Africa. A third, rarer version, found in more affluent areas of the world, may depend upon neither the herpesvirus nor malaria.

Here we focused on the oldest, most common, and one of the saddest versions of this cancer, largely restricted in location to Africa, and small ‘hotspots’ elsewhere. Sad, because it hits mainly otherwise healthy children between the ages of 5-10, who survived infancy in parts of the world where childhood death rates before age 5 are particularly high.

Oultine.

The documentary follows British mother, Stephanie Hampton, who’s son died from this cancer 7 years ago in the UK to Malawi, to understand first hand what can be done to speed up the diagnosis and treatment of these children.

Stephanie observes the treatment of three children at various stages of Burkitt’s Lymphoma at the Queen Elizabeth Hospital in Blantyre; shadowing Elizabeth Molyneux OBE head of oncology and world-renowned expert on the disease; here we are given a window into the lives of these children and their parents.  Eleven year old Grace and three year old Ganizani have just been emitted to the hospital with large tumours on their eyes, Stephanie observes their full treatment from the initial diagnosis and chemotherapy.  Five year old Precious, has been in the hospital for sometime, because of logistical problems getting to hospital and initially being treated by a traditional medicine man, therefore the cancer has aggressively advanced throughout his fragile body.

Through interviews with Elizabeth, parents, children, Beatrice from the palliative care unit, village headmen and women, traditional medicine men and government official, Stephanie discovers that awareness of this cancer is a major issue.  In remote villages parents rarely understand what these small facial tumours are, they will therefore initially consult a traditional medicine man, when this fails they will then visit the local medical centres were once again a child can easily be misdiagnosed.   This along with the arduous journey from the village to the hospital, often taking a number of days, can lead to a more advanced stage of the cancer being treated.

Conclusion

Unfortunately towards the end of filming Precious died and also Aida a girl who Stephanie visited with the palliative care unit.  By providing the DVD as resource for the aforementioned we hope it will advance understanding and awareness of the disease and in the long term make a difference to the lives of these children, their parents and communities across Malawi and eventually Sub-Saharan Africa.

For more information about the work of The Scott Hampton Foundation please visit:- http://www.scotthamptonfoundation.org.uk/index.htm

For more information on the work of Angry Man Pictures please visit:- www.angrymanpictures.co.uk

About Dr. Denis Parsons Burkitt, MD (1911-1993)

Denis Burkitt FRS, was born on February 28, 1911 in Enniskillen, Nothern Ireland. He attended  Trinity College medical school Dublin graduating with an MB in 1935. He then went on toreceive his F.R.C.S (Royal College of Surgeons Fellowships Examinations) from Edinburgh in 1938. He served in the Second World War with the Royal Army Medical Corps in England, Kenya, and Somaliland. He then moved to Uganda in 1946 to work with His Majesty Colonial Service in Uganda as government surgeon and lecturer at the Makerere University College Medical School. He became committed to serving less privileged people than himself, and the rest in medical history.  In 1957 he treated a child with swellings in both maxillae and mandible, a condition which ultimately came to be known as Burkitt ’s lymphoma. This led to the discovery of the cause and to the subsequent identification of the Epstein – Barr virus. (TBE)

Additional reading:

• A sarcoma involving the jaws in African children by Denis Burkitt

http://onlinelibrary.wiley.com/doi/10.1002/bjs.18004619704/abstract

Article first published online: 6 DEC 2005 DOI: 10.1002/bjs.18004619704 British Journal of Surgery Volume 46, Issue 197, pages 218–223, November 1958

• Burkitt’s lymphoma- Elizabeth M. Molyneux, Rosemary Rochford, Beverly Griffin, Robert Newton, Graham Jackson, Geetha Menon, Christine J Harrison, Trijn Israels, Simon Bailey

 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961177-X/abstract

The Lancet Volume 379, Issue 9822, 31 March–6 April 2012, Pages 1234–1244

Summary

“Burkitt’s lymphoma is a highly aggressive B-cell non-Hodgkin lymphoma and is the fastest growing human tumour. The disease is associated with Epstein-Barr virus and was one of the first tumours shown to have a chromosomal translocation that activates an oncogene (c-MYC). Burkitt’s lymphoma is the most common childhood cancer in areas where malaria is holoendemic. The incidence is very high in immunosuppressed patients in non-endemic areas, especially when associated with HIV infection. Outcome with intensive chemotherapy has improved and is now excellent in children, but the prognosis is poor in elderly adults. The success of intensive treatment relies on good supportive care. The therapy offered in oncology units in low-income countries is not as aggressive as in centres in high-income countries and outcomes are less successful. Adjuvant monoclonal antibody therapy with rituximab shows promise for improved outcomes and reduced toxic effects in the future.”