Despite the circumstances, we aim to plant a sapling

Our primary goal at 57357 is not only to treat cancer and increase the survival rate of children but also to maintain the quality of life after treatment. Our vision has always been to continuously improve and update our diagnostic modalities and treatment options, in order to improve the outcome of our children and in the same time to maximally reduce the late effects of therapy which negatively reflect on the future life of the child and pose an extra burden on the healthcare service in Egypt.

Despite the difficult circumstances and the lack of donations, our keenness to develop as much as possible comes from a saying of the Prophet, may Allah bless him and grant him peace, “If the Final Hour comes while you have a shoot of a plant in your hands and it is possible to plant it before the Hour comes, you should plant it.”

The journey of a child with brain tumor is long and challenging, starting from diagnosis, which is essential for proper tumor staging and management. Using a state-of-art imaging modalities and top-notch histopathologic and molecular diagnostics, we make sure an accurate diagnosis is made. This is crucial for proper planning of treatment and setting expected outcomes. This is followed by multi-modal treatment and ending with post-therapy rehabilitation dealing with the complications of disease and the late effects of treatment.

The Children Cancer Hospital of Egypt (CCHE-57357) receives more than 320 new cases of pediatric brain tumor every year from all over Egypt. Similar to other types of pediatric cancers in 57357, new patients with brain tumors are accepted according to a first-come first-serve basis. However, there cannot be a waiting list for patients with brain tumors, unlike other types of cancer where some patients can wait for some time. The majority of new patients with brain tumor present with an increased pressure inside their brains causing what is called “brain edema”. Brain edema is a medical emergency that requires immediate surgical intervention to insert a shunting device for reducing pressure inside the brain. Thus, for such patients, either they get admitted on spot if there are availability of operative and ICU beds, or they have to be referred elsewhere for shunt insertion then come back to us for definitive management.

CCHE-57357 has accomplished a remarkable progress in the field of pediatric neurosurgical oncology, with a great success in resecting difficult and challenging brain tumors in children such as Craniopharyngioma, which is one of the most technically-challenging brain tumor due to its eloquent location and proximity to vital brain centers, as well as skull-base tumors and some tumors of the pituitary gland.

57357 does not select patients, and all types of cancers are accepted, including brainstem gliomas which are aggressive tumors known for their dismal outcomes worldwide. They account for 17% of our brain tumor patients with a median survival of 9.5 months after irradiation which is the only available treatment option until now. Despite their very poor prognosis, children with brainstem glioma never failed to find a place for them at CCHE, where they receive the standard-of-care radiation therapy as well as all sorts of supportive care such as rehabilitation, psychiatric counseling, and pain management. Meanwhile, we continue to conduct our research and studies on these lethal tumors as we believe this is the only way to find a new and curative treatment for our children.

Until now, more than 4500 children with brain tumors have been diagnosed and treated at CCHE-57357 with a five-year overall survival rate of almost 65%. Most common types of brain tumors in our children include low-grade gliomas which represent around 28% of cases with an excellent survival outcome exceeding 91% using surgery and chemotherapy. The second most common brain tumor type in our cases is medulloblastoma accounting for almost 19% with a survival rate ranging between 65% and 72% according to tumor subtype.

Management of pediatric brain tumors requires several modalities of treatment including surgery, chemotherapy and irradiation. Many other specialties are also involved in the care of a child with a brain tumor such as neurology, endocrinology, ophthalmology, physiotherapy and psychiatry. Several studies have shown that this multi-disciplinary care approach is crucial for optimum management and improved outcome of children with brain tumors.

The neurosurgery department at 57357 has an amazing team of expert neurosurgeons which comprises 5 consultants and 21 specialists and fellows led by the renowned neurosurgeon Dr. Mohamed Elbeltagy. More than 1100 successful surgical interventions are being performed every year at 57357, with a success rate of 72% which augmented our experience in this field given the huge numbers of patients that we receive every year.

Click here to know more about the members of our neurosurgical team

In addition to the outstanding skills of our neurosurgeons, such success is also attributed to the implementation of up-to-date technologies and devices for these interventions, such as the intra-operative MRI and ultrasound, surgical microscope, neuro-monitoring and neuro-navigation systems which allow for accurately defining the tumor location while delineating the track of neural plexus responsible for essential functions like speech, vision and memory and indicating their relation to the tumor.

These advanced technologies permit the conduction of highly sophisticated and challenging surgeries to remove tumors from very critical areas of the brain while protecting vital structures and brain

57357, the radiation oncology department is one of the best pediatric radiation therapy services in the MENA region in terms of equipment, infrastructure, and staff. The department uses the latest radiotherapy techniques and applies the latest international protocols and the highest quality standards in order to provide the best caring for our patients, to reach international cure rates.

This radiation therapy department has a highly-qualified team of expert clinicians and physicists led by Professor Dr. Mohamed Saad Zaghloul and a group of distinguished professors of radiation oncology. This team includes 5 consultants, 6 specialists, 3 residents, 8 medical physicists besides technicians and nurses. The role of medical physicists is not only restricted to dose calculations and planning but also includes quality assurance for utilized equipment.

Click here to know more about the members of our radiation oncology team

The radiation therapy department has two linear accelerator machines that offer precision irradiation treatment such as 3D-RT, IMRT, VMAT & SBRT. Also there is IGRT with CBCT serving the 2 linear accelerators with 1 CT simulation and 1 MRI simulation.

Following surgery, the final diagnosis is made and the child continues his treatment protocol. In CCHE-57357, we follow the most recent international guidelines and we treat our kids according to the latest chemotherapy protocols. However, the treatment plan for each case is tailored according to the patient’s age, condition, stage of the disease, and nature of the tumor. Such individualized therapy approach helps attaining the best treatment outcome with the least possible side effects of therapy. These treatment protocols are implemented by a fine selection of expert high-caliber doctors and clinicians led by Prof. Dr. Alaa Elhaddad and Dr. Moatasem Elayadi.

Click here to know more about the members of our pediatric oncology team

Moreover, cases can be discussed in international tumor boards with leading experts in the field to settle on the best treatment strategy when needed. Our doctors work in collaboration with colleagues and neuro-oncology experts from eminent centers in the world such as Boston Children Hospital (Dana-Farber Cancer Institute), St. Louis Children Hospital (Washington University), St. Jude Children Research Hospital and Children Hospital at University of Alabama. Such collaborative efforts largely reflect on the quality of our practice and hence the healthcare service that our patients receive.

Click here to know more about collaborating international centers and hospitals

In alignment with our vision for the future, and our keenness to continuously develop and improve, we keep looking for new sources of income that can secure necessary funds for treating our children for free. New projects have been accomplished such as the CyberKnife unit (operating) and the Proton Therapy building (in preparation) which will be used for the treatment of our children free-of-charge and in the same time for the treatment of adult patients from outside the hospital, as a charitable endowment directed in favor of the treatment of patients at 57357 to ensure the continuity of the service provided to them.

CyberKnife Unit

In August 2022, an important achievement for 57357 has been accomplished as the Cyberknife linear accelerator started to function and serve patients. This robotic radiosurgery machine is a breakthrough in radiation therapy as it is very useful for treating deeply seated tumors in critical locations with the least possible number of sessions, while protecting the healthy tissues and organs surrounding the tumor. It’s particularly useful in tumors such as brain metastases, spinal and pituitary tumors.

Proton Therapy

Another breakthrough in radiation oncology is the use of Proton Beam Radiotherapy instead of the ordinary photon irradiation. The machine is a grant from the proceeds of the Sheikh Zayed Charity Marathon in 2014. The Proton Therapy has the advantage of being restricted to the area of the tumor with a very limited dose of scattered radiation reaching the normal brain tissue. This makes Proton Therapy a much safer and less toxic option for the treatment of pediatric brain tumors and has now become the standard-of-care in most European and North-American centers for brain tumor types requiring irradiation. For that reason, the CCHE-57357 is acquiring their own Proton Therapy machine, expected to function late 2023, which will be the first Proton Therapy machine in Africa and the Arab world.

Despite all the circumstances we are going through, we are keen to “plant the sapling,” as our noble Messenger, may God bless him and grant him peace, commanded us. We work to complete some necessary expansion projects to save the lives of a larger number of children, and the most important of these projects is the expansion of the bone marrow transplant unit, from 9 to 27 beds, so that we can perform a greater number of bone marrow transplantations, which contributes to improving cure rates for challenging brain tumors, and saving the lives of more children suffering from serious brain tumors.

The expansion of the bone marrow transplantation unit at 57357 will help us accommodate more pediatric patients who will undergo tandem transplant. The hypothesis of this treatment approach is to conduct 3 consecutive cycles of bone marrow transplantation instead of irradiating the brain and the spine of children with certain types of brain tumors, aiming for improving the overall survival rate for those children while avoiding the long-term side effects of cranio-spinal irradiation. For that reason, the expansion of bone marrow transplant unit in 57357 has become a necessity to accommodate more patients who will undergo tandem transplant.

Applying knowledge into action is not just an idea, it’s a philosophy. We – in CCHE – believe that research is the only way to go forward, and translating basic research into clinical application is crucially important for improving outcomes of children with cancer especially brain tumors. For that reason, we were keen to join international study groups and research organizations to promote the scientific research in our hospital and keep in touch with the most recent updates in the scientific community.

However, maintaining high standards and quality healthcare services comes at a high cost. The cost of treatment for a child with brain tumor can vary from 700,000 up to 815,000 EGP in some cases. This includes different treatment requirements such as diagnostic imaging, lab investigations, medical consultations, surgery, chemotherapy, radiotherapy, transfusion of blood products, neuro-psychiatric care, accommodation, nutrition, indirect costs, and others. This cost is getting even higher due to the recent economic crisis and the ongoing devaluation of the Egyptian pound.

We are in the utmost need for your continuous help and donations. Despite the huge funds needed in such circumstances, we trust your empathy with our children and your keenness to help us to continue our mission in treating those kids with the highest quality standards and improving their survival outcome.

CCHE-57357 is a great blessing that Allah has bestowed upon us for our children, and it is our responsibility to preserve it and not neglect it.

As the Messenger of Allah, may Allah’s prayers and peace be upon him, said:

“Be a good neighbor to the blessings of God Almighty, and do not alienate them, for they are seldom alienated from the people of a household, and are about to return to them.”

The blessing, if it is not good for it, will perish, and if it is removed, it will not return to its owner again.

Participate in the cost of his diagnosis, chemotherapy, radiological or surgical treatment, or the expenses of his accommodation, nutrition or others, or part thereof.

We continue to fulfill our mission and continue to develop to increase the cure rates for our children, despite the difficult circumstances and lack of capabilities. We trust that Allah will do justice to the children of 57357.

Certainty is when you pray to Allah for something and all the reasons around you suggest that it will not be fulfilled, but inside you there’s complete faith and certainty that Allah will respond and that Allah if assigned a task to someone, helps him.

We are all responsible for preserving this edifice and contributing to saving our children with brain tumors in their difficult treatment journey.