The chances that a child has cancer are rare but still it constitutes less than 5% of all causes of cancer in India.  The statistics say the chances of a child getting cancer before 19 yrs are 1 in 330 children. Seven out of 10 children with cancer in the resource-rich countries are cured, with a five-year survival for certain cancers, for example, Hodgkin’s disease and retinoblastoma, now 95%.

The childhood cancer are very rapidly growing and a quick diagnosis with proper treatment enhances the chances that he can be cured and can live a long life. As the saying goes “education begins at home” the parents are the best person to recognize the early signs and symptoms of cancer.

Leukemia

Leukemia is a cancer of the bone marrow, it accounts for nearly 35% of childhood cancers. It is more commonly seen in children younger than 10yrs.

Signs and Symptoms of leukemia:

• lethargy, weakness, paleness, dizziness
• back, leg, and joint pain, headache, trouble standing or walking
• easy bruising, unusual bleeding, frequent nose bleeds, bleeding gums, petechiae (red pinpoints on the skin)
• repeated, frequent infections
• fever that lasts for several days
• loss of appetite, weight loss
• swollen lymph nodes, bloated or tender stomach, swollen liver or spleen
• night sweats
• irritability

A child with leukemia will most likely show a blood test with:

• decreased red cells (low hemoglobin count)
• possible blast cells (lymphoblasts, leukemia cells)
• decreased platelets
• a low level of normal white blood cells
• increased lymphocytes

Bone-marrow aspiration and biopsy is essential for the diagnosis

Neuroblastoma

It’s a cancer of sympathetic nervous system. It is commonly diagnosed before the age of 5yrs. The most common presentation is lump or mass in the abdomen or around the spinal cord.

Signs and Symptoms of neuroblastoma:

• lump or mass in the abdomen, chest, neck, or pelvis
• loss of appetite, nausea, weight loss, stomach pain, constipation, difficulty urinating
• changes in the eyes: black eyes, a droopy eyelid, a pupil that doesn’t constrict, vision problems
• pain in the chest, difficulty breathing, persistent cough
• pain or numbness in the lower extremities, limping, inability to stand, stumbling
• bone pain, fever, irritability, listlessness
• backaches (backaches in children are not usual)

The mother commonly notices the lump or mass in the abdomen while bathing. The child feels full after small feed, and the abdomen is distended gradually. Apart from abdomen the other sites involved are head and neck, chest.Tumors located in the head and neck may present as a mass. The child may have “black eyes”, much like bruises, an eyelid that droops, or a pupil that doesn’t constrict properly. Chest tumors may cause pain, difficulty breathing, or a persistent cough. Tumors that grow in spinal areas may cause the child to have pain, numbness of the lower extremities, constipation and difficulty urinating. Sometimes the disease may present after spreading to other sites and may present as bone pain, fever etc.

Wilms tumor

Wilms tumor is a tumor of the kidney. It is commonly seen in children below 7yrs. It ususaly occurs due to genetic alteration of WT1 and WT2 genes. A lump is noticed by the mother in abdomen during bathing.

Signs and Symptoms of wilms Tumor

• abdominal swelling and/or pain
• nausea
• vomiting
• constipation
• loss of appetite
• fever of unknown origin
• night sweats
• abnormal urine color or blood in the urine
• malaise

Wilms tumor is a fast growing cancer. Early diagnosis can save the child.

Brain Cancers

 

Brain tumor constitutes nearly 15% of childhood cancers. The child won’t complain but the parents need to know and observe the symptoms, early diagnosis and treatment with surgery ,radiation therapy and chemotherapy is potentially curable. 5yr survival rate is 40-80%.

Signs and Symptoms childhood Brain tumor

• a seizure not related to high fever
• staring, repetitive automatic movements
• persistent vomiting without any known cause (projectile vomiting), nausea
• progressive weakness or clumsiness; neck tilt, squint
• walking, balance problems
• precocious puberty; growth retardation
• sleep apnea
• vision problems
• headache, especially that wakes the child up at night or is early in the morning
• pain, especially back pain, which should be taken seriously in a child
• changes in personality, irritability, listlessness
• excessive thirst and excessive urination (rare, if the tumor is pressing against the pituitary)

Rhabdomyosarcoma (RMS)

Rhabdomyosarcoma is a fast-growing, highly malignant soft-tissue sarcoma which arises in undifferentiated striated muscle cells. This type of cancer can occur in a variety of places in the body: the head, neck, and around the eyes; the extremities (shoulders, arms, and legs); in the pelvic region and genitourinary tract; and in the chest and lungs. It usually affects children the ages of 2 to 6 and 15 to 19.

Signs and Symptoms of RMS

• lump or swelling, firm and painless to touch, in the extremities, the groin area, or the vaginal area
• drooping eyelids, swelling of the eye, protruding eyeball, rapid vision changes
• hoarseness, difficulty in swallowing
• abdominal pain that persists for more than a week

Keep a close eye on your child for small lumps which do not disappear in a week or so, but instead keep growing larger. Especially watch the pelvic region and the arms and legs. Also watch for any changes in the eyes. Rhabdomyosarcoma is a rapidly growing tumor and the sooner treatment begins, the more favorable is the prognosis

Lymphomas

Lymphomas are malignant cell infiltrations of the lymphatic system. It presents with enlargement of lymph nodes in the neck, armpit, and groin. The lymphoma is broadly classified in to Hodgkins lymphoma and Non Hodgkin’s Lymphoma. They are classified according to cell types and IHC staining with help of competent pathologists. . Hodgkin’s generally occurs in individuals between 15-40 years of age, while non-Hodgkin’s generally occurs in individuals between 30-70 years of age. The Hodgkin’s lymphoma has favorable prognosis than NHL.

Signs and Symptoms withLymphoma

• swollen lymph node, especially in the neck, armpit or groin
• swelling of the face
• weakness, tiredness
• sweating, especially at night
• unexplained fever
• unexplained weight loss
• abdominal pain or swelling
• pain
• breathing difficulties, occasional cough, sometimes difficulty in swallowing

Retinoblastoma

Retinoblastoma is a malignancy of the retinal cell layer of the eye and is the most common eye tumor in children. It usually occurs before the age of five and can occur in one or in both eyes and is hereditary in some cases. Retinoblastoma accounts for 3-4% of all childhood cancers; about 1 in every 15,000 children will be diagnosed with this cancer. Retinoblastoma is treated by surgery, chemotherapy, and radiation. Current statistics state a 80-90% 5 year survival rate.

Signs and Symptoms of retinoblastoma

• whitish color behind the pupil ( White eye reflex in photograph)
• problems with eye movements (crossed eyes)
• a red irritation that persists

Bone Cancers

Osteosarcoma and Ewing’s sarcoma are the most common malignancies of bone tissues in children. Osteosarcoma, the more common of the two types, usually presents in bones around the knee; Ewing’s sarcoma may affect bones of the pelvis, thigh, upper arm, or ribs. Bone cancers are most common in ages 10-20yr and they account for about 6% of all childhood cancers. Bone pain is the most common symptom. Sometimes a lump can be felt on the bone, or the tumor will interfere with normal movements. What often happens is that a child injures themselves while playing, and the pain persists long after the injury should have healed. So, assuming that a bone is broken, the parents take the child to the doctor for evaluation, at which time X-rays reveal a bone tumor.

Signs and Symptoms of Bone Cancers in child

• pain in a bone
• swelling or tenderness around a bone or joint
• interference with normal movements
• weak bones, leading to fractures
• fatigue, fever, weight loss, anemia

Bone cancer is treated by surgery to remove the tumor combined with chemotherapy. The prognosis depends on the location of the tumor and whether or not it has spread; generally a five year survival rate of 70% is given for childhood bone cancers.