Childhood Cancer: Know the Warnings

Cancer in children accounts for just 1 % of the total number of cancer cases. The ‘Golden Ribbon’ which is symbolic of paediatric cancers denotes the importance in curing these cancers. Although rare, they cause much distress in the young parents and immediate family members, for obvious reasons. Unlike adult cancers, the onset can be quite rapid and dramatic.

The most common cancer, Leukaemia or blood cancer is usually detected when a child is evaluated for fever. Other solid tumours in the kidney, liver may be felt by the parents while the child is bathing. Brain tumors are diagnosed during evaluation for unexplained weakness or persistent headaches. Although the symptoms may be nonspecific, an astute paediatrician will be able to think of a sinister reason when these danger signs are flashed.

The earliest signs and symptoms of paediatric cancer include:

– Fatigue and nausea
– Nose and gum bleeding
– Aching bones, joints, easy bruising and fractures
– Stomach aches and poor appetite
– Unexplained weight loss
– Constant and persistent infections
– Frequent headaches with/without frequent vomiting
– Unexplained persistence or recurrence of fever
– Changes in vision, bulging of the eyeball
– Neurological problems like loss of balance
– Night sweats
– Formation of lumps in the stomach, arms, legs, pelvis

The different types of cancer in children are:

– Leukaemia (the most common form of childhood cancer)
– Brain tumor
– Bone cancer
– Lymphoma
– Wilms tumor
– Neuroblastoma

Changes in the genetic composition of the cell leading to uncontrolled growth may happen even before birth, as in the case of hepatoblastomas (liver tumors) or nephroblastomas (kidney tumors). There is also a genetic predisposition for development of leukaemia’s and brain tumors. However, majority of paediatric cancers are sporadic or occur randomly without any specific reason. Lifestyle or infections don’t play an important role here.

After suspecting cancer, the child has to go through specific diagnostic investigations.  This may be a simple blood smear/bone marrow examination for leukaemia. For cancers in solid organs, scans to know the extent of disease and biopsy of the affected organ have to be done. A comprehensive workup and multimodality discussion involving Oncologists, radiologists and pathologists are essential.

Cure rates in paediatric cancers are quite high compared to adult cancer. Surgery, chemotherapy and radiotherapy are the main modalities of treatment. Children usually go through the rigors of cancer treatment in a better way compared to adults. The current focus is to tailor the various modalities described above to reduce long term side effects. Protocol based cancer treatments and clinical trials are available for almost all paediatric cancers. Long term follow up clinics ensure that the cancer survivor is integrated into mainstream devoid of any physical or mental trauma.

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