Vijay Kumar
We generally think that cancer cannot happen to children. We are wrong here, because the truth is something else. Let’s take a look at it. childhood cancer is the number one killer disease of children — more than asthma, diabetes, AIDS and cystic fibrosis combined. In US, 46 children are diagnosed with cancer every day. 4000 children die from cancer each year. That means 11 children die every single day, every single year. Cancers in children occur regularly, randomly and spare no ethnic group, socioeconomic class or geographical region. The type of cancers that occur in children are different from adults. Lifestyle or environmental risk factors have little role to play in it. Instead, it’s usually the result of DNA changes in cells that take place very early in life. Because of major treatment advances, more than 80 percent of children with cancer now survive five years or more. Still, cancer is considered the second most common cause of death in children younger than 15 years old, after accidents. Cancers in children are sometimes hard to recognize because common illnesses or everyday infections and bruises can mask the early signs. Here are five most common pediatric cancers discussed along with warning signs & symptoms.
Leukemia(Blood Cancer) is a cancer of the bone marrow, the spongy center of the bones that makes blood cells. It accounts for approximately 35% of all childhood cancers; approximately 1 in 1000 children will be diagnosed with leukemia by the age of 19, although it is more common in children under the age of 10. Three out of four childhood leukemia cases are acute lymphoblastic leukaemia. Symptoms include, bone and joint pain, fatigue, weakness, bleeding, fever, weight loss. If parents suspect any of these above symptoms, then child should be immediately taken to doctor. The doctor checks for enlarged liver, spleen, or lymph nodes and take blood for a complete blood test. The blood test is most important for the diagnosis. Do not wait: as blood cancer progresses quickly and must be treated promptly. Remember that about 10% of the patients with leukemia will show a normal blood test at the time of diagnosis. To confirm that the child has blood cancer, a bone marrow test must be done.
Brain tumors(cancers) account for 15% of pediatric cancers. The symptoms depend on the site of the tumor. Since young children often do not complain of the symptoms, parents must rely on their own observations of their child to be aware of signs and symptoms. Signs and Symptoms includes seizure, repetitive automatic movements, persistent vomiting, nausea, progressive weakness, 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, back pain, which should be taken seriously in a child, changes in personality, irritability, listlessness, excessive thirst and excessive urination. If the patient is a baby, the only symptom may be fast growing head. Brain tumours are diagnosed by CT scan and MRI scan. Treatment includes surgery, chemotherapy and radiotherapy.
Neuroblastoma accounts for 5%-7% of all childhood malignancies; about 1 in 6000 children will be diagnosed with neuroblastoma by the age of five. Neuroblastoma manifests as a lump or mass in the abdomen or around the spinal cord. The average age at diagnosis is 2 years. Signs and Symptoms includes mass in the abdomen, chest, neck, or pelvis, loss of appetite, nausea, weight loss, stomach pain, constipation, difficulty urinating, black eyes, a droopy eyelid, vision problems, pain in the chest, difficulty breathing, persistent cough, pain or numbness in the lower extremities, limping, inability to stand, bone pain, fever, irritability, backaches (back pain in children is not common). Most neuroblastomas are found in the abdomen. Parents may feel a mass while dressing or bathing their child. The doctor should check for abnormal mass and do a urine test. A simple 24 hour urine collection is done to detect these abnormal levels. Other tests will include x-rays, abdominal ultrasound, CT scans of the head, chest and abdomen, a complete blood count. Treatment includes surgery, chemotherapy and radiotherapy.
Wilms tumor is a cancerous tumor of the kidney, although it is totally unrelated to adult kidney cancer. It accounts for 6-7% of childhood cancer cases. It is more common in children under the ages of 7 years. Signs and Symptoms includes 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 best treated when it is found early, before it has spread to other organs of the body. Infact, Wilms tumor is the only cancer of children with best results if diagnosed early and treated properly. Treatment includes surgery, chemotherapy, and possibly radiation, depending on how far the cancer has spread. The 5 year survival rate for children treated for Wilms tumor is approximately 90%.
Lymphoma starts in certain cells of the immune system called lymphocytes. These cancers affect lymph nodes and other lymph tissues, like the tonsils or thymus. They can also affect the bone marrow and other organs, and can cause different symptoms depending on where the cancer is growing. There are two main types of lymphoma: Hodgkin disease, is rare in children younger than 5 years of age. This type of cancer is very similar in children and adults, including which types of treatment work best. Non-Hodgkin lymphoma is more likely to occur in younger children than Hodgkin lymphoma, but it is still rare in children younger than 3 years. These cancers often grow quickly and require intensive treatment, but they also tend to respond better to treatment than most non-Hodgkin lymphomas in adults. Lymphoma Symptoms includes Swollen lymph nodes in the neck, armpit, or groin, weight loss, fever, sweats and weakness.
General warning signs for all childhood cancers
Continued, unexplained weight loss
Headaches, often with early morning vomiting
Increased swelling or persistent pain in bones, joints, back, or legs
Lump or mass, especially in the abdomen, neck, chest, pelvis, or armpits
Development of excessive bruising, bleeding, or rash
Constant infections
A whitish color behind the pupil
Nausea which persists or vomiting without nausea
Constant tiredness or noticeable paleness
Eye or vision changes which occur suddenly and persist
Recurrent or persistent fevers of unknown origin
(The Author is Consultant Neonatal & Pediatric Surgeon at Dayanand Medical College & Hospital, Ludhiana)
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