It’s heart-breaking to see a child that’s seriously ill, particularly when they’ve got cancer and might not survive.
But children do get the disease – and it’s being highlighted during September’s Childhood Cancer Awareness Month.
Fortunately, it’s not common. But every day in the UK, 10 families receive a cancer diagnosis for their child, teenager or young adult, and it’s the leading cause of death in children under 14, according to the charity Children With Cancer UK (CWCUK).
However, Jeanette Hawkins, chief nurse at the Children’s Cancer and Leukaemia Group (funded by Young Lives vs Cancer), stresses that childhood cancer isn’t as rare as people might think, with a similar risk as diabetes, epilepsy and bacterial meningitis.
“Use of the word rare for childhood cancer is a barrier to diagnosis as both GPs and parents therefore don’t consider it’s possible,” she explains.
“Families, on average, have three to five GP visits before cancer is suspected. We need to reduce that by increasing awareness. Remember that childhood cancer is often a constellation of non-specific persistent symptoms, rather than a single ‘red flag’ that would alert a GP.
“If you’re worried about your child keep going back.”
Christiana Ogunbote, head of research at CWCUK, says childhood cancer accounts for less than 1% of all cancers in the UK, and explains there are 12 main categories of cancers affecting children, with the most common being leukaemia (30%), brain, central nervous system (CNS), intracranial tumours (26%) and lymphomas (11%).
Ogunbote says cancer symptoms in children can vary widely depending on the cancer type and where it is in the body, but points out: “Often the individual symptoms of cancer can be similar to common childhood illnesses, so it can be hard to identify.
“If a symptom progresses or doesn’t get better as quickly as expected, we would suggest getting it checked out by a medical professional. It’s useful for parents who know what’s ‘normal’ for their child to be aware of the signs and symptoms of cancer, as earlier diagnosis will support better outcomes for children and young people.”
Here, Ogunbote outlines the symptoms of the three most common childhood cancers…
1. Leukaemia
Symptoms of leukaemia in children and babies, which may be acute myeloid or acute lymphoblastic leukaemia (ALL), can include frequent and persistent infections, unusual bleeding and/or bruising, tiredness, paleness, breathlessness and, with ALL, coughing and anaemia.
“Childhood leukaemia develops quickly,” says Ogunbote. “but it’s possible for some or all of these symptoms to be apparent.”
She says a leukaemia diagnosis can be made from a blood test, which may reveal low numbers of normal white blood cells and large numbers of abnormal white blood cells. Further tests will then be done on a sample of bone marrow to confirm the diagnosis.
2. Brain and spinal tumours
The symptoms of brain and spinal tumours (central nervous system tumours) vary between age groups, says Ogunbote, but symptoms in babies may include persistent/recurrent vomiting, balance/co-ordination/walking problems, abnormal eye movements or suspected loss of vision, behaviour change (particularly lethargy), fits or seizures (not with a fever), abnormal head position such as head tilt or stiff neck, and increasing head circumference.
Children’s brain tumour symptoms are similar to symptoms in babies, but may also include a persistent/recurrent headache, blurred or double vision, fits or seizures, reduced consciousness and abnormal growth.
Ogunbote says symptoms vary depending on the type and site of the tumour, and develop much more slowly with low grade tumours. But she stresses: “It’s important to remember that many of these symptoms are extremely common, and experiencing one by itself is rarely a sign of a brain tumour.”
A CT or MRI scan will be done if a brain tumour is suspected, and if the scan confirms the diagnosis, further investigations will determine the type of tumour and best treatment.
3. Lymphoma
Children may get a cancer of the lymphatic system known as either Hodgkin or non-Hodgkin lymphoma, and Ogunbote says symptoms of both include a persistent (lasting a few weeks) painless swelling of a single lymph gland, usually in the neck, or possibly in the armpit or groin with non-Hodgkin, a cough or breathlessness (if glands in the chest are affected), fevers, sweats, and weight loss. There may be itching with Hodgkin lymphoma, and with non-Hodgkin there may be tiredness, feeling full after a small meal, stomach pains (if abdominal lymph glands are affected), and sleep sweats.
Diagnosis is confirmed by removing part or all of an affected lymph gland, usually under general anaesthetic, and doing a biopsy on it so the cells can be examined in a laboratory.
Further tests, like x-rays, CT and MRI scans and blood tests, will also be carried out to determine the size and position of the lymphoma and whether it has spread. This is known as staging.
“Many of the symptoms of lymphoma can also be symptoms of other illnesses, so this can make it difficult to diagnose,” explains Ogunbote. “Symptoms your child might experience depend on where the lymphoma is in their body, and symptoms vary from child to child, even if they have the same type of lymphoma.”
