Childhood cancer is a major health issue affecting children and adolescents. Early symptoms are common childhood illness symptoms but are difficult to detect. If a patient has persistent fever and bruising, weight loss and pain that continues, the patient may need to go to the doctor.
According to the World Health Organization (WHO), over 400,000 children and adolescents aged 0 to 19 worldwide develop cancer each year. Early diagnosis and timely treatment can improve the prognosis of many childhood cancers.
But those symptoms do not necessarily mean a child has cancer. Most are more commonly associated with other illnesses. Parents should take care of symptoms that persist, worsen or occur together and consult a doctor if concerned.
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What is Childhood Cancer?
Cancer in childhood is when abnormal cells grow uncontrollably in a child’s body. It can affect organs, tissues and parts of the blood and immune system as well.
Some of the most common types are leukaemia, brain tumours, lymphomas and some solid tumours such as neuroblastoma and Wilms tumour.
The risk of childhood cancer is not so closely related to lifestyle factors. The causes of most childhood cancers are largely unknown, but genetic and medical conditions can affect the risk for some children.
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Early Warning Signs of Childhood Cancer
The symptoms of childhood cancer differ based on the type of cancer and the part of the body affected. Some of the warning signs might be delayed while others may be more obvious.
1. Persistent or Unexplained Fever.
Fever is common in children and often due to an infection. But if a fever returns or does not improve as expected, a fever that is accompanied by fatigue, unusual bruising, or other unexplained symptoms needs to be treated.
Parents should consult a paediatrician if a child's fever continues to persist or is associated with other concerning changes.
2. Unusual Bruising or Bleeding.
Children often get bruises while playing. But frequent or unexplained bruising, small red or purple spots on the skin, repeated nosebleeds, or bleeding gums might need to be looked into.
These may also be caused by other medical conditions.
Parents should see a doctor when bruising or bleeding occurs without a clear explanation or becomes unusually frequent.
3. Unexplained weight loss or loss of appetite.
A very noticeable reduction of weight without diet or exercise is a warning sign that something is affecting a child’s health.
Some children may also have a persistent loss of appetite, poor growth or a decline in their usual energy levels.
These changes are not specific to cancer. But ongoing weight loss or poor growth should be evaluated by a healthcare professional.
4. Persistent pain in Bones or Joints.
Young children might have occasional aches and pains. But persistent or worsening bone and joint pain should not be taken as a symptom of growing pains.
Pain that repeatedly wakes a child at night, leads to a limp or interferes with walking and daily activities deserves medical care.
In some cases persistent bone pain can be related to leukaemia or bone cancer. A doctor can check the symptoms and determine whether more tests are necessary.
5. Unusual Lumps or Swelling.
Lumps or swelling in the neck, armpit, groin, or another part of the body may be caused by infections or swollen lymph nodes.
But a lump that continues to grow, persists without any obvious explanation, or is accompanied by other symptoms should be checked by a doctor.
Swelling in the abdomen also warrants medical evaluation if it is persistent or causes pain, reduced appetite, or unexplained weight loss.
6. Persistent Headaches or Repeated Vomiting.
Children are commonly diagnosed with headaches. But persistent or worsening headaches, especially when accompanied by repeated vomiting, changes in vision or unusual sleepiness, need medical evaluation.
Children with brain tumours may experience headaches, balance problems, seizures or changes in behaviour.
These symptoms can have a variety of possible causes (e.g., common infections, neurological disorders). A headache does not necessarily mean cancer for parents, but they should go to the doctor if symptoms persist or get worse.
7. Unusual Tiredness or Pale skin.
Even with sufficient rest, children who are always tired even with sufficient rest might need medical evaluation, especially if their energy levels have changed significantly.
Unusual paleness, weakness, dizziness, and reduced interest in normal activities may also indicate anaemia or another underlying condition.
Anaemia can be caused by nutritional deficiencies and other diseases. In some cases it can occur alongside childhood leukaemia.
A doctor can make a determination whether blood tests or further studies are necessary.
8. Changes in vision or the appearance of the eyes.
Some childhood eye cancers can cause visible changes in the eyes. Warning signs can include a white reflection in the pupil, a newly formed squint, or unexplained changes in vision.
Parents may notice an unusual white reflection in photographs taken with a camera flash. Such a reflection does not establish a diagnosis but should be assessed promptly by an eye specialist or paediatrician.
Such evaluation is especially important when the changes affect only one eye or appear suddenly.
9. Frequent Infections.
Children tend to develop infections as their immune systems mature. However, unusually frequent, severe or prolonged infections might need more study.
Some blood cancers can interfere with the body’s ability to produce healthy blood cells, affecting its ability to fight infections.
Parents should discuss recurrent infections with a doctor, especially when they occur alongside persistent fever, unusual bruising, paleness or unexplained fatigue.
When should parents take their child to a doctor?
Parents should arrange a medical appointment if a child has symptoms that persist, worsen, recur without a clear explanation, or interfere with normal activities.
A paediatrician should assess unexplained lumps, ongoing bone pain, repeated fevers, unusual bruising, unexplained weight loss, and persistent headaches.
If the child has severe breathing difficulties, a seizure, sudden weakness, confusion, difficulty waking up, or another serious or rapidly worsening symptom, seek urgent medical care.
Parents should not wait for a few warning signs to show before seeking medical advice. A single persistent or concerning symptom may be enough to justify an assessment.
How is Childhood Cancer Diagnosed?
A doctor will typically begin by asking about the child’s symptoms, medical history and how long the symptoms have been present. The doctor may also perform a physical examination.
Depending on the findings, the investigations may include:
- Blood tests can also tell if blood cells are affected and not normal.
- Ultrasound, MRI, CT scans, or other imaging tests may be used to investigate a lump, persistent pain, or other symptoms.
- Biopsy: In some cases, a small tissue sample is examined to determine whether cancer cells are present.
- Specialist evaluation: A paediatric oncologist may be involved if the initial findings raise concerns about cancer.
Not every child with these symptoms will need all these tests. The appropriate investigations depend on the child’s symptoms and the doctor’s assessment. Cancer screening is generally not recommended for children at average risk. Instead, early detection is based on identifying symptoms and getting a diagnosis.
Can Childhood Cancer be treated successfully?
Many childhood cancers can be treated successfully but the cancer type, stage at diagnosis, child's overall health and access to appropriate treatment are dependent on treatment. Treatment can be chemotherapy, surgery, radiotherapy or a combination. Specialised medicines and supportive care are also required for some children.
The WHO says more than 80% of children with cancer can be cured in high-income countries, where comprehensive cancer services are widely available. In many low- and middle-income countries, the reported cure rate is less than 30% indicating there is a difference in access to timely diagnosis and effective treatment.
These are population-level estimates and not predictions for an individual child. Treatment outcomes vary widely for different types of cancer and healthcare settings.
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