Cancer in children

Cancer is uncommon in children#

Cancer is caused by genetic changes in a cell that lead to uncontrolled growth. In adults, these changes are often linked to lifestyle factors such as smoking or being overweight, which usually take years to have an effect.

In children, the genetic changes that cause cancer are not due to lifestyle. Children have not lived long enough for lifestyle factors to play the same role, so childhood cancers tend to be driven by random genetic changes. This makes them more difficult to predict and to prevent.

Some children inherit genetic changes and a higher risk of cancer from a parent, but more often the changes are not inherited and happen early in life, sometimes before birth. The reasons for these changes are usually not known. They are considered random, though in some cases they may be linked to environmental factors such as exposure to radiation.

A cancer diagnosis in a child is a very difficult time for the child, the parents, and family and friends. Ask your healthcare professional about how to find support for yourself and how best to support your child.

The types of cancer seen in children differ from those in adults#

Common childhood cancers include:

• leukaemia – such as acute lymphoblastic leukaemia or acute myeloid leukaemia, which begin in the bone marrow and spread through the bloodstream
• lymphoma – Hodgkin and non-Hodgkin lymphomas, which begin in white blood cells (lymphocytes), usually in the lymph nodes and other lymph tissue
• brain and central nervous system tumours – such as gliomas and medulloblastoma
• neuroblastoma – a cancer of nerve tissue, often found around the kidneys
• Wilms’ tumour – a type of kidney cancer
• retinoblastoma – cancer of the retina, the light-sensing tissue at the back of the eye
• bone cancer – such as osteosarcoma and Ewing sarcoma
• rhabdomyosarcoma – cancer of muscle and connective tissue such as tendons and cartilage

Symptoms of cancer in children#

Symptoms vary greatly depending on the type of cancer. If you are concerned about your child’s health, the best course of action is to see your doctor. Possible symptoms include:

• leukaemia – bone or joint pain, fatigue, weakness, pale skin, bleeding or bruising, fever, or weight loss
• brain and central nervous system tumours – headaches, nausea, vomiting, blurred or double vision, dizziness, or difficulty walking
• lymphoma – weight loss, fever, sweats, tiredness, and lumps (swollen lymph nodes) in the neck, armpit or groin
• retinoblastoma – the eye looks unusual and may appear white or pink rather than red in flash photographs
• neuroblastoma – swelling in the abdomen, bone pain, or fever
• Wilms’ tumour – fever, pain, nausea, or lack of interest in food
• bone cancer – bone pain and swelling
• rhabdomyosarcoma – pain and swelling almost anywhere in the body

Diagnosis of cancer in children#

If your doctor thinks your child’s symptoms may be caused by cancer, your child will be referred to a specialist doctor called an oncologist. Medical tests can be unpleasant for everyone, and especially hard for children. Your healthcare team can help you support your child through this time.

The tests used depend on the type of cancer, and may include:

• imaging tests – such as a bone scan, CT scan (computed tomography), MRI (magnetic resonance imaging), PET (positron emission tomography), ultrasound or x-ray
• biopsy – a small amount of tumour is removed and analysed
• blood tests
• bone marrow aspirate – a small amount of bone marrow is taken with a needle and analysed
• lumbar puncture – a small amount of spinal fluid is removed with a needle

Test results can take a few days to come back. It is natural to feel anxious while you wait. It can sometimes help to talk to a close friend or relative about how you are feeling, or to contact a cancer support service and speak with a cancer nurse.

Once testing is complete, the specialists will usually ‘stage’ the cancer, which helps guide treatment. The meaning of each stage depends on the type of cancer, but in general:

• stage 1 – cancer has not spread to other parts of the body
• stages 2 and 3 – cancer has spread to areas close to the original (primary) tumour, such as nearby lymph nodes
• stage 4 – cancer has spread (metastasised) to other parts of the body and may have formed secondary tumours

The treatments for cancer depend on the type and stage#

Common treatments, used alone or in combination, include:

• surgery – common for solid tumours
• radiation therapy – uses high-energy x-rays to kill or damage cancer cells, though it can also affect nearby healthy cells
• chemotherapy – drugs that are toxic to cancer cells

Much cancer research is focused on developing new immunotherapies, and new treatments are constantly being researched and tested for all types of children’s cancers. Clinical trials are available for many cancers; they may test new treatments, new combinations, or better ways to manage side effects. Ask your doctor about clinical trials that may be relevant to your child.

Side effects of treatment#

Although treatment is designed to kill or damage cancer cells, it usually also harms some healthy cells, which causes side effects. Talk with your healthcare team about how best to manage the side effects most likely with your child’s treatment.

Some families choose supportive therapies such as massage and relaxation to help a child cope with diagnosis and treatment. Other complementary approaches, such as herbal therapies and dietary changes, are not scientifically proven to help and may be harmful. In some cases they can make conventional treatment less effective. Always speak with your doctor before starting any complementary or alternative medicine for your child. Never let your child stop their conventional treatment or change the dose without your doctor’s knowledge and approval.

Key points#

• Cancer is uncommon in children, and the most common types differ from those in adults.
• Cancer is caused by genetic changes in a cell that lead to uncontrolled growth.
• In adults these changes are often linked to lifestyle factors such as smoking or obesity.
• In children the genetic changes are not due to lifestyle and are more likely to be random.
• This makes cancer in children difficult to predict and to prevent.

Where to get help#