Early signs of cancer in children, every parent should

Cancers in children are uncommon, although they remain the biggest cause of death among children. There’s a danger that parents would confuse early cancer symptoms with those of viral infections or injuries. While the majority of childhood malignancies are treatable, raising awareness about them is critical for improved outcomes.

On February 15 every year, International Childhood Cancer Day 2022 is observed to spread awareness around the kinds of childhood cancers, their diagnosis and treatment.

An estimated 400,000 children and adolescents of 0-18 years develop cancer. The most common types of childhood cancers include leukemias, brain cancer, lymphomas, solid tumours, such as neuroblastoma, Wilms tumour and bone tumors. In high-income countries, where comprehensive services are generally accessible, more than 80% of children with cancer are cured. In low and middle-income countries (LMICs), this percentage is less and the major hurdle is lack of awareness leading to delay in the diagnosis.

Common symptoms of childhood cancer

“Cancer often presents with nonspecific symptoms resembling to common viral illnesses, thus delaying access to proper and specific medical care. Primary care physicians should have a raised index of suspicion in children who have worrisome or persisting signs and symptoms,” Dr. Vikas Dua, Director, Pediatric Haematology, Haemato – Oncology & Bone Marrow Transplant, Fortis Memorial Research Institute, Gurugram told HT Digital.

He also opens up on signs of different kinds of childhood cancers parents must watch out for:

Red flag signs for leukemia or lymphoma include:

* Prolonged fever with no identifiable cause

* Unexplained and protracted pallor

* Malaise, limp or refusal to walk

* Palpable lymph nodes: When lymph nodes increase in size they are called enlarged lymph nodes. They can be in neck, armpits, and groin

* Bleeding diathesis characterized by petechiae (tiny purple, red, or brown spots on the skin), ecchymoses (a discoloration of the skin resulting from bleeding underneath), recurrent nosebleeds and bleeding gums

* Hepatosplenomegaly, a disorder where both the liver and spleen swell beyond their normal size.

Warning signs of Hodgkin lymphoma

Prolonged drenching night sweats, fever, and significant weight loss; together with lymphadenitis (enlargement in one or more lymph nodes), are typical signs of Hodgkin lymphoma.

Signs of tumour of central nervous system

New onset or persistent morning headaches associated with vomiting, neurologic symptoms like unsteady staggering gait, or back pain should raise concern for tumors of the central nervous system.

Signs of abdominal and bone tumour

Palpable masses in the abdomen or soft tissues, and persistent bone pain not responding to pain killers and that awakens the child are some of the red flags for abdominal, soft tissue, and bone tumors. Abdominal mass when associated with blood in urine (hematuria) or hypertension should raise a suspicion towards renal tumors (Wilms tumor).

Warning signs for retinoblastoma

White pupillary reflex (leukocoria) is a red flag for retinoblastoma (malignant tumor of the retina). Increased suspicion is also warranted for conditions including various immunodeficiency syndromes, certain genetic conditions and familial cancer syndromes such as Down syndrome, Li-Fraumeni syndrome, hemihypertrophy, neurofibromatosis, and retinoblastoma which are associated with a higher risk of cancer.

“A correct diagnosis is essential to prescribe appropriate therapy for the disease. Children also need special attention to their continued physical and cognitive growth, nutritional status, thus requiring a dedicated, multi-disciplinary team. Cure is possible for more than 80% of children when childhood cancer services are accessed timely,” concludes Dr Dua.