What Are the Symptoms of Childhood Cancer?

Certain types of cancer are more prevalent in childhood. Early detection of these cancers is more likely when families are aware of the symptoms. Cancers detected early are easier to treat and have less chance of spreading.

Common Types of Cancer in Children

As with any cancer, early diagnosis is crucial in childhood cancers. Along with regular childhood check-ups, awareness of symptoms can lead to early detection of childhood cancers. Cancers detected early have a higher chance of recovery and can improve survival rates.

Leukemia
Acute leukemia is the most common childhood cancer. Leukemias are classified as acute lymphoblastic leukemia, acute myeloid leukemia, chronic myeloid leukemia, and juvenile myelomonocytic leukemia. There are also rarer forms of chronic leukemia. If leukemia is suspected in children based on symptoms, lab tests such as white blood cell count, platelet count, and complete blood count are examined. A bone marrow biopsy is performed to confirm the diagnosis by examining immature blood cells. Leukemias develop in the bone marrow and cause symptoms due to excessive production of white blood cells in the bone marrow. These symptoms include:

• Anemia: In leukemia, anemia may develop, causing difficulty keeping up with peers, frequent need for rest, dizziness, shortness of breath, tachycardia, and heart palpitations.
• Thrombocytopenia: Thrombocytopenia develops in children with leukemia due to low platelet count, which may lead to easy bruising and bleeding.
• Paleness: Often observed with anemia, paleness affects skin color.
• Fever: Fever may occur due to suppressed white blood cells and can be recurrent.
• Infections: Persistent or recurrent infections that do not respond well to treatment.
• Bone or joint pain: Many children with leukemia experience unexplained pain in their bones or joints.

Other symptoms include:

• Fatigue
• Loss of appetite
• Cough
• Headache
• Vomiting
• Seizures
• Hepatomegaly

Brain and Spinal Cord Cancers
This is the second most common childhood cancer after leukemia, occurring from birth to 14 years old. It commonly affects the brainstem, spinal cord, or cranial nerves. The most common brain tumors are gliomas, glioblastomas, astrocytomas, oligodendrogliomas, ependymomas, and brainstem gliomas. While the causes are not fully known, radiation exposure or certain syndromes are thought to play a role. Symptoms vary depending on the child's age. Especially in children under two, head circumference measurement is essential to detect such symptoms. Shaking the head and irritability are key symptoms in infancy. For diagnosis, CT scans, MRI, and biopsy (for confirmation) are recommended. Symptoms vary based on cancer type and include:

• Increased intracranial pressure: Leads to headache, vomiting, nausea, irritability, drowsiness, depression, and reduced heart function.
• Frontal lobe tumor: Can cause seizures, visual and speech problems, partial paralysis, confusion, personality changes, short-term memory loss, and walking difficulties.
• Brainstem tumor: Can lead to seizures, endocrine issues, double vision, nerve or muscle paralysis, increased intracranial pressure, and hearing loss.
• Posterior brain tumor: Can cause increased intracranial pressure, vomiting, uncoordinated muscle movements, and walking issues.

Lymphoma
Lymphomas are cancers affecting the lymphoid tissues in children. They are divided into Hodgkin and non-Hodgkin lymphomas. Hodgkin lymphoma is more common in adolescents, while non-Hodgkin lymphoma is more common in younger children and occurs more often in girls. The most common symptoms are swollen, immobile, hard, and painless lymph nodes (lymphadenopathy). Non-Hodgkin lymphoma often involves coughing. Other symptoms include fatigue, fever, weight loss, pain, night sweats, and itching.

Neuroblastoma
Neuroblastoma, or cancer of the autonomic nervous system, is seen in children under five. Since young children's immature nerve cells spread throughout the body, cancerous tumors can appear anywhere in the body. Symptoms vary depending on the tumor's location, but palpable masses may appear in the abdomen, neck, pelvis, chest, and spine. Other symptoms include abdominal pain, constipation, urination problems, high blood pressure, anemia, bone pain, fever, and weight loss. Neuroblastomas also increase catecholamines in the bloodstream, so urine and blood samples play a role in diagnosis.

Nephroblastoma (Wilms Tumor)
Also known as kidney cancer, this is the most common abdominal cancer in childhood, especially affecting children under five, with a higher incidence in girls. Wilms tumor can grow without symptoms, but symptoms such as abdominal pain, fatigue, and high blood pressure may appear. Genetically at-risk children should have regular abdominal ultrasounds without waiting for symptoms.

Retinoblastoma
This rare childhood cancer forms in the retina and can be inherited. The most common symptom is leukocoria (white light reflection). Other symptoms include strabismus and red eye.

Osteosarcoma
Osteosarcoma, a bone cancer, is an aggressive type of childhood cancer. It affects bones that grow rapidly, mainly during adolescence, often impacting the arms, legs, and pelvis. Common symptoms include persistent bone pain, which does not ease with rest, especially at night or during physical activity, and lumps. If the tumor is in the upper limbs, it may reduce hand dexterity.

Rhabdomyosarcoma
This soft tissue cancer of the smooth muscle occurs in the head, neck, and extremities. It can appear anywhere in the body. There are two types: embryonal (affecting younger children) and alveolar (affecting adolescents). Symptoms vary by location and timing and can include masses, vomiting, constipation, nerve paralysis, and lymph nodes.

The Importance of Early Diagnosis

When cancer is diagnosed early, the likelihood of responding positively to treatment increases. Additionally, patients with early diagnosis have a higher chance of survival. Early diagnosis allows the disease to become more manageable, making it possible for treatment to be less painful and shorter in duration. Moreover, starting treatment at an early stage prevents cancer from spreading to other organs and tissues. To achieve early diagnosis, it is crucial for both families and healthcare institutions to be highly aware of symptoms and for clinical evaluations, diagnosis, and staging to be timely. This approach enhances the chances of successful treatment for many types of cancer when initiated early.

In cases of childhood cancer, it is essential for families to recognize the symptoms and consult a healthcare provider if they have any concerns. Treatments administered by a specialized team significantly increase the likelihood of recovery and survival.