Cancers are the abnormal growth of cells (mass or tumour) in the body mostly caused by poor lifestyle choices or environmental risk factors in adults unlike those in children. Childhood cancers are rare and are caused majorly due to alterations in the genes or DNA in the early formative years of a child.

As per the estimates of the World Health Organization (WHO), about 400 000 children and teenagers aged between 0-19 years old are diagnosed with cancer every year. But, the most distressing is only 15 to 45% of children with cancer are curable in the low- and middle-income countries (LMICs) compared to the 80% in high-income countries. Thus, it becomes crucial to detect cancer at the early stages for its timely treatment.

This leaves us with the question- Is childhood cancer easily diagnosed? Detection of cancer in children may not be an easy task. Cancer symptoms may be easily misunderstood with that of common diseases or injuries in children or occasionally there may be no changes observed at all.

We must know that- the cause of a symptom or an indication may be another medical condition that may not be cancer. A child may just be unwell or have bruises or bumps that might conceal early cancer signs.

Now, let’s look at some of the common signs and symptoms of childhood cancer:

• Skin inflammation or unusual lump or mass (commonly in neck, abdomen, chest, pelvis, or armpits
• Pale skin and loss of energy or persistent tiredness
• Swelling or continuous pain in a particular part of the body
• Excessive bruising or bleeding
• Recurring or persistent fevers
• Sudden weight loss
• Frequent headaches and vomiting
• Limping
• Sudden changes in eye or vision
• Chronic infection

Childhood cancer types: The most prevalent cancers in children can be classified into 4 types, these are:

1. Leukaemia (Blood Cancer)
2. Lymphoma (Cancer of the immune system)
3. CNS or Brain tumours
4. Solid tumours (Cancer of tissues, bones or organs)

Leukaemia (Blood Cancer):

About 40–50 % of childhood cancer burden in India is attributed to Leukaemia with a median age of presentation between 6 to 10 years. This is the most common childhood cancer which starts in the bone marrow which proceeds to the blood and other organs.

Leukaemia can either be ‘acute type’ that gets worse quickly and spreads fast or ‘chronic type’ that gets worse gradually.

Leukaemias presented in children as Acute lymphocytic or lymphoblastic leukaemia (ALL) and acute myeloid or myelogenous leukaemia (AML). About 3 out of 4 leukaemia cases in children are of ALL.

Juvenile myelomonocytic leukaemia (JMML) is one of its few other rare types, which displays in a child's myeloid cells.

Lymphoma (Cancer of immune system and lymphoid tissues):

Lymphoma most often begins in lymph nodes or in other lymph tissues (tonsils or thymus), which contributes to poor or compromised immunity.

Typically, lymphomas can be divided as:

• Hodgkin lymphoma or Hodgkin disease (rarely observed in children younger than 5 years) and,
• Non-Hodgkin lymphoma (more common in younger children).

Brain cancer or tumours of the central nervous system (CNS):

The unusual growth of immature nerve cells in the brain or spine leads to brain cancer which makes up for around 27% of childhood cancers. These can interrupt the normal movement, sensation, thought and/or behaviour in children.

Solid tumours (Cancer of tissues, bones or organs):

• Neuroblastoma (Nerve cancer):

This type of cancer starts in the initial stages of nerve cells in the development of the embryo or fetus. It develops in infants and young children and is rare in children aged older than 10 years. The tumour is normally observed as swelling in the belly (abdomen).

• Wilms’ tumour (Kidney Tumours or nephroblastoma):

This type of cancer is derived from immature kidney cells and is most frequently observed in children aged 3-4 years.

In rare cases, some of these cells start to grow erratically and results in a mass of quickly dividing, small cells, known as the Wilms tumours. It typically affects only one kidney (unilateral) or both kidneys (bilateral).

• Bone tumours:

This cancer of the bones comprises about 3% of childhood cancers. They are generally observed in older children and adolescents but can develop in age groups.

The main types of bone cancers in children are:

• Osteosarcoma:

It is most common in teenagers which progresses at the ends of the long bones (legs or arm). It frequently causes bone pain along with swelling that gets severe at night or with movement.

• Ewing’s sarcoma:

It is a less common type of malignant bone tumour, mostly found in children in their young teen years. It commonly starts at the pelvic or hip bones, chest wall (like ribs or shoulder blades), or in the middle of leg bones leading to swelling and pain.

• Rhabdomyosarcoma:

It is a tumour in which malignant cells appear to be young and naive muscle cells. It is a well-known soft tissue sarcoma found in children that can occur in any muscle.

• Retinoblastoma:

It is a malignancy of the retina of the eye which usually occurs in children before 5 years of age. It is generally limited to the eye and does not spread to other tissues.

Conclusion:

As the threat of cancer mostly affects when a baby is still in the womb and at a growing age, so these are the times when a parent can contribute to the prevention of childhood cancer.

A healthy lifestyle (healthy diet, regular exercise), protection from cancer-causing sunburns, radiations and poisons, timely vaccinations, following good habits can surely help!

FAQs:

Q. What is the other name of cancer in children?
Ans. Childhood cancer or pediatric cancer involves a wide range of cancer types in children.

Q. What is the most common cause of cancer in children?
Ans. They are almost always induced by a DNA (genetic) mutation that is not inherited but happens by chance (acquired).

Q. Can childhood cancer be cured?
Ans. More than 70% of childhood cancer is now curable with the best available treatments.