Childhood cancer refers to cancer that occurs in children from birth to 14 years old and in teenagers between the ages of 15 – 19 years old. It is important to understand that cancer in children is NOT one illness but comprises of various conditions that can affect children of all ages, gender, ethnicity and socio-economic backgrounds.
Childhood cancer is a critical health issue worldwide. Each year, an estimated 400,000 children and adolescents aged 0 - 19 years old develop cancer. In Malaysia, the Malaysian National Cancer Registry (2012 - 2016) reported 3829 cases of childhood cancer in children and adolescents aged between 0 – 19. Over the last five decades, improvements in the diagnostics and treatment of cancer have drastically improved survival rates of children diagnosed with cancer. In most high income countries, more than 80% of children survive their cancer diagnoses.
Types of Childhood Cancer
There is a common misconception that cancer is a singular disease. On the contrary, cancer is a group of different conditions. Imagine cancer as an umbrella term that describes a group of conditions characterised by uncontrolled cell growth. Under this umbrella are the various types of cancer, and within each sub groups, there are different subcategories of cancers.
Risk Factors of Childhood Cancer
Generally, there is a system within the human body which involves chemical signals that control cell growth. However, sometimes the system does not work properly, resulting in uncontrolled growth of abnormal cells. The uncontrollable growth of abnormal cells is known as cancer.
Unlike adults, where environmental and lifestyle factors contribute to cancer, this is generally not the case in children. Most childhood cancers occur spontaneously by chance. While some cancers are caused by inherited cancer-causing genes, this only affects a small percentage of children, approximately 5- 10%.
Symptoms of Childhood Cancer
As mentioned above, there are numerous types of childhood cancer and typically, each cancer type has different presenting signs and symptoms. Diagnosing childhood cancer can sometimes be difficult as many of its presenting symptoms are similar and can mimic common childhood conditions. In contrast to adult cancers, for which screening tests are available for many different cancer types, there are no screening tests available for childhood cancer.
Some of the common symptoms of childhood cancers are listed below:
Prolonged, unexplained fever
Unexplained lumps and bumps
Unexplained weight loss
Feeling tired all the time without reason
Persistent or prolonged cough or shortness of breath
Abdominal pain or swelling that does not go away, or progressively increases in size
Severe headaches, especially those associated with early morning vomiting
Unexplained bruises or small red or purple dots, easy bruising or prolonged bleeding
Bone or back pain that does not go away or that wakes your child up at night
Changes in the appearance of the eye or unusual reflections of the eye in photos
What to Do Next?
- These symptoms of childhood cancer are similar to common childhood conditions, and it is important to remember that having any of these symptoms above, does not necessarily mean that your child has cancer.
- Childhood cancer is rare. According to the Malaysian National Cancer Registry, cancer in children and adolescents only accounts for 1% of cancer diagnoses in the country.
- If your child exhibits any of these symptoms, please bring your child to see their regular doctor (GP or Paediatrician) for a check-up. If your doctor feels that there are signs and symptoms suggestive of cancer after evaluating your child, he or she will refer your child to a paediatric haematologist & oncologist for further evaluation.
- In the case of an emergency, bring your child to the emergency department as soon as possible for urgent assessment. The emergency department physician will refer your child to a paediatric haematologist & oncologist if their symptoms suggest cancer.
Diagnosing Childhood Cancer
Depending on the type of cancer, the doctor may perform several tests to diagnose the condition following a thorough history and physical examination.
Some of these tests may include:
- Blood tests
- Bone marrow aspiration and/ or biopsy
- Lumbar puncture
- Computed tomography (CT) scan
- Magnetic Resonance Imaging (MRI) scan
- Positron Emission Tomography (PET) scan
- Biopsy of tumour