Childhood Cancer and Leukaemia: Signs and Symptoms
Childhood cancer and leukaemia are among the most serious medical and social challenges affecting children and adolescents worldwide.
Early diagnosis, made possible by the prompt recognition of warning signs and symptoms by parents and caregivers, can significantly improve the chances of successful treatment and cure.
Education about the early detection and diagnosis of childhood cancer should be a priority in our collective fight against cancer. The better informed we are, the better equipped we are to protect children—and adults—from this disease.
Childhood cancer: a global challenge
Every year, at least 450,000 children and adolescents worldwide are diagnosed with cancer or leukaemia. The true number is likely to be even higher because many countries still lack comprehensive childhood cancer registries or have incomplete reporting systems.
Cancer and leukaemia are the second leading cause of death in children, after accidents. However, they are the leading cause of death from disease during childhood.
The causes of childhood cancer remain largely unknown. Less than 10% of childhood cancers are associated with inherited genetic factors.
Cancer develops when damage occurs to the DNA of a cell, causing it to grow and divide uncontrollably. This uncontrolled growth eventually forms cancer, which may spread to other parts of the body and become life-threatening.
The most common childhood cancers include:
- Acute lymphoblastic leukaemia (ALL)
- Acute myeloid leukaemia (AML)
- Brain tumours (including astrocytoma, glioma, medulloblastoma and ependymoma)
- Hodgkin and non-Hodgkin lymphoma
- Neuroblastoma
- Retinoblastoma
- Soft tissue sarcomas (including rhabdomyosarcoma)
- Wilms tumour (nephroblastoma)
- Hepatoblastoma
- Bone cancers (osteosarcoma and Ewing sarcoma)
In practice, cancer can arise in almost any part of a child's body.
Childhood cancer differs from adult cancer
Childhood cancers differ significantly from those affecting adults. Their biology, treatment and overall management are different.
While prevention plays a major role in reducing adult cancers, opportunities for preventing childhood cancers are currently very limited. The encouraging news is that, when diagnosed early and treated appropriately, childhood cancers are far more curable than adult cancers.
In high-income countries, cure rates can now reach up to 80%.
Unfortunately, in many parts of the world, children still lack access to specialised healthcare professionals, essential medicines and the necessary healthcare infrastructure. As a result, many children continue to die from diseases that are now highly treatable.
Why early recognition matters
Parents and everyone responsible for the care of children should be familiar with the warning signs and symptoms that may indicate childhood cancer or leukaemia.
Although childhood cancers include many different diseases, approximately 85% initially present with similar signs and symptoms.
The earlier childhood cancer is recognised and treated, the greater the likelihood of a successful outcome.
Although childhood cancer is often difficult to recognise in its early stages, early diagnosis is possible.
What should parents and caregivers do?
Children should receive regular medical care and routine health assessments.
Whenever unusual signs or symptoms appear and persist, parents should seek medical advice promptly from their child's paediatrician.
Warning signs and symptoms
Parents should consult their child's doctor if any of the following signs or symptoms persist or remain unexplained:
- A lump, swelling or mass anywhere on the body, including the face, neck, armpits, abdomen, groin, testes or limbs.
- Unexplained paleness.
- Persistent tiredness, unusual fatigue or loss of normal energy.
- Sudden changes in behaviour.
- Easy bruising or unexplained bleeding.
- Persistent localised pain or limping.
- Persistent unexplained fever or prolonged illness.
- Repeated or recurrent infections.
- Frequent headaches, especially when accompanied by vomiting, particularly in the morning.
- Sudden eye abnormalities, including squint (strabismus), double vision or changes in vision.
- Problems with balance or coordination.
- A white reflection or white spot visible through the pupil of the eye (leukocoria).
- Unexplained, excessive or rapid weight loss.
An important message for parents
The presence of one or more of these signs or symptoms does not necessarily mean that a child has cancer. Most of these symptoms are caused by much more common childhood illnesses.
However, if they persist or remain unexplained, they should never be ignored. Appropriate medical evaluation is essential to determine the cause and, when necessary, to rule out childhood cancer.
Early diagnosis saves lives.
Author
Professor Loizos G. Loizou, MD, PhD
President, ELPIDA Foundation for Children and Adolescents with Cancer and Leukaemia
Professor of Medicine, University of Nicosia, Cyprus
Paediatrician – Paediatric Oncologist and Haematologist
Former Director, Paediatric Oncology and Haematology Unit
Archbishop Makarios III Hospital, Nicosia, Cyprus
