Alarming symptoms of cancer in children

Proven content

Childhood cancers are less common than in adults, accounting for 3% of cancers in the entire population. They develop insidiously, usually over a long period of time without impairing the child’s performance, and the symptoms they manifest are very non-specific. The child usually feels well and nothing hurts. The effect of this is that malignant tumors are still the second cause of death in children after accidents and poisoning, as they are diagnosed too late, which reduces the effectiveness of treatment.

A young organism is characterized by intensive growth and development, unfortunately, cancer cells multiply equally quickly in children. The diagnosis of cancer at an earlier stage of development enables its complete recovery. A great responsibility rests with family doctors, whose duty is to diligently examine the entire patient at each visit, regardless of its cause. A careful examination of a child who has come to the doctor for a respiratory infection can speed up cancer diagnosis and increase the chances of a cure.

Oncological vigilance is required when a parent or doctor notices any of the following symptoms:

1. enlarged lymph nodes, especially in the cervical and abdominal glands
2. prolonged (more than 2 weeks) recurrent fever not related to infection
3. morning vomiting with headache
4. swelling and / or pain in bones and joints, sometimes with limping, pathological bone fractures
5. neurological symptoms such as uneven eyelid cracks and imbalance
6. significant pallor and increased fatigue and weakness
7. a child is prone to bruising and bleeding
8. whitish reflection of the pupil of the eye, strabismus or sudden visual disturbance
9. progressive and unexplained weight loss
10. lumpy thickening of tissues or organs, investigational tumor, e.g. in the abdomen
11. prolonged cough

Lymphadenopathy

In children, lymph nodes, especially in the cervical and inguinal regions, are very often tested, because the body fights the viruses and bacteria that attack it every day with the help of immune cells that multiply in the lymph nodes. It is a natural way to defend the body against infections. Enlargement of the lymph nodes (i.e. when they are over 1 cm) for more than 2 weeks with the presence of symptoms such as: fever, night sweats or weight loss and the exclusion of infection may raise the suspicion of a malignant neoplasm, most often Hodgkin’s disease. Its only symptom is often a slow increase in the enlargement of the cervical and supraclavicular lymph nodes. They are painless, flexible, and tend to be packaged. The best way to assess the node is a histopathological examination, i.e. a microscopic assessment of the collected material.

Fever

A fever, even if it lasts long, is most often a symptom of an infection. In most children, temperatures return to normal with appropriate doses of antipyretics. Sometimes, however, it persists despite treatment, then it is necessary to visit a doctor who will examine the child and decide on blood count tests and possibly other tests that he deems appropriate. In a small percentage of cases, prolonged fever may be a symptom of neoplasm, especially if its cause has not been found or when it occurs periodically over periods of 3-10 days with a feverless break. In contrast, most children diagnosed with cancer had a fever.

Pale, fatigue, weakness and a tendency to bruise or bleed from the mucous membranes of the mouth and nose.

The above disorders with the accompanying enlargement of peripheral lymph nodes or fever are the most common symptoms of leukemia in children. In acute leukemia, the history is short, usually 2-6 weeks, therefore early diagnosis is extremely important. Leukemias, i.e. neoplastic diseases of the hematopoietic system, the essence of which is the clonal growth of immature cells, constitute approx. 30% of childhood cancers. The most common of these is acute lymphoblastic leukemia.

Headache

A common symptom, which coexisting with morning vomiting on an empty stomach, should always raise neoplastic alertness. Brain tumors (astrocytomas, gliomas, meningiomas, medulloblastomas) are, after leukemias and lymphomas, the second most common group of cancers in children. The clinical picture is very diverse and depends on the child’s age, tumor location and growth rate. The smallest children do not complain of a headache, the leading symptoms of cancer are changes in behavior, often in the form of tearfulness or hyperactivity, as well as enlargement of the head circumference or impaired ability to look up. Seizures, double vision, decreased visual acuity, and visual field defects can also occur. Close attention should be paid to unsteady gait, that is, “on a broad basis”.

The greatest number of atypical symptoms is characteristic of sympathetic neuroblastoma, i.e. neuroblastoma, which accounts for approx. 8% of childhood cancers. It develops from the sympathetic cells of the autonomic nervous system and locates where these cells are. A lump may be felt in the neck, in the abdomen, or on rectal examination while it is in the rectum. Its presence in the chest can put pressure on the airways and vessels, causing coughing, shortness of breath and neck swelling. Tumor cells secrete substances called catecholamines that trigger paroxysmal sweating and flushing, headache, palpitations and high blood pressure. Watery diarrhea, abdominal pain and ion disturbances may also appear as a result of the vasoactive intestinal hormone produced by the tumor. It is not uncommon that systemic disorders such as weakness, fatigue or fever appear in the picture of the disease.

Researchable tumor in the abdomen, noticeable by parents while bathing or changing, especially when it is accompanied by hematuria, difficulty passing stools or lack of appetite, may turn out to be Wilms’ tumor originating in the kidney.

Bone ache is found in Ewing’s sarcoma and osteosarcoma in 89 and 79% of children with these diseases, respectively. They are the most common malignant bone tumors and account for 4-7% of childhood malignancies. They are most often located in the area of ​​the knee joint (osteosarcoma), in the shaft of the femur or flat bones (Ewing’s sarcoma), most often in adolescents. Bone pain is most often accompanied by swelling and even a testable tumor. Children who report the above symptoms should receive X-rays of the painful bone as soon as possible. Musculoskeletal pain is one of the first symptoms in 21-33% of children with acute lymphoblastic leukemia. They are often accompanied by joint ailments, which is why these children are most often suspected of having rheumatological diseases.

Strabismus, worse vision or lekokoria (white reflection of the pupil) may be symptoms of retinoblastoma, i.e. an intraocular malignant tumor. When they appear, they are an indication for a thorough ophthalmological examination of every child, regardless of their age.

Cure rates of cancer in children increased from 45% in 1974 to 80%, and even to 90% in 1995, compared to only 30% in adults. It could be even higher if children in the early stages of the disease were admitted to specialist oncology centers. Unfortunately, in Poland, therapy is most often started when the cancer is in a high (III or IV) stage, which reduces the chance of its cure and is associated with higher mortality. Surgery, chemotherapy and radiotherapy are used to treat cancer. Large tumors with metastases are not a contraindication to treatment. Currently, chemotherapy is friendlier to small patients thanks to more and more effective drugs to combat its side effects and the possibility of outpatient treatment.

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