Childhood Cancers: Diagnosis, Treatment, and Late-effects

Cancer is a complex disease that can affect anyone at any age. However, there are some differences between childhood cancers and adult cancers, including the types of cancers that they tend to get, the way they are diagnosed and treated, and the long-term effects they may face. In this blog, we will discuss the differences between childhood and adult cancers and the treatments available.

Childhood Cancers vs Adult Cancers

Childhood cancers are those that occur in individuals under the age of 18. The most common types of childhood cancers include leukaemia, brain and spinal cord tumours, neuroblastoma, Wilms tumour, and lymphoma. The causes of childhood cancers are not well understood, although some genetic and environmental factors may play a role.

In contrast, adult cancers are those that occur in individuals above the age of 18. The most common types of adult cancers include breast cancer, lung cancer, prostate cancer, colorectal cancer, and bladder cancer. These cancers are more common in older adults and are often caused by lifestyle factors such as smoking, alcohol consumption, and poor diet.

Common Types of Cancers in Children:

Unlike cancers in adults, childhood cancers are not a result of lifestyle or environmental risk factors. In rare conditions, childhood cancers are caused by genetic mutations that are inherited from the parents. The types of cancers a child will develop are different from adult cancers. Some of the common childhood cancers are:

Leukaemia: Leukaemia is a cancer of the blood cells and bone marrow. It is the most common type of childhood cancer, and according to the American Cancer Society, it accounts for about 28% of all childhood cancers. Acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) are the two primary types of leukaemia.

Symptoms of Leukaemia in Children: 

• Tiredness and weakness
• Pale skin
• Bleeding and bruising
• Persistent Fever
• Weight loss
• Bone and joint pain

Brain and Spinal Cord Tumours: Brain and spinal cord tumours are the second most common type of childhood cancer, accounting for about 26% of all childhood cancers. These tumours can be benign (non-cancerous) or malignant (cancerous) and can affect a child’s cognitive functions.

Symptoms of Brain Cancer in Children:

• Nausea and vomiting
• Frequent headaches
• Blurred or double vision
• Cognitive problems like difficulty thinking, concentrating or handling things
• Seizures

Neuroblastoma: Neuroblastoma is cancer that starts in immature nerve cells and affects children below the age of 10. It can occur anywhere in the body but it usually starts in the abdomen. It is the third most common type of childhood cancer, accounting for about 6% of all childhood cancers.

Symptoms of Neuroblastoma in Children:

• Swelling of the abdomen
• Bone pains
• Persistent fever

Wilms Tumour: Wilms tumour is a cancer of the kidneys (also called nephroblastoma) and is most commonly found in children under the age of 5. It is the fourth most common type of childhood cancer, accounting for about 5% of all childhood cancers.

Symptoms of Wilms Tumour in Children:

• Swelling or lump in the abdomen
• Nausea
• Poor appetite
• Persistent fever
• Pain

Lymphoma: It is a cancer of the immune cells called lymphocytes. It usually starts in lymph nodes and can also affect the bone marrow and other organs. Hodgkin lymphoma and non-Hodgkin lymphoma are the two main categories of lymphoma. 

Symptoms of Lymphoma in Children:

• Lumps or swollen lymph nodes in the neck, underarm, or groin.
• Tiredness
• Excessive sweating
• Tiredness
• Persistent fever

Rhabdomyosarcoma: Rhabdomyosarcoma is a cancer that develops in the soft tissues of the body, such as muscles or connective tissue. It is most commonly found in the areas of the head and neck, groin, abdomen, pelvis, or hands and legs.

Symptoms of Rhabdomyosarcoma in Children:

• Swelling or presence of lumps
• Pain

Retinoblastoma: Retinoblastoma is cancer that develops in the retina, the part of the eye that senses light and gives vision. It is most commonly found in children under the age of 5.

Symptoms of Retinoblastoma in Children:

• Pupil usually appears red when we flash a light on the eye. But in kids with retinoblastoma, the pupil appears white or pink.

Bone Cancers: Bone cancers usually begin in the bones and often affect older children and teens. The two main types of bone cancers that occur in children are Osteosarcoma and Ewing’s sarcoma.

Symptoms of Bone Cancers in Children:

• Bone pain that persists or worsens, mainly at night or after any activity.
• Swelling around the bone areas

While childhood cancers are rare, they can have a significant impact on a child’s health and well-being. It is important for their parents to be aware of the signs and symptoms of various childhood cancers and to seek medical attention if they observe any. Early diagnosis and treatment can improve the chances of a successful outcome and minimize the long-term effects of treatment.

Diagnosis of Childhood Cancers:

The diagnosis of childhood cancers and adult cancers also differ. Childhood cancers are often diagnosed through a combination of physical exams, blood tests, and imaging tests such as X-rays, CT scans, and MRI scans. 

Treatment for Childhood Cancers:

Treatment for childhood cancers usually involves a combination of chemotherapy, radiation therapy, and surgery. Since children’s bodies are still developing, it is crucial to choose less intense treatments to minimize the side effects and preserve their long-term health. Whereas adults can withstand intense treatments as their immune systems are developed. A paediatric oncologist is a primary doctor who specialises in treating childhood cancers. The choice of treatment depends on the type and stage of cancer, as well as the child’s age, overall health, and other factors. 

Available Treatment Options:

Chemotherapy: Chemotherapy is a treatment that uses anti-cancer drugs to kill cancer cells. Chemotherapy drugs can be administered intravenously or orally. It is often the first treatment option for childhood cancers because most children respond well to chemo.

Surgery: Surgery may be used to remove tumours and some surrounding healthy tissue. In certain cases, surgery alone may be sufficient as a treatment. In other cases, surgery may be followed by chemotherapy or radiation therapy.

Radiation therapy: High-energy radiation is utilised in radiation therapy to destroy cancer cells. It is often given in combination with chemotherapy or surgery. Radiotherapy is chosen in rare cases because it may affect other healthy parts of the younger ones. Doctors maximum try to avoid it to prevent late and long-term side effects for children.

Other Treatment Options:

Bone marrow or stem cell transplant: A bone marrow transplant or stem cell transplant may be recommended for certain types of childhood cancers, such as leukaemia or lymphoma. This treatment involves replacing damaged bone marrow with a healthy one. It is done after a specific number of chemotherapy cycles.

Immunotherapy: Immunotherapy is a new treatment option that utilises the body’s immune system to combat cancer. It can be used to treat certain types of childhood cancers, such as neuroblastoma. It is a new treatment modality and several clinical trials are ongoing to find out more about the safety and efficacy of immunotherapy.

Targeted therapy: Targeted therapy is a treatment that targets specific molecules or proteins in cancer cells. It can be used to treat certain types of childhood cancers, such as leukaemia and neuroblastoma. It is also a new treatment modality but is clinically proven to give successful outcomes in many cases.

The treatment of childhood cancers can be challenging, and it often requires a team of healthcare providers, including pediatric oncologists, medical oncologists, surgeons, radiation oncologists, and other specialists. In addition to medical treatment, children with cancer may also benefit from psychological and emotional support, as well as educational support to help them stay on track with their schooling during treatment.

Long-Term Effects After Childhood Cancer Treatment

Long-term side effects occur only if proper care is not taken on the part of the treatment team or on the part of the parents. The long-term effects on children after their cancer treatment can be more severe than in adults. These may include fertility problems, growth and development issues, and an increased risk of secondary cancers later in life. 

It is important to note that the long-term effects of cancer treatment can be specific depending on the type of treatment received and the location of the body treated. For example, chemotherapy and radiation therapy can cause long-term damage to a child’s developing organs, leading to cognitive impairment, growth problems, and an increased risk of secondary cancers. For this reason, children who have been treated for cancer should receive ongoing monitoring and follow-up care to ensure their long-term health and well-being.

Ask the Doctor About Your Child’s Cancer

• Who should be involved in my child’s treatment team?
• When will my child recover?
• How I can take care of my child at home?
• Are there any alarming signs I should watch for?
• When should I seek emergency help?

Also, don’t forget to opt for customised diet plans from a registered oncology nutritionist. This can help your kid to cope with cancer treatments and side effects while nurturing the body with enough nutrients.

Take away:

Childhood cancers and adult cancers have different causes, diagnostic procedures, treatment options, and long-term effects. Childhood cancers are rare and often require specialised treatment to minimize the impact of treatment on a child’s developing body. Both childhood and adult cancer survivors may experience long-term effects of treatment. So, ongoing care and monitoring with regular follow-ups are necessary. It is also essential to get a personalised treatment that addresses individual needs and minimizes the long-term impact of treatment.

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