Types And Symptoms of Childhood Cancers

Cancers in children and teens differ notably from cancers in adults and symptoms sometimes appear to be similar to other childhood illnesses.  Children Against Cancer and ChildHealth Research provide information to help parents identify their child’s symptoms and to be alert to signs that something might be seriously wrong. 

When your child shows sudden, persistent changes in their health or behavior that appear to be similar to the symptoms listed below, we encourage you to have your child examined by a qualified licensed health professional and to not hesitate to seek a second opinion if your pediatrician is not certain of the exact cause of your child’s symptoms.

 

According to the National Cancer Institute (NCI), there are 12 major types of childhood cancers.

Cancers of the Central Nervous System  

Brain Cancers:  The central nervous system (CNS) is the medical term for the brain and spinal cord. Together, they control many functions that are important to sustain life. Brain cancers are the most common solid malignancy found in children. There are several types of brain tumors and most are known as gliomas.  

Symptoms typical of brain cancers:  

·         Headaches, often upon awakening

·         Problems with vision or eye movement

·         Speech difficulty

·         Loss of balance

·         Vomiting, especially early in the day

·         Weakness

·         Increase in head size or fontanelle in infants

·         Seizures

·         Back or neck pain      

 

Neuroblastoma: A cancer of the Sympathetic Nervous     System, Neuroblastoma is a solid tumor that usually originates in the adrenal glands just above the kidneys, but can also be found in the nerve tissue of the abdomen, chest, neck or pelvis.  90% of kids diagnosed with neuroblastoma are younger than five years old with only 3% older than ten years of age.  Unfortunately, by the time the child is diagnosed, there is a 70% chance that the cancer has already spread to the bone marrow and other parts of the body.  Neuroblastoma is most often diagnosed in infants and children under two years of age and is the third most common kid’s cancer.   

            Symptoms of Neuroblastoma:          

·         Pain and swelling of the abdomen

·         Bone pain

·         Protruding eye, drooping eyelid, small eye pupil

·         Fatigue caused by anemia

·         Bruises, bleeding

·         Fever

·         High blood pressure

·         Rapid heartbeat

·         Spastic muscle jerking

 

Sarcomas

Sarcomas are malignant tumors that develop in the bones and soft tissues.  

Ewing’s Sarcoma: 87% of the time, this cancer will grow in the middle of the long bones in the thigh or upper arms, although the tumor can be found in the spine, ribs or hipbones or begin in the soft tissues.  Ewing’s Sarcoma occurs most frequently in teenagers.   

Symptoms of Ewing’s Sarcoma:   

·         Pain at the site of the tumor mass.

·         Soft tissue at the site may be swollen and tender

·         Fluid around the lungs if cancer has spread to chest wall and lungs   

 

Osteosarcoma:  The most common form of bone cancer, usually occurring in older children and teenagers.  It is associated with rapid growth, so is usually not seen in children before puberty.  Osteosarcoma generally affects more boys than girls.  This type of bone cancer usually begins around the knee joint, or the thigh, or in the upper or lower leg near the knee.  The next most common site is the upper arm close to the shoulder, although Osteosarcoma may develop in any bone.  

Symptoms of Osteosarcoma may include:  

·         Pain or swelling around bone joints

·         A bone may fracture

·         Pain in the area of the back

 

Rhabdomyosarcoma (RMS): The most common soft tissue sarcoma in children and teenagers, this is a cancer that occurs most frequently where skeletal muscles are located: in the head and neck, urinary and reproductive organs, arms and legs, and trunk.  Almost two-thirds of RMS cases are found in children less than 10 years old, and boys are one and a half times more likely to develop RMS.  

Symptoms to look for in Rhabdomyosarcoma:  

·         Usually RMS is found as a mass although the symptoms depend on the location of the primary tumor.  

·         Genitourinary tumors may cause bloody urine, difficulty voiding, or blood from the vagina.  They can also cause a tumor close to the testicles.  

·         Parameningeal tumors are close to the base of the skull and may cause weakness in the facial nerves, signs of sinus infection, discharge from the ear, headaches or swelling around the eye.  

·         A rapidly enlarging, firm lesion may be found on the arm or leg.  

 

Kaposi’s Sarcoma:  Believed to be caused by the virus known as Human Herpes Virus 8 (HHV8), Kaposi’s Sarcoma is the most common childhood cancer in Equatorial Africa.  British scientists discovered that Kaposi’s Sarcoma first develops in the inner cell lining of the lymphatic vessels. Typically, lesions appear at the mouth or skin and some may penetrate to the bone, digestive system, and lungs.  Endemic Kaposi’s Sarcoma strikes children before puberty, in more girls than boys.  The cancer known as Acquired Kaposi’s Sarcoma can develop in children who have weakened immune systems after organ transplant, and the form of the disease known as Epidemic Kaposi’s Sarcoma develops lesions in patients infected with HIV.   

Symptoms of Kaposi’s Sarcoma may include:  

·         A skin lesion that is red, purple, or brown

·         Breathlessness

·         Pain in the chest

·         Diarrhea

·         Fatigue

·         Swollen lymph glands or limbs

·         Nausea, vomiting

·         Sores inside the mouth

 

Leukemias  

Cancer of the white blood cells in the bone marrow, Leukemia is the most common of the twelve childhood cancers.  It may spread to the spleen, lymph nodes, blood, liver and other organs.  

Acute Lymphoblastic Leukemia (ALL): Nearly half of children with leukemia are diagnosed with ALL, a cancer that begins in the bone marrow and then spreads to the bloodstream. ALL is most often diagnosed in children 2 to 4 years of age and sometimes develops before birth. A common cause of death in children, despite aggressive treatments, a significant number of children with ALL will relapse (cancer returns) and not survive.     

Symptoms of Acute Lymphoblastic Leukemia (ALL)  

·         Fatigue

·         Fever

·         Bleeding

·         Bruising

·         Pain in bone joints

·         Pale skin tone

·         Swollen spleen, liver

·         Tender lymph nodes

·         Tiny red spots beneath skin

 

Acute Myeloid Leukemia (AML): There are eight different types of AML.  The child with AML has bone marrow that makes an abundance of abnormal blood cells that prevent white blood cells’ ability to fight infection. AML cancer can spread to the Central Nervous System, the skin, and gums. Children with Down syndrome or certain other genetic conditions are more likely to develop AML.   

Symptoms of Acute Myeloid Leukemia (AML):  

·         Paleness

·         Night sweats

·         Fever

·         Tired, fatigue

·         Bruises easily

·         Lumps in the neck, underarm, stomach, groin may be present

·         Look for lumps also around the eyes

·         Skin may have a rash

·         Headaches, seizures

 

Lymphomas  

A lymphoma is cancer that develops in the lymph tissue, including the bone marrow, spleen, thymus gland, lymph nodes, tonsils and adenoids.  Lymphomas are the third most common childhood cancers.  Types of lymphoma include:  

Hodgkin Disease: Cancer that tends to develop in the lymph nodes found in the armpit, groin, or in the neck, near the skin’s surface. The incidence of Hodgkin’s lymphoma increases with age. Childhood Hogkin’s Disease has higher rates of developing in males than females. A weakened immune system increases the risk.  

What are the symptoms of Hodgkin’s Lymphoma?  

·         Swollen lymph nodes that do not respond to antibiotic treatments

·         Poor appetite

·         Night sweats

·         Itching skin (usually in advanced stages of the disease)

·         Weight loss

·         Fever

·         Generally not feeling well

 

Non-Hodgkin’s Lymphoma:  A type of cancer that affects lymph nodes found deeper in the body, most often in the bowel, near the appendix or in the upper portion of the chest.  Non-Hodgkin’s Lymphoma occurs three times more often in boys than girls and generally strikes children ages ten to 20.  

Symptoms associated with Non-Hodgkin’s Lymphoma:  

·         Swelling of the abdomen if located at this site

·         Fever, chills

·         Night sweats

·         Coughing, shortness of breath if cancer is in upper chest

 

Burkitt’s Lymphoma:  A rare cancer in most parts of the world, however, new cases are rising in most countries. Burkitt’s Lymphoma is the dominant, most aggressive childhood cancer in Central Africa and Uganda, where children weakened by malaria are more prone to developing the disease.  It is associated with the Epstein-Barr virus and HIV.  More males than females develop the cancer that in Africa usually appears first as a facial tumor. Ninety percent of American children with Burkitt’s Lymphoma generally have tumors that appear in the abdomen that may also affect the testes, ovaries, skin, nasal sinuses, and lymph nodes.  Most of the cases involve children ages 2 to 16.   

Symptoms of Burkitt’s Lymphoma to look for:  

·         In Africa/Uganda forms of the disease, look for swollen jaw

·         Loosened teeth

·         Protruding eyeballs

·         Tumor on mouth or skin of face

·         United States symptoms include swollen abdomen   

All Types may include:  

·         Pain

·         Vomiting

·         Weight loss

·         Itchy skin

·         Night sweats  

 

Liver Cancers  

There are two types of liver cancers generally found in children.   

Hepatoblastoma:  The most common liver cancer in kids is found in babies 2 months old to 3 years of age.  It is extremely rare in children older than 6 years.  It is thought that most of the time, this liver cancer develops in babies before they are born.  Premature babies have a higher risk.  Not many studies have been done to determine the causes.  This type of liver cancer generally does not spread to other sites in the body.  

Hepatocellular:  Occurs more frequently in older children between ages of 10 and 16 years although it can affect kids of any age.  This form of liver cancer often spreads outside the liver.  A risk factor is a child having Hepatitis B or C and is greatest when the Hepatitis virus passes from mother to child during birth.  Other risk factors include damage caused by certain diseases.  

Symptoms of childhood liver cancers include:  

·         Pain in the abdomen

·         Jaundice (yellow skin)

·         Vomiting

·         Weight loss

·         Loss of appetite

·         Nausea

·         Early puberty in boys  

 

Cancer of the Kidneys  

Wilms Tumor, Or Nephroblastoma:  Nearly 95% of kidney cancers in kids are Wilms Tumors and usually is diagnosed in children whose ages range from 6 months to 10 years.  The kidneys are a pair of organs protected by the lower rib cage.  Kidneys filter waste and create urine to pass into the bladder.  It is the second most common abdominal cancer in children and occurs more often in African American girls.  A Wilms Tumor generally forms in only one kidney although both may be malignant.  Most kidney cancers in children grow rather large (about half a pound) before they are discovered.  The American Cancer Society says that some Wilms Tumors occur in children with certain kinds of birth defects.  

Signs and Symptoms of Wilms Tumors  

·         Fever

·         Anemia

·         A lump in the abdomen

·         Bloody urine

·         Diarrhea

·         Abdominal pain

·         High blood pressure

·         Weight loss

·         Urogenital infections

·         Shortness of breath

·         Nausea and vomiting (rare)

 

Clear Cell Sarcoma:  Very rare in infants younger than 6  months, children with Clear Cell Sarcoma range between 2 months and 14 years.  It is twice as common in male children.  

Symptoms for Clear Cell Sarcoma:  

·         Abdominal pain

·         Mass in the abdomin

·         Fever

·         High blood pressure  

 

Cancer of the Eye  

Retinoblastoma:  A rare cancer, Retinoblastoma begins in the retina, the part of the eye that allows a person to see.  It occurs most often in children from babies to around 14 years.  About 40% of children are born with a genetic form of the disease.  Most children with the genetic form had the change in an important gene in either the sperm of the father or the egg of the mother before the baby was conceived.  The genetic form of the eye cancer may increase the risk of the child developing other cancers during his or her lifetime.  Children born without the genetic issues do not have a risk of developing other cancers later on.  

Symptoms of Retinoblastoma:  

·         An enlarged pupil

·         A crossed eye

·         Poor vision

·         A pupil that appears to be white or red instead of black

·         Different colored iris

·         Painful eye, perhaps red

 

Other Childhood Cancers  

Germ Cell Tumors: Germ cells get their name from “germinate” and originate in the developing fetus at four weeks after conception and soon descend along the midline path in the body to the pelvis area where they become the sperm cells in the boy’s scrotal sac and egg cells in the girl’s ovaries.  Cancer can form in these organs as well as anywhere along the midline of the body, including the head, chest, abdomen, and lower spine.  

Testicular Cancer:  Boys with an undescended testicle have a “strong and consistent risk factor” for developing Germ Cell Testicular cancer.  There has been a dramatic increase in the disease recently and is the biggest cancer killer of boys and men from age 14 to 34 years.  Unfortunately, most teenage boys don’t know how to examine themselves or are too embarrassed to talk to parents about symptoms, assuming that a lump or ache is the result of a muscle strain that will eventually go away.  

Symptoms of Testicular Cancer: 

·         Lump in one or both testicles

·         Enlarged testicle

·         Sense of heaviness in the scrotum

·         Enlarged nipples and breasts in boys

·         Collection of blood or fluid in the scrotum

·         Dull ache in the groin or abdomen  

 

Rare Cancer  

Thyroid Cancer:  The Thyroid is a small, butterfly-shaped gland located in the neck, beneath the Adam’s apple.  It makes and stores hormones that regulate the child’s growth, also the body temperature, heart rate, blood pressure and much more.  Cancer of the Thyroid is more common in girls than boys and can affect all ages.  In some cases it is hereditary.  

Symptoms associated with Thyroid cancers:  

·         One or more lumps (nodules) in the neck

·         Difficulty swallowing or breathing

·         Hoarseness

·         A sense of tightness in the neck

·         Family history of thyroid cancers

·         Vocal cord paralysis (rare)  

Families should keep in mind that childhood cancers are different from adult forms of the disease.  Adult cancers are named for the primary cancer site (such as the breast or prostate) while cancers in children are classified by their histology, which means how their cells and tissues are identified under the microscope in the laboratory.  The histological classification helps identify the origin of the cancer and decisions on how best to treat it.

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