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• Childhood cancer
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  • Symptoms and diagnosis
  • Treatment and follow-up
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Childhood Cancer symptoms and diagnosis

The symptoms of childhood cancer depend upon the site of the tumour.

Leukaemias can cause anaemia, frequent infections or abnormal bleeding and bruising. Very rarely a solid 'lump' of leukaemia may be the first sign of the disease.

Most other tumours produce symptoms related to their position and will be brought to medical attention either because a lump is felt or because the tumour or tumours are impairing normal functioning of one or more organs.

With the exception of some brain tumours, tissue from the tumour is required to make a definitive diagnosis. (Some brain tumours are in positions that would make taking a biopsy so dangerous that it is considered best to rely on scans to make the diagnosis.) This tissue is essential to confirm the type and subtype of the disease and thus determine the optimal treatment.

Often additional blood tests, bone marrow examinations, X-rays and body scans of various types (including CT - computed tomography or MRI - magnetic resonance imaging) are required to determine the extent of the disease.

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Screening

Screening for childhood cancer has been adopted as standard only for families with high risk of retinoblastoma for whom there is proven benefit.1

Population screening of infants for neuroblastoma began in parts of Japan in 1973 and was offered nationally from 1985, and has been evaluated in trials in North America, Germany and England. It has not been adopted as routine because it was not shown to have any beneficial effect on the mortality from this disease, and has now been discontinued in Japan. This was because many neuroblastomas, especially in very young children, regress spontaneously and the screening programmes detected large numbers of such cases which would otherwise have resolved without treatment; the invariable result of screening was a large increase in incidence but little effect on mortality rates.2-5

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References

1. Abramson, D.H., et al., Screening for retinoblastoma: presenting signs as prognosticators of patient and ocular survival. Pediatrics, 2003. 112(6 Pt 1): p. 1248-55
2. Yamamoto, K., Marginal decrease in mortality and marked increase in incidence as a result of neuroblastoma screening at 6 months of age: cohort study in seven prefectures in Japan. J Clin Oncol, 2002. 20(5): p. 1209-14
3. Woods, W.G., et al., Screening of infants and mortality due to neuroblastoma. N Engl J Med, 2002. 346(14): p. 1041-6
4. Schilling, F.H., Neuroblastoma screening at one year of age. N Engl J Med, 2002. 346(14): p. 1047-53
5. Honjo, S., Neuroblastoma trends in Osaka, Japan, and Great Britain 1970-1994, in relation to screening. Int J Cancer, 2003. 103(4): p. 538-43

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