Cancer In Children

Overview

Cancer is a condition where some cells in the body grow out of control and crowd out healthy cells. In children, cancer can affect any part of the body, such as the blood (leukemia), the brain, or the bones. It is important to remember that childhood cancer is not the same as adult cancer, and it often responds very well to treatment. Most children who receive treatment for cancer go on to live healthy lives.

Childhood cancer is rare. In the UK, about 1 in 500 children will develop cancer before age 15. It is the leading cause of disease-related death in children, but because it is so rare, most children with symptoms will not have cancer.

Cancer can affect a child of any age, from newborns to teenagers. Certain types of cancer are more common at certain ages. For example, leukemia is most common in early childhood, while bone tumors are more common in older children and teenagers. Slightly more boys than girls are affected.

Symptoms

Common symptoms

• Unexplained fever that does not go away
• Lumps or swelling, especially in the neck, armpit, or belly
• Pallor (pale skin) or tiredness without a clear reason
• Easy bruising or tiny red spots on the skin
• Persistent pain in bones, joints, or back
• Frequent infections that do not clear up
• Headaches, especially in the morning, sometimes with vomiting

Symptoms in children

• A persistent and unexplained limp
• Tummy swelling or a feeling of fullness in the belly
• Sweating at night or unexplained weight loss
• A whitish glow or white pupil in a flash photograph (can be a sign of a rare eye tumor)
• Strabismus (crossed eyes) or bulging of one eye
• Slow growth or changes in behavior or coordination
• Seizures or fits for the first time

Symptoms in older adults

• This article focuses on cancer in children. Symptoms in older adults are not covered here; if you are an adult with concerns about cancer, speak to your own doctor.

Causes

Main causes

• The exact cause of most childhood cancers is not known. Cancer happens when a single cell in the body develops a change (mutation) in its DNA, causing it to multiply without proper control.
• Childhood cancer is not caused by anything a parent did or did not do. It is not a punishment and is not contagious.

Risk factors

• A small number of children inherit a changed gene from a parent that increases their risk, but this is uncommon.
• Previous treatment with certain types of cancer drugs or radiation for an earlier cancer.
• Some rare genetic conditions, such as Down syndrome, are associated with a higher risk of leukemia.
• Most children with cancer have no known risk factors.

When to see a doctor

See a doctor urgently if:

• A persistent, growing lump anywhere on the body
• Unexplained fever lasting more than a few days
• Bone or joint pain that is constant and not linked to sport or injury
• A sudden limp in a child who was walking normally
• Repeated vomiting in the mornings with headaches
• Blood in the urine or stool that is not from a known infection

Book a routine appointment if:

• Ongoing tiredness or paleness that does not improve
• Slow growth or delayed development for no clear reason
• Frequent infections or a pattern of unusual bruising
• Changes in appetite or unexplained weight loss over weeks

Diagnosis

A doctor will examine your child and ask about their symptoms and medical history. If cancer is suspected, the doctor will refer your child to a specialist children's cancer center. There, a team of experts will do tests to confirm or rule out cancer.

Tests that may be done

• Blood tests to check blood cell counts and look for unusual cells
• Imaging tests such as ultrasound, X-ray, MRI, or CT scan to see inside the body
• A biopsy, where a small piece of the suspected tumor is removed and looked at under a microscope
• A bone marrow test (if leukemia is suspected) to check for abnormal cells in the bone marrow
• Lumbar puncture (sometimes called a spinal tap) to check fluid around the brain and spine for cancer cells

What to expect at your appointment

These tests can take a few days to a few weeks. It is normal to feel anxious while waiting. Your child may be given special support to help with needles and scans. You will have a dedicated nurse and a named doctor who will explain each test and what the results mean. Ask as many questions as you like – nothing is too small to ask.

Treatment

Treatment for childhood cancer is planned by a team of specialists and tailored to the exact type of cancer and the child's age and needs. The goal is to cure the cancer while protecting the child's growth and development as much as possible.

Self-care at home

• During treatment, give your child plenty of rest and gentle comfort.
• Let your child move and play as much as they feel able – be led by their energy levels.
• Keep track of all appointments and write down questions to ask the care team.
• Bring a familiar comfort item (like a blanket or toy) to treatment sessions.

Medical treatments

Treatment approaches include chemotherapy (strong medicines that kill cancer cells), radiotherapy (high-energy beams to target tumors), and surgery to remove a tumor if it is safe to do so. Other approaches, like immunotherapy or targeted therapies, may be used for certain types of childhood cancer. The exact plan is always explained clearly by the child's oncology team. Children may also receive medicines to prevent infection, manage pain, or help with side effects – these are chosen by the care team for the individual child.

When is surgery considered?

Surgery is used when a tumor is in one place and can be removed without harming vital organs. In some cases, surgery may be the only treatment needed; in others, it is combined with chemotherapy or radiotherapy. Sometimes surgery is done after chemotherapy to shrink the tumor first.

Living with this condition

A child's daily life during cancer treatment will be different but can still include school (or hospital school), play, and time with friends. The care team will work with you and the school to make a plan. Many children continue school while in treatment, with extra support.

Lifestyle tips

• Keep a consistent routine as much as possible, but be flexible when energy is low.
• Encourage quiet activities like reading, drawing, or puzzles for days in hospital.
• Keep the whole family informed and talk openly using words the child can understand.
• Create a list of small things that bring comfort — favorite snacks, soft pillows, stories.

Diet and exercise

Good nutrition is important, but a child's appetite may change with treatment. Offer small, frequent meals and let your child choose what appeals. Your dietitian can help if eating is difficult. Gentle activity, like short walks, helps maintain strength, but rest is equally important. Let your child be the guide.

Mental health and emotional wellbeing

A cancer diagnosis is frightening for both the child and the family. Children may feel scared, sad, or angry, and parents often feel overwhelmed. It is normal to have big emotions. Ask your care team about child life specialists, psychologists, and social workers who are trained to support children with cancer and their families. They can help with coping, communication, and grief if needed.

Prevention

Most childhood cancers cannot be prevented because their cause is unknown and they are not linked to lifestyle or behavior. There is nothing you did to cause this, and there is no known way to stop it from happening. Research is ongoing, and the most important thing is early detection and treatment.

Vaccines

Routine childhood vaccines are given for general health, but they do not prevent the vast majority of childhood cancers. The HPV vaccine is given to teenagers to prevent cancers caused by HPV later in life, but it does not prevent childhood cancers.

Screening programmes

There is no routine screening test for childhood cancer in the general population. If your family has a known hereditary condition that raises the risk of cancer, your specialist may recommend regular check-ups and scans. Talk to your doctor about this if it applies to you.

Complications

If left untreated

• Cancer can grow and spread to other parts of the body, making it harder to control.
• A growing tumor in the brain or near the spine can press on important nerves, causing disability or life-threatening problems.
• Leukemia can cause severe anemia, serious infections, and bleeding because healthy blood cells are crowded out.
• Without treatment, childhood cancer is often fatal. However, treatment is very effective and most children are cured.

Long-term outlook

The outlook for children diagnosed with cancer has improved dramatically over recent decades. In the UK, more than 8 in 10 children with cancer are now cured. Many survivors go on to live full, active, and healthy adult lives. Some may have long-term side effects from treatment, and they will have follow-up care to monitor their health. Every child's situation is different, so ask your oncology team about your child's specific outlook. There is real hope, and families are not alone on this journey.

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