Pediatric Cancer: Types, Symptoms, and Treatment

The word "cancer," which usually makes people shudder, takes on an unfortunate new meaning when it affects children. Pediatric cancer affects 1 in 285 children under the age of 18 every year, a diagnosis that no parent ever wants to hear. But hope still persists in the midst of the anxiety and uncertainty. Helping little warriors in their battles starts with having a solid knowledge of this illness, including its kinds,symptoms, risks, and treatments.

The malignancies that affect children, referred to as "pediatric cancers," are typically different from those that affect adults. Generally, children respond better to treatment when compared to adults. Children can get cancer in any part of their body, including the brain, spinal cord, kidneys, blood and lymphatic systems, and other organs and tissues. The majority of juvenile malignancies have no known causes. Even if they originate in the same area of the body, childhood and adult malignancies are different in nature. Cancers in children include lymphoma,rhabdomyosarcoma, neuroblastoma, Wilms tumor, bone cancer, leukemia, and malignancies of the brain and spinal cord.

Types of Pediatric Cancer

The most common types of childhood cancer are leukemia, brain and spinal cord tumors, Wilms tumors, lymphoma,rhabdomyosarcoma, neuroblastoma, bone cancer, and bone cancer.

Leukemia

The most prevalent cancer among children is leukemia. In young people, the cancer rate is about 1 in 3 cases. Leukemia is a type of blood cancer. In this type, cancer begins in cells that the body usually converts to red blood cells and spreads there. The marrow, which makes new blood, contains these cells. Leukemia is divided into two primary groups. Doctors refer to the initial case as "acute leukemia." Treatment for these rapidly growing tumors is urgent.

Acute leukemia is classified into two types:

Roughly 75 percent of juvenile leukemias are acute lymphocytic leukemias (ALL), which begin with lymphocytes, which are white blood cells.

1. ALL is the most prevalent kind of leukemia, as is acute myeloid leukemia (AML).
2. The second main type of leukemia is "chronic leukemia."

Compared to acute leukemia, these are slow in growth but more difficult to treat. Leukemia that is chronic can manifest in either myeloid cells or lymphocytes. It is uncommon in children. A few other uncommon types of leukemia exist. Among them is juvenile myelomonocytic leukemia (JMML), which develops in the myeloid cells of children. It grows less rapidly than acute leukemia but faster than chronic leukemia.

Brain and spinal cord tumors

Masses or clusters of enlarged cells make up tumors. Certain tumors are considered "benign," denoting that they are not cancerous. However, some are malignant, meaning they contain cancer cells that are prone to spreading. Brain tumour make up about 26% of pediatric cancer cases. The cause of pediatric brain and spinal tumors is not known to medical professionals. Genetic alterations might be one reason. Researchers believe there may be a connection between this kind of cancer and radiation therapy administered to a child's brain region as a result of another illness.

Neuroblastomas

Tumors originating from nerve cells are known as neuroblastomas. Although they can grow anywhere in the body, they have a preference for the stomach region, where they first appear. They account for roughly 6% of child cancer.

Wilms Tumor

These tumors develop in the kidney and make up up to 4% of all childhood cancers. Doctors do not have a solid cause as to why children get Wilms tumors, but gene mutations, as in other cancers, may play a role. Wilms tumors may also be associated with certain birth abnormalities.

Lymphoma

This type of cancer develops in lymphocytes, or immune system cells. It usually appears first in places where lymph nodes or tissues are present, such as the throat, armpits, or groin. Lymphomas are further classified into two categories. They are as follows:
Hodgkin's lymphoma, which affects fewer children. It commonly manifests itself in the upper body.
Non-Hodgkin's lymphoma is seen commonly in children and can be present anywhere in the body.

Rhabdomyosarcoma

Cancer arising from the body's connective tissue, like muscle and fat, is called sarcoma.
Rhabdomyosarcoma forms in cells that normally become muscles.

Types: Two common types of rhabdomyosarcoma in children are

• Embryonal rhabdomyosarcoma (ERMS) has an age predilection of less than 6 and is seen in the head,neck, groin, or bladder area.
• Alveolar rhabdomyosarcoma (ARMS), which affects children of all ages, tends to show up in the arms,legs, or trunk.

Symptoms: The most common symptoms of rhabdomyosarcoma are pain, a swollen lump, or both. The other symptoms depend on the part of the body where the cancer forms. For example, tumors in the ear can cause ear pain, nosebleeds, and a severe headache.

Risk Factors: Some uncommon inherited conditions may increase a child's chance of having

• Rhabdomyosarcoma, such as:
• Li-Fraumeni syndrome
• Beckwith-Wiedemann syndrome
• Neurofibromatosis type
• Costello syndrome

Bone Cancer

Bone cancers make up about 3% of childhood cancers.

There are two main types:

Osteosarcoma and Ewing Sarcoma.

Osteosarcoma is commonly seen in teenagers. It is seen near the ends of the arm or leg bones. Bone pain is a common symptom. Ewing sarcoma happens more often in younger teens. The symptoms are bone pain and swelling.

Retinoblastoma

Eye cancer, also known as retinoblastoma, accounts for around 2% of all juvenile cancers. This cancer is more common in young children under the age of two. When doctors detect something odd about a child's eyes, they commonly suspect malignancy. When a doctor shines a light on the pupil of the eye (the dark spot in the center), it may seem white or pink, unlike red. Apart from traditional methods, cryotherapy, which involves freezing cancer cells, is also an option.

Read More: Best Pediatric Oncology Hospitals in the world

Pediatric cancer symptoms:

• Pediatric cancer is difficult to detect. Children suffering from cancer may have a variety of signs and symptoms mentioned below, which are similar to other childhood diseases.
• Cancer can be hard to detect in children. At times, children with cancer may not have any of the signs and symptoms mentioned below. Or the symptom may be due to any other medical condition than cancer.
• Continued, unexplained weight loss
• Headaches, frequently with early morning vomiting
• Increased swelling or continuous pain in the bones, joints, back, or legs
• Lump or mass, mainly in the abdomen, neck, chest, pelvis, or armpits
• Development of extreme bruising, bleeding, or rash
• Constant or recurrent infections
• A whitish color behind the pupil
• Nausea that persists or vomiting without nausea
• Constant tiredness or noticeable paleness
• Eye or vision changes that occur abruptly and persist
• Recurring or persistent fevers of unknown origin

Risk factors for childhood cancer:

The majority of pediatric malignancies have an unknown etiology. Inherited mutations, which are genetic mutations that can be passed on from parents to their children, account for 8 to 10 percent of all childhood cancer cases. The majority of malignancies in children, like those in adults, are assumed to arise from genetic abnormalities that cause uncontrolled cell development and, ultimately,cancer. These gene alterations are suggestive of the combined effects of aging and long-term exposure to substances known to cause cancer in adults. It is challenging to identify potential environmental triggers for childhood cancer, partially due to the rarity of childhood cancer and the difficulty in finding out what exposures children may have had during their early years of growth.

Treatment:To treat cancer in children, its correct diagnosis is crucial to prescribing the correct medicine. There are various factors that are to be considered before opting for any treatment, like the type and stage of cancer, possible side effects, prognosis, and overall health. There is a multidisciplinary team, including various specialists, along with the family of the child, to provide care. Working Some of the common treatments are:

Surgery:Surgery is the total uprooting of the tumor, whether cancerous or noncancerous, including a very small amount of neighboring healthy tissue during an operation. In most childhood tumors,there is a high risk of microscopic cancer cells being present even after surgery. Surgeons then recommend additional courses of chemotherapy,radiation therapy, or other treatments.

Chemotherapy:Chemotherapy is the use of drugs to kill cancer cells and prevent the cancer cells from growing, dividing, and making more cells.

Immunotherapy:This method uses the body's natural defenses to fight against cancer by boosting your immune system’s ability to attack cancer cells.

Radiation therapy:Radiation therapy uses high-energy x-rays or other particles, such as photons or protons, to destroy cancer cells.
 
Bone marrow transplantation or stem cell transplantation:

A bone marrow transplant is a medical process in which diseased bone marrow is replaced with highly specialized cells. These cells, known as hematopoietic stem cells, grow into normal bone marrow. Hematopoietic stem cells are blood-forming cells that can be present in both the circulation and the bone marrow. This is commonly referred to as a stem cell transplant or hematopoietic stem cell transplant. Children need excessive care even after undergoing complete treatment for cancer to monitor cancer recurrence and timely manage any possible long-term impact of treatment.

References : 

https://www.cancer.gov/types/childhood-cancers
https://www.who.int/news-room/fact-sheets/detail/cancer-in-children
https://www.indiancancersociety.org/cancer-information/childhood-cancer
https://www.cancer.net/cancer-types/childhood-cancer/symptoms-and-signs
https://www.who.int/news-room/fact-sheets/detail/cancer-in-children

What is the most common pediatric cancer?

Leukemia is the most common pediatric cancer. Leukemia, a type of blood cancer, accounts for 28% of all cancers in children.
 
What causes pediatric cancer?

In the majority of pediatric cancers, the cause is not known, but gene mutation is believed to be the reason behind child cancer. Some long-term infections, such as HIV, malaria, and the Epstein-Barr virus, are risk factors for childhood cancer.
 
What is pediatric cancer?

Pediatric cancer, also known as childhood cancer, is generally used to describe a range of cancers in children below the age of 15.

What are the three main childhood cancers?

The most common childhood cancers, i.e., those below 15 years of age, include leukemias, brain and other central nervous system (CNS) tumors, and lymphomas.