Approximately 12 in 100,000 children under the age of 15 are diagnosed with cancer in England and Wales each year, similar to the rates of Down’s syndrome, childhood diabetes and meningitis. Private and NHS treatment for children with cancer is very similar, with the same high quality care and equivalent therapies available. The private sector offers parents who have private medical insurance the chance have their child treated in a private clinic if they prefer.
Children with cancer – why does it happen?
Cancer in children seems totally unfair as cancer is a usually a disease of ageing. The causes of cancer in children are not always known, but genetic susceptibility is thought to play a part in some cases. Exposure to radiation, infections or abnormal development in the womb may also be important factors in children with cancer. Some childhood cancers are more often associated with other conditions; for example, leukaemia is often associated with Down's syndrome.
Types of cancer in children
Leukaemia is the most common type of cancer in children. There are four main types of leukaemia:
Acute lymphoblastic leukaemia (ALL)
Acute myeloid leukaemia (AML)
Chronic lymphocytic leukaemia (CLL)
Chronic myeloid leukaemia (CML)
About 85% of children with cancer, specifically leukaemia, are ALL, occurring in about 400 children in the UK each year, most commonly between the ages of two and four years. Chronic leukaemias are rare in childhood.
Other childhood cancers include cancers of the brain and spinal cord, eyes (retinoblastoma), kidneys (Wilm‘s tumours), bones or muscles. Children may develop lymphoma – cancer of the cells of the immune system.
What symptoms are seen in children with cancer?
Symptoms may arise rapidly in children with cancer. The symptoms of acute leukaemia include:
Appearing unnaturally pale (anaemia)
Joint pain (can be mistaken for growing pains)
Recurrent infections such as sore throats
Bruising easily and/or having nosebleeds
Acute leukaemia develops rapidly and is a particularly aggressive type of cancer, so it requires urgent diagnosis and medical treatment.
What tests are used to diagnose children with cancer?
Several tests may need to be used in diagnosing children with cancer and assessing the type and stage of the cancer:
Blood tests – to detect cancer cells in the blood stream and assess the condition of other blood cells
Chest X-ray – to check for enlarged lymph glands in the chest
Bone marrow aspirate – to determine the type of cancer
Lumbar puncture – to check for cancer cells within the spinal fluid
What treatments are available for children with cancer?
The first aim of treatment in children with cancer is to achieve ‘remission’ – a state where as many cancer cells as possible have been killed. The next goal is to give further treatment to completely eradicate the cancer. Children with cancer receive treatment in several phases, beginning with induction therapy (usually a course of intensive chemotherapy treatment) followed by less intensive chemotherapy or intrathecal chemotherapy. This involves injecting drugs directly into the spinal fluid to prevent cancers spreading to the brain and spinal cord. Around 2 to 3% of children with cancer do not respond well to chemotherapy or their cancer returns – they may need a bone marrow transplant.
The exact course of treatment for children with cancer depends on the type and stage of their cancer, their age, and other factors such as their response to treatment or genetic factors. Wherever a child is treated, the medical team recognises the stress on the family and will offer informal and formal counselling and support to get you through this difficult time.