Learn About Types of Paediatric Cancer

Acute Lymphoblastic Leukemia (ALL)

Acute lymphoblastic leukemia (also called acute lymphocytic leukemia, or ALL) in children is cancer of the blood that starts in the bone marrow and spreads to the bloodstream. Leukemia starts in the bone marrow, the spongy internal part of bones where new blood is made.

Leukemia develops because of a mutation in a white blood cell that causes it to multiply uncontrollably. These mutated white blood cells, called “blasts” take over the bone marrow and crowd out normal blood cells. One blast soon generates billions of other blasts, with a total of about a trillion leukemia cells typically present in the body at the time of diagnosis.

ALL is the most common children’s cancer.

Signs and Symptoms:

• Fatigue and paleness.
• Bruising or bleeding – known as thrombocytopenia.
• Bone pain, sometimes associated with swelling of the joints.
• Weight loss or loss of appetite.
• Enlarged lymph nodes.

Acute Myeloid Leukemia (AML)

Acute myeloid leukemia in children is also a cancer of the blood that starts in the bone marrow and spreads to the bloodstream.

Signs and Symptoms:

• Fatigue and paleness – anemia.
• Bruising or bleeding from decreased platelets.
• Petechiae, a rash of tiny red spots caused by low platelet levels.
• Bone pain.
• Weight loss or loss of appetite.
• Frequent infections.

The signs and symptoms of leukemia are the same as more common childhood illnesses, such as colds or flu, and many children are treated for those other illnesses before leukemia is diagnosed.

Hodgkin Lymphoma (Hodgkin Disease)

Hodgkin lymphoma, also called Hodgkin’s lymphoma and Hodgkin disease, is a cancer of the lymphoid system. The lymphoid system is made up of various tissues and organs, including the lymph nodes, tonsils, bone marrow, spleen, and thymus. These organs produce, store and carry white blood cells to fight infection and disease.

It has been reported in infants and very young children, but it is considered rare before the age of five. The majority of cases are in teenagers. Hodgkin lymphoma is a common cancer of teenagers and young adults.

Signs and Symptoms:

The most common symptom of Hodgkin lymphoma is swelling of the lymph nodes. Lymph nodes are small tissues located throughout the body that store white blood cells to help filter out germs. Swollen lymph nodes are a common symptom of colds and flus, but in Hodgkin disease, the lymph nodes are usually larger than those that occur with common infections, and they do not shrink when treated with standard medications like antibiotics.

The affected lymph nodes are usually found in the neck or above the collarbone, and less commonly under the arms or in the groin. The lymph nodes are usually painless, firm, rubbery, and movable in the surrounding tissue.

Children and teens with lymphoma may experience other symptoms before they are diagnosed. Often, these are “systemic” symptoms that affect the entire body. These generalized symptoms of lymphoma include:

• Poor appetite.
• Weight loss.
• Night sweats.
• Fatigue or sense of ill-feeling.

Non-Hodgkin Lymphoma (NHL)

Lymphoma, or non-Hodgkin lymphoma is a general term for cancers of the lymphatic system. The lymphatic system is part of the immune system that protects the body from infections. The lymphatic system contains a particular family of cells, called B and T lymphocytes. These cells are present in lymph glands, the spleen, the tonsils, adenoids and many other organs and tissues, including the intestinal tract. In non-Hodgkin lymphoma, these B and T lymphocyte cells have mutated and become malignant, or cancerous.

Signs and Symptoms:

• Enlarged lymph nodes, which may cause swelling in the neck, underarm or groin. Sometimes the lymph nodes involved are in the stomach or intestines so there may be swelling of the abdomen, abdominal pain or constipation.
• Difficulty breathing, such as wheezing or shortness of breath, or high-pitched breathing.
• Unexplained fever.
• Weight loss.
• Night sweats.

Rhabdomyosarcoma

Rhabdomyosarcoma in children (also called “rhabdo” or RMS) is a tumor in which malignant (cancer) cells look like young, immature muscle cells. It is the most common soft tissue sarcoma (cancer of soft and connective tissue) found in children.

RMS can arise in any muscle of the body, but the most common sites are:

• Adjacent to the base of the skull.
• Around the eye.
• Other sites in the head and neck, such as the cheek or lip.
• Arms and legs.
• Urinary and reproductive organs including bladder, vagina, prostate and soft tissue around the testicles.

In children, there are two major subtypes of RMS:

Embryonal rhabdomyosarcoma (ERMS)

Alveolar rhabdomyosarcoma (ARMS)

Signs and Symptoms:

The most common presenting symptom of RMS is a growing mass or swelling wherever the tumor forms. Other signs and symptoms depend on the location of the primary tumor, which are described below.

For tumors presenting in the urinary and reproductive organs, children may experience blood in the urine, difficulty urinating, or bleeding from the vagina.

For tumors presenting adjacent to the base of skull the cancer can cause facial asymmetry, blurred vision, difficulty breathing, ear bleeding or discharge, headaches and facial pain. Swelling or bulging around the eye is a common sign of a tumor arising around the orbit.

Extremity tumors (those in the arms or legs) often present as a rapidly enlarging, firm mass.

Wilms Tumor

Wilms tumor is the most common form of kidney cancer in children.

Signs and Symptoms:

• A lump or mass in the abdomen of an otherwise well child.
• Abdominal pain.
• Blood in the urine.
• High blood pressure.
• Fever.
• Diarrhea.
• Weight loss.
• Urogenital infections.
• Shortness of breath.
• A general feeling of being tired and unwell.
• Nausea and vomiting.

Osteosarcoma

Osteosarcoma is a type of bone cancer. It starts in immature bone cells that normally form new bone tissue, destroys local tissue and weakens the bone. This type of cancer most often begins in the thigh or shin bones. The second most common place for it to begin is in the upper arm bone, close to the shoulder, but it can develop in any bone in the body.

Signs and Symptoms:

• Pain in the bone or joint that gets worse over time.
• A painless swelling or a noticeable mass in the arm or leg.
• A broken bone that occurs without injury or with minimal injury.
• Stiffness or swelling of joints.
• Back pain or loss of bowel or bladder control.

Eye Cancer (Retinoblastoma)

Retinoblastoma is a rare eye cancer affecting children. Retinoblastoma in children can occur in one eye or both eyes.

Signs and Symptoms:

• A pupil that looks white or black instead of red when light hits it.
• A crossed eye (looking either toward the nose or toward the ear).
• Poor vision.
• A red, painful eye.
• An enlarged pupil.

Neuroblastoma

Neuroblastoma most often originates in the adrenal glands, which are located on top of each kidney. However, tumors can begin anywhere in the body. Other common sites are the chest, neck and pelvis. While neuroblastoma may be found in only one spot in the body at the time of diagnosis in some patients, in others the cancer may have spread (metastasized) from its primary location to the lymph nodes, bone marrow, or bones.

Signs and Symptoms:

• Abdominal swelling, pain, constipation or difficulty urinating.
• A lump or bump in the neck sometimes accompanied by drooping of the eyelid.
• Bone pain.
• Bleeding and bruising.
• Fever.
• Difficulty breathing if the tumor is present in the chest.
• Weakness or paralysis if the tumor is near the spinal cord.
• High blood pressure
• Rapid heartbeat
• Persistent diarrhea

Brain Tumors and Central Nervous System Tumors

Brain tumors in children occur in the central nervous system (CNS) and spinal cord. Together, these important organs control functions such as breathing, heart rate, movement, thinking and learning.

Brain tumors tend not to spread to distant areas of the body outside the brain or spinal cord.

Signs and Symptoms:

Typical symptoms of CNS tumors are directly related to the location of the tumor, how fast it is growing and any associated tissue swelling that occurs in conjunction with the tumor.

• Headaches (frequent, recurrent).
• Vomiting, especially in the morning.
• Eye movement problems and/or vision changes.
• Unsteady gait or worsening balance.
• Weakness of one side of the face.
• Loss of previously acquired developmental milestones.
• Weakness in the arms or legs.
• Bulging fontanel (soft spot on an infant’s head) or increased head size.
• Tilting of the head or neck to one side.
• Seizures / Dizziness / Loss of Consciousness.
• Difficulty with speech, swallowing or drooling.
• Back or neck pain, often waking the child at night.
• Lethargy, irritability or other behavior changes.
• Loss of sensation in the arms or legs.
• Hearing loss, without evidence of infection.

Liver Cancer

The liver is one of the largest organs in the body. It helps store nutrients from food, creates bile to break down fat, and removes harmful chemicals from the body. Cancer develops in the liver when malignant cells form in liver tissues.

Signs and Symptoms:

The most common symptom of liver cancer is swelling or enlargement of the abdomen caused by the tumor enlarging. Additional symptoms may include:

• Loss of appetite.
• Weight loss.
• Nausea & vomiting.
• Stomach pain.
• Unequal growth of one part of the body compared to another.
• Early signs of puberty.