Childhood cancer

Between 800 and 1000 children under the age of 15 are diagnosed with cancer in South Africa each year, says the Cancer Association of South Africa (CANSA).

Cancers that occur in children are quite different to those in adults. Because a child is growing, most cancers occur in cells that are developing, for example, the bone marrow, blood, kidneys and tissues of the nervous systems.

Worldwide, a child is diagnosed with cancer every three minutes, and it is estimated that one in 408 children will be diagnosed with cancer before the age of 15. Children can even be born with cancer.

In South Africa, early diagnosis is still a challenge and both the Cancer Association of South Africa (CANSA) and Childhood Cancer Foundation of South Africa (CHOC) have embarked on campaigns to increase the awareness of the early warning signs of childhood cancers.

Early warning signs of childhood cancer

Parents, caregivers and those in the health profession should be on the alert for the following signs and symptoms of possible cancer in children, including babies:

  • Continued, unexplained weight loss
  • Headaches with vomiting in the early evening or early morning
  • Increased swelling or pain in bones, joints, back or neck
  • Lump/mass in abdomen, neck, chest, pelvis or armpits
  • Development of excessive bruising, bleeding or rash
  • Constant infections
  • A whitish colour behind the pupil
  • Nausea that persists, or vomiting without nausea
  • Constant tiredness or noticeable paleness
  • Eye or vision changes that occur suddenly and persist
  • Recurrent fevers of unknown origin

Survival and treatment

The chances of surviving childhood cancer can be as high as 77 percent with early diagnosis and treatment. With some exceptions, childhood cancers tend to respond better to chemotherapy, and children’s bodies also tend to handle the chemotherapy better than adults do. But both chemotherapy and radiation can have long-term effects on children’s health, so follow-up care is important, and may last well into adulthood.

Childhood cancer is usually treated by a multidisciplinary team of carers lead by a paediatric oncologist at a specialised paediatric oncology unit.

Common types of childhood cancers

The types of cancer that develop in childhood are often different to cancers that occur in adults. Childhood cancers are often the result of DNA changes in cells that take place very early in life, sometimes before birth. Unlike many adult cancers, childhood cancers are not strongly linked to lifestyle or environmental factors.

These are the most common kinds of cancers affecting children:

1. Leukaemia: Cancer of the bone marrow and blood can affect children of any age and accounts for about 30% of cancers in children. Leukemia needs to be treated promptly as these cancer cells can grow very quickly.

2. Brain and other central nervous system cancers: Abnormal cell growth that forms tumours in the brain or spinal cord account for about 26 percent of cancers in children. The treatment and prognosis of these cancers vary depending on where they occur.

3. Neuroblastoma: This type of cancer, which develops in the nerve cells of embryos, occurs in infants and very young children and accounts for about 6 percent of cancers. These tumours usually start growing in the abdomen.

4. Wilms tumour: Also referred to as nephroblastoma, this cancer starts in one kidney (it will rarely affect both kidneys), and usually occurs in children around the age of three or four.

5. Lymphoma: These occur in certain cells of the immune system called lymphocytes. They most often grow in lymph nodes and other lymph tissue, such as the tonsils or the thymus gland. Lymphomas can also affect the bone marrow and other organs.

6. Rhabdomysarcoma: This is the most common type of soft-tissue sarcoma in children and affects the cells that develop into skeletal muscles. They can grow in almost any part of the body including the head, neck, groin, belly, pelvis or the arms or legs.

7. Retinoblastoma: Cancer of the eye affects children around the age of two, but is seldom seen in children older than six.

8. Bone cancers: Primary bone cancers (cancers that starts in the bone) most often occur in older children and teens. Osteosarcoma usually affects teens and develops in areas where the bone is growing quickly (the long bones of the arms or legs). Ewing sarcoma is less common and usually occurs in younger teenagers, affecting the pelvic bones, the chest wall (ribs or shoulder blades) and the middle of the long bones in legs.

For more information

CHOC Childhood Cancer Foundation SA: www.choc.org.za or call (011) 326-1717

The South African Childhood Cancer Study Group: www.saccsg.co.za

Cancer Association of South Africa: www.cansa.org.za (CANSA offers support to parents of children who have been diagnosed with cancer. Email [email protected] to find out more about their TLC Support Groups.)

Read More: Cancer Super Section