Health Tips

LEUKEMIA: Most common childhood cancer

Cancer. A disease no one would wish on anyone, more so in children. But it happens. Cancer is hard to deal with and hard to break it to a young child. What more when they do not seem to understand what is going on. Both parents and healthcare professionals understand the real pain of childhood cancer. Learn how to identify the risks, signs and symptoms early so they can be treated immediately. 

Most common cancers in children:

• Leukemia

• Brain and spinal cord tumors

• Neuroblastoma

• Wilms tumor

• Lymphoma (including both Hodgkin and non-Hodgkin)

• Rhabdomyosarcoma

• Retinoblastoma

• Bone cancer (including osteosarcoma and Ewing sarcoma)

* Other cancers not stated above could still occur in children although not as common.

LEUKEMIA

The most common cancer in children is leukemia, known to the public as blood cancer (abnormal cancer cells that arise from blood cells). There are two main types of leukemia namely Acute Lymphocytic Leukemia (ALL) and Acute Myeloid Leukemia (AML).

ALL accounts for 3 out of 4 childhood cancers.

Very rarely, acute leukemias can have both characteristics of AML and ALL.  And chronic leukemia such as CLL and CML are also rarer in children, however it could still occur.

How does it develop?

Blood cells are formed in various stages in the bone marrow. Lymphocytes are a type of white blood cell while myeloid is a cell that can develop into red blood cells, white blood cells or platelets. When these cells grow abnormally, cancer develops. 

What increases the risk of childhood leukemia?

• Genetics 

• Genetic syndromes - Trisomy 21 (Down Syndrome), Li-Fraumeni Syndrome

• Inherited immune system problems

• Radiation exposure

• Exposure to chemicals

• Immune system suppression

While there are multiple proven and uncertain or even controversial risk factors, there are times when the risk is unknown. Known risk factors should be avoided however, when dealing with a case of childhood cancer, one of the most important factors to remember is to focus ahead on treatment. 

Recognizing the signs?

If your child has an increase risk as mentioned above, be it a syndrome or a sibling with history of cancer, or have immunosuppressive conditions, check with your doctor to run tests in order to rule it out. 

Symptoms to look out for in children include symptoms of anemia. This is due to the fact that since the blood cells develop abnormally not much mature blood cells will form completely therefore leading to anemia. While a lack in white blood cells opens up opportunities for infection as the immune system is compromised. There might also be signs of low platelet count which increases bleeding or bruising. Signs include:

• Fatigue, Feeling weak

• Loss of appetite/ weight loss

• Feeling cold

• Dizzy or lightheadedness

• Shortness of breath

• Pale skin

• Infections

• Fever 

• Bruising or bleeding

• Frequent or severe nosebleeds

• Bleeding gums

• Bone or joint pain

• Abdominal swelling

Seeking treatment

Once diagnosed, your physician will determine its type and subtypes before offering treatment options. If there is an emergency situation where certain conditions may put your child at risk, those measures will be undertaken first before definitive treatment starts. An example would be infection or risk of leukostasis (abundant white blood cells in the circulation causing possible blockage)

Treatment options

• Chemotherapy - the main treatment. As anti-cancer drugs are given via the intravenous route most of the time, it is effective to reach every part of the body especially in blood cancers. 

• Radiation - not always needed but is helpful in certain situations with other treatment modalities 

• Targeted therapy drugs - these specific drugs target certain parts of the cancer preventing it from growing. Commonly given with chemotherapy drugs.

• Immunotherapy 

• Surgery - rarely an effective option as blood cells are present in every part of the body.

• High dose chemotherapy with bone marrow transplant 

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Reference:

1. https://www.cancer.org/cancer/cancer-in-children/types-of-childhood-cancers.html

2. https://www.cancer.org/cancer/leukemia-in-children/treating.html

Picture credit:

1. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-radio-childhood-cancer-awareness-month/

2. https://www.medicalnewstoday.com/articles/322389

3. https://www.thebaynet.com/articles/0318/threetimechildhoodcancersurvivor.html

4. https://www.acco.org/treatment-2/

Written by

Dr. Jessamine Chong Sze Lynn