When to worry about a new lump or swelling with childhood cancer

A lump can occur in the neck, chest, abdomen, groin, limb, or elsewhere. Causes include a lymph node, infection, injury, treatment effect, fluid, or the cancer itself. Children may not describe pain clearly, so changes in play, sleep, appetite, movement, or mood are useful clues.

Note the site, approximate size, colour, warmth, tenderness, and whether it is growing. A photograph beside a familiar object can help show change, but do not delay contacting the team to collect measurements.

Call the child’s oncology nurse, doctor, or hospital contact provided by the treatment team. Explain when the area appeared and mention fever, reduced drinking, vomiting, bruising, fatigue, or reduced movement. Avoid squeezing the lump or giving new medicines unless the team recommends them.

The team may arrange an examination, blood tests, imaging, or another assessment. The right approach depends on the child’s diagnosis, treatment, age, and current condition.

Seek urgent help if the child has breathing difficulty, trouble swallowing, sudden severe pain, rapidly worsening swelling, unusual sleepiness, confusion, seizure, uncontrolled bleeding, or fever according to the emergency instructions from the oncology team. These signs require rapid attention and are not a way to identify the cause.

Ask how to measure or photograph the area, whether the child needs same-day review, which fever threshold applies to their treatment plan, and which number to use after hours. Ask whether normal activities, school, or medicines should change while waiting for review.