Childhood Cancer: Signs, Diagnosis and Care

Childhood cancer describes cancers diagnosed in children and young people, which need assessment by a specialist paediatric oncology team.

These cancers can begin in blood cells, organs, bones, muscles or the nervous system. Care is planned around the child’s diagnosis, general health, development and family circumstances.

Symptoms vary widely and commonly have causes other than cancer. Easy bruising, a new lump or swelling, and unexplained fever are common presentations of childhood cancer. Contact a clinician when a symptom persists, recurs, worsens or is accompanied by unusual tiredness, pallor, pain, weight change or a change in normal behaviour.

In many children, the exact reason a cancer develops is not known. It begins when cells acquire changes that affect how they grow and divide. Families should not blame themselves for everyday activities, food choices or parenting decisions.

After diagnosis, the team explains the cancer type, where it is located and which tests guide the plan. Treatment is delivered in phases for some diagnoses, with regular checks for response and side effects. The pace and setting of care differ between children.

Most childhood cancers occur without a clear risk factor. Some inherited conditions or previous medical treatments can be relevant for a small group of children. A genetics discussion may be offered when personal or family history suggests it could help clarify care.

A paediatric team starts with a history and examination, then may use blood tests, imaging or a sample of tissue or bone marrow. The tests selected depend on the symptoms and suspected diagnosis. Results are brought together before treatment recommendations are made.

Treatment can include chemotherapy, surgery, radiation treatment, targeted medicines or other specialist approaches. Proton therapy may be considered for selected situations. Before treatment that could affect future fertility, the team may discuss fertility preservation. Supportive care addresses infection risk, nutrition, pain, school and emotional wellbeing.

A child may need help maintaining routines, play, education and contact with friends while energy changes. Bring a written list of medicines, symptoms and questions to appointments. Siblings and caregivers may also benefit from clear explanations and practical support.

Treatment can affect blood counts, appetite, energy, growth and emotional wellbeing. The team explains symptoms that require same-day contact and monitors for effects that may emerge later. A survivorship care plan can help families keep track of follow-up needs.

Paediatric oncologists work with nurses, surgeons, radiologists, therapists and psychosocial professionals. Ask who to contact outside clinic hours and which symptoms should trigger urgent review.