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Childhood Cancer 2nd edition,
Childhood Cancer

Parents are usually the first to notice that something is wrong.

Most physicians refer the the closest major medical center with expertise in treating children with cancer.

Signs and Symptoms of Cancer

The following excerpt is taken from Chapter One of Childhood Cancer: A Parent's Guide to Solid Tumor Cancers , 2nd Edition by Honna Janes-Hodder & Nancy Keene, copyright 2002 by O'Reilly & Associates, Inc. For book orders/information, call 1-800-998-9938. Permission is granted to print and distribute this excerpt for noncommercial use as long as the above source is included. The information in this article is meant to educate and should not be used as an alternative for professional medical care.

Cancer begins with the transformation of a single cell. The malignant changes that occur in these renegade cells can cause several signs and symptoms, many of which mimic common childhood illnesses.

Parents are usually the first to notice that something is wrong with their child. Occasionally, a diagnosis of cancer is based on chance findings during well baby visits to the pediatrician. Rarely, it is discovered accidentally on an x-ray done for other reasons.

Any deviation from the child's normal behavior or health that persists or is not easily explained gives reason for further investigation by the pediatrician. The following are some of the signs and symptoms which may indicate the presence of childhood cancer:

  • Continued, unexplained weight loss

  • Headaches, often with early morning vomiting

  • Increased swelling or persistent pain in bones, joints, the back, or legs

  • Lump, especially in the abdomen, neck, chest, pelvis, or armpits

  • Development of excessive bruising or bleeding

  • Constant infections

  • A whitish color behind the pupil

  • Nausea which persists or vomiting without nausea

  • Constant tiredness or noticeable paleness

  • Eye or vision changes which occur suddenly and persist

  • Recurrent or persistent fevers of unknown origin
The day that I took Cassandra (age 5) to the pediatrician, I had assumed she would be sent home on antibiotics for some type of infection. She had been complaining of pain in her left knee and had developed a large lump on her left buttock. Instead, we left with instructions for her to eat nothing, since she was going to be sedated the following morning for some scans at the hospital. From that point on, things happened very fast. I remember only bits and pieces of those first few days at the hospital. I was told that Cassandra had rhabdomyosarcoma, that the following day they would do a biopsy and implant a central catheter, and that chemotherapy would be started as soon as possible.
Most parents react to their concerns by taking their child to a doctor. Usually, the doctor performs a physical exam and may order a complete blood count (CBC) or x-rays. Sometimes the diagnosis is not as easy and fast as Cassandra's.
When Hailee was a baby, we noticed that sometimes her eye appeared white and sometimes it looked reddish. We were worried, but the pediatrician said that she was healthy. He eventually gave us a referral to see an ophthalmologist when we insisted. Since he didn't feel it was an emergency, it took three months to see the eye specialist, who diagnosed her unilateral retinoblastoma. By that time, Hailee's retina was detached, and her eye had to be enucleated. I remember feeling completely shocked when the specialist said that she had a disease that would kill her if left untreated. We were angry, because for several months we had been taking her to the pediatrician, and even told him about a picture that had been taken of Hailee that showed an odd white reflex in her eye. Still, he felt that there was nothing wrong. If it had been diagnosed sooner, we might have been able to save her eye.
After a tentative diagnosis of childhood cancer, most physicians refer the child for further tests and treatment to the closest major medical center with expertise in treating children with cancer. Every child with cancer should be treated at a facility that uses a team approach, including pediatric oncologists/hematologists, specialized surgeons and pathologists, pediatric nurse practitioners, radiologists, pediatric surgeons, rehabilitation specialists, education specialists, and social workers. State-of-the-art treatment is provided at these institutions, offering your child the best chance for remission (disappearance of disease in response to treatment) and, ultimately, cure.

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