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Children's tumours: Treatment, symptoms, advice and help


Incidence

 
  • Approximately 1200 children aged < 15 years in England & Wales are diagnosed with cancer each year, giving a rate of 12 per 100,000 children < 15 years.
  • 1 in 550-600 children will be affected by the age of 15 years - which is similar to the rate for Down's syndrome, diabetes or meningitis in childhood.
  • Acute leukaemia accounts for about 1/3 of all childhood cancers and brain/CNS tumours account for almost one-quarter. See table 1.1

Risk Factors


In most cases no risk factor can be identified. However, genetic susceptibility is apparent in some cases, associated conditions (see Table 1.2) or a family history in first degree relatives may be important.


Table 1.1 - Childhood Cancers*


Childhood Cancer No of Cases Age Group Affected
Acute Leukaemia (ALL/AML) 31060 2-4 years
Brain Tumours 280
Lymphoma (Hodgkin's/NHL) 5070 10-14 years
Neuroblastoma 80 < 4 years
Soft Tissue Sarcoma 80
Wilm's Tumour (Nephroblastoma) 70 < 5 years
Bone Sarcoma 60 10-14 years
Germ Cell Tumours 30
Retinoblastoma 30 < 1 year
Hepatoblastoma 10 < 1 year

 

*Reference - C. Stiller et al. United Kingdom National Registry of Childhood Tumours, England and Wales 1981-1990. In D M Parkin et al (ed) International Incidence of Childhood Cancer, Vol II. IARC Scientific Publication No 144 IARC Lyon 1998 pp 365-367

Table 1.2


Childhood Tumour Association
Leukaemia Down's syndrome
CNS Tumours Neurofibromatosis Type I
Wilms' Tumour Aniridia, hemihypertrophy; Beckwith-Wiedemann Syndrome
Soft tissue sarcoma Li Fraumeni syndrome (e.g. relatives with premenopausal breast cancer)
Hepatoblastoma Familial adenomatous polyposis coli
Retinoblastoma May be familial/heritable (mainly bilateral tumours)

 


Notes on Individual Childhood Cancers


1. Leukaemia


Children usually present with a relatively short history (weeks rather than months) with pallor, fatigue, irritability, fever, bone pain and bruising/petechiae.

  

  • 70% have large liver and spleen
  • > 50% have enlarged lymph nodes

 

Differential diagnosis includes infectious glandul