During the pediatric age, cancer is a rare disease that can initially manifest itself with the same signs and symptoms as other common pathological processes. The aim of this article where we talk to Dr. Oliván Gonzalvo, specialist in Pediatrics, is to help parents to know those early signs and symptoms that should alert them to the possibility of cancer. Early detection by the pediatrician will generally improve the prognosis.
Leukemia
It usually presents with a history of a few weeks of evolution. It should be suspected when one or more of the following signs and symptoms appear that are not justified by other reasons: pallor, tiredness, irritability, fever of unknown origin, generalized lymphadenopathy, hematomas, petechiae, persistent osteoarticular pain, repeated respiratory infections and/or hepatosplenomegaly. Special attention should be paid in children with Down syndrome.
Lymphoma
It usually presents with a history of months of evolution. It should be suspected in the absence of signs of local infection, in the presence of non-painful adenopathy (lymph node disease) and its location: cervical, supraclavicular and/or axillary. In addition to the consistency which is usually hard and the progressive increase in size.
Central Nervous System Tumor
It usually presents with a history of 2 to 4 weeks of evolution. It should be suspected when one or more of the following signs and symptoms appear: bulging fontanelle, increased head circumference, loss of developmental milestones (in children under 2 years of age), persistent headache, vomiting that awakens at night or is morning, first seizure, visual disturbances, motor or sensory disturbances, impaired school performance and/or unexplained behavioral changes. Special attention should be paid in children with neurofibromatosis.
Nephroblastoma (Wilms’ tumor)
Usually presents as a persistent, progressive, painless abdominal mass or distention. Less commonly the first manifestation may be gross hematuria.
Neuroblastoma
It should be suspected in the presence of one or more of the following signs and symptoms that are not justified by other reasons: persistent bone pain, back pain, pallor, fatigue, leg weakness, irritability, fever of unknown origin, repeated respiratory infections, generalized lymphadenopathy, hematomas, abdominal distention and/or urinary retention.
Bone Tumor (osteosarcoma / Ewing’s sarcoma)
Should be suspected with the appearance of persistent pain and/or swelling in the extremities, especially around the knee. Less commonly presents with back pain or lameness for no apparent reason for more than 4 weeks.
Soft tissue tumor (sarcomas)
It should be suspected in the appearance of an unwarranted tumor in any location, with any of the following characteristics: size greater than two centimeters in diameter, rapid or progressive growth and hard consistency, adherent to deep planes and/or regional adenopathies.
Retinoblastoma
It usually occurs in children under two years of age and should be suspected by visualization of a white pupillary reflex (leukocoria) in a photograph or by physical examination. Less frequently it occurs with new onset strabismus or a change in visual acuity. Special attention should be paid in children of parents with a history of retinoblastoma and in twins of affected children.