Introduction
While cancer is understood to be a disease of adults, its occurrence in children is not entirely uncommon. For example, 7% of all cancer cases in Nigeria occur in children. Nigeria is also sadly lagging behind in the care of childhood cancers. Despite the global decline in the number of cases and mortality from childhood cancer, in developing countries like Nigeria, the number of cases keeps rising and outcomes remain poor.
In this article, we will be introducing you to the most common cancers that affect children. We will explore what these cancers are, their risk factors, their symptoms, their treatments and prognosis.
Common Childhood Cancers in Nigeria
Leukaemia
Leukaemia is colloquially called “cancer of the blood”.
What happens in leukaemia is that there is excessive production of immature forms of white blood cells. These immature forms can’t effectively fight infection, so the patient has a higher risk for dangerous infections. Also, since the body is entirely focused on producing only white blood cells, there is less formation of other cell types like red blood cells and platelets. This puts the patient at risk of anaemia and abnormal bleeding. This shows as fatigue, nosebleeds, gum bleeds, etc.
Leukaemia is the commonest cancer in children worldwide. It is most prevalent in children 4 years old and below.
Risk factors for leukaemia include:
- Male sex
- Caucasian ethnicity
- A family history of leukaemia
- Environmental exposures such as ionizing radiation
- Prior chemotherapy or radiotherapy
- Hydrocarbons such as benzene
Blood tests and bone marrow biopsies establish the diagnosis.
Chemotherapy is the mode of treatment. Cycles are long and can last almost 2 years.
Tumours of the Brain and Central Nervous System
These tumours, affecting the brain and spinal cord, are the second commonest cancers among children worldwide.
The only certain risk factors are rare genetic syndromes and exposure to major ionizing radiation, such as in a nuclear accident. However, people with no identifiable risk factors can still develop these tumours.
Symptoms include:
- Headaches
- Loss of developmental milestones
- Seizures
- Vomiting
- Limb weakness
- Among others
Diagnosis is made by imaging, like with CT or MRI scans. Then we confirm the diagnosis with biopsies.
Radiotherapy, surgery and sometimes chemotherapy are the main modes of treatment.
Non-Hodgkin’s Lymphoma, Especially Burkitt’s Lymphoma
This is another type of cancer involving the blood system. Again, there is an excess of poorly functional white blood cells. The symptoms are similar to those of leukaemia.
But we can tell them apart by symptoms and signs such as the presence of swollen lymph nodes or an enlarged spleen or liver.
Other lab tests also help, like a peripheral blood film or a biopsy of the lymph nodes or bone marrow.
Among the different forms of non-Hodgkin lymphoma, Burkitt’s lymphoma is the commonest. It is prevalent in tropical regions like Nigeria and has been strongly linked to infections like malaria and Epstein-Barr virus.
Burkitt’s lymphoma is the fastest-dividing tumour known to man and will almost certainly kill a patient within 3 months without treatment. The good news, however, is that Burkitt’s lymphoma is very amenable to treatment.
Other Solid Tumours Affecting Children
These include tumours of the kidneys, retina, adrenal gland, skeletal muscle and bones. Or, as researchers name them: nephroblastoma, retinoblastoma, neuroblastoma, rhabdomyosarcoma and osteosarcoma.
This assortment of cancers has varying signs and symptoms and affects different age groups. Retinoblastoma and neuroblastoma mostly occur in infancy; nephroblastoma before 4 years of age; rhabdomyosarcoma in somewhat older children; and osteosarcoma in teens and young adults (17–22 years).
There may be abdominal swelling or swellings in other body parts, like the eyes, limbs or even in the female genital tract.
Diagnosis is by imaging, like with CT scans and MRIs, and biopsies.
Treatment varies by the cancer type but may involve chemotherapy, radiotherapy or surgery.
Prognosis of Childhood Cancer
Deaths from cancer in children have greatly reduced globally. In high-income countries, the 5-year survival rate is up to 80%. Sadly, in low-income countries, only about 30–50% survive.
This is due to late diagnosis and inadequate resources, both in the health system as well as on the part of the caregiver to fund care for children with cancer.
Moreover, about 1% of children who survive cancer will have a permanent disability from the treatment. Some chemotherapy can render patients infertile, damage lung structure or even pose risks for a later cancer. However, in the absence of better medications, we have to use what we have.
Conclusion
Your child can survive cancer. But early recognition and diagnosis are key. Ensure to seek care from trusted physicians and institutions.
