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CHILDHOOD CANCER DETECTION CHART
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Cancer Type Overview
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Subtypes
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Age
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Signs and Symptoms
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Initial Diagnosis Tests(*)
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Leukemia:
The most common childhood malignancy. Leukemia is cancer of the blood cells. Most childhood leukemias are acute and will progress quickly if not treated early. Chronic leukemias usually present milder symptoms and progress more slowly.
Early symptoms of leukemia are very similar to those of a common viral infection, but persist much longer than a typical viral infection. Parents of children with leukemia often recall a general sense that there was "something wrong” with their kids for many weeks or longer. Whenever parents experience such pervasive and persistent uneasiness about a child's health, it is recommended that they proceed to obtain a second opinion even if the initial diagnosis is normal.
While persistent back pain is common in adults, it is rare in children. If a child experiences chronic back pain, consult your doctor immediately.
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Acute Lymphoblastic Leukemia (ALL):
Cancer of the blood and bone marrow. ALL is the most common malignancy in children and can spread from the blood stream to other vital organs very quickly if left untreated. |
2-5
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Fever; infection; easy bruising or bleeding; bone or joint pain; constant feeling of fullness below ribs; painless lumps in the neck, underarm, stomach, or groin; weakness and constant fatigue; loss of appetite; weight loss. |
Complete physical exam; complete blood count (CBC) with differential; bone marrow aspiration and biopsy; cytogenetic analysis; immunophenotyping; blood chemistry study; chest x-ray. |
Acute Myelogenous Leukemia (AML):
Second most frequently diagnosed leukemia in children. Although AML generally responds well to initial treatment, many patients later experience a relapse. Ongoing research is focused on decreasing the risk of relapse and improving the long-term outcomes for AML patients. |
1-20
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Shortness of breath; fever with or without an infection; painless lumps around the eyes (may be blue-green); pain in the bones or joints; easy bruising or bleeding; painless lumps in the neck, underarm, stomach, or groin; significant weight loss. |
Complete physical exam; complete blood count (CBC) with differential; bone marrow aspiration and biopsy; cytogenetic analysis; imunophenotyping; blood chemistry study; chest x-ray. |
Chronic Myelogenous Leukemia (CML):
Most people with CML carry a gene mutation (but it is not passed on from parent to child), and only on rare occasions does it occur in young children. |
13-20
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>40
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Feeling very tired; night sweats; fever; unexplained weight loss; constant feeling of fullness below ribs on the left side. Sometimes CML doesn't cause any symptoms at all. |
Complete physical exam; complete blood count (CBC) with differential; bone marrow aspiration and biopsy; blood chemistry study. |
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Cancer of the Central Nervous System (CNS):
Second most common childhood malignancy. CNS includes the brain and spinal cord. Unlike other types of cancers, CNS tumors arising within the brain or spinal cord often do not spread to other organs. They interfere with normal body functions by spreading locally and destroying tissues of the central nervous system and their surroundings.
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Medulloblastoma:
Cancer of the cerebellum (lower back of the brain that controls movement, balance, and posture). Also called Primitive Neuroectodermal Tumor (PNET).
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1-15
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Having trouble speaking; loss of balance; worsening handwriting; change in personality or behavior; unusual exhaustion; unexplained nausea or vomiting; headache that goes away after vomiting; seizures. |
CT/CAT scan, MRI, brain tumor biopsy. |
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Gliomas:
The most common brain and spinal cord tumors which develop from glial cells. Glial cells are those that surround, support, and protect nerve cells. Glioma is not a specific type of cancer but rather a general category. The most common type of glioma is astrocytoma, which arises in a type of glial cells called astrocytes in the brain.
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1-15
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The symptoms of different types of gliomas depend upon their location, size and rate of growth. Symptoms can include headache, nausea, vomiting; double vision; change in personality and behavior; having trouble speaking; loss of balance, or paralysis. |
CT/CAT scan, MRI, brain tumor biopsy. |
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Lymphoma:
Lymphoma is the third most common childhood cancer and is closely related to leukemia in its disease origin.
Lymphoma is a term referring to a group of cancers originating in the lymphatic system. The lymphatic system includes lymph nodes throughout the body, lymphatic vessels that produce and transport lymph fluid from tissues to the circulatory system, the spleen, and other organs in our immune system.
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Hodgkin’s Lymphoma:
Currently more curable than Non-Hodgkin’s Lymphoma, and considered one of the most curable forms of cancer.
Hodgkin’s Lymphoma is unique in its predictable pattern of cancer progression. It usually begins as a lump in a lymph node, and spreads systematically from one lymph system to the next, moving into organs such as the liver, lungs, bones, and bone marrow. |
5-14
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Painless swollen lumps in the neck, chest, underarm, or groin; itchy skin; persistent fatigue; unexplained weight loss; fever; night sweats. |
Complete physical exam; lymph node biopsy; complete blood count (CBC); chest x-ray; CT/CAT scan; gallium scan; sedimentation rate; blood chemistry studies; detection for presence of Reed-Sternberg cell. |
Non-Hodgkin’s Lymphoma (NHL): Common subtypes of NHL include lymphoblastic lymphoma, Burkitt's lymphoma, anaplastic large cell lymphoma, and large B-cell lymphoma.
Because all of NHL subtypes generally progress very quickly, treatment for each of these diseases needs to begin immediately after diagnosis. |
10-20
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Painless swollen lumps in the neck, chest, underarm, abdomen, or groin; itchy skin; shortness of breath or difficulty breathing; persistent fatigue; lower back pain that extends to one or both legs; unexplained weight loss; fever; night sweats. |
Complete physical exam; CT/CAT scan; x-ray; MRI; thoracentesis; gallium scan. |
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Neuroblastoma:
Cancer of the sympathetic nervous system. Usually manifests as a lump or mass in the abdomenal region or around the spinal cord (chest, neck, and/or pelvis).
Neuroblastoma is often presented at birth, but diagnosis is often delayed until the child shows symptoms of the disease. When diagnosed before 1 year old, children experience cure rates as high as 90%.
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Special Note
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Neuroblastoma can be very difficult to diagnose and can sometimes be misdiagnosed as lymphoma or rhabdomyosarcoma. Make sure a physician who is familiar with neuroblastoma is consulted for a child suspected of having this disease.
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<5
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Lump in the abdomen, neck, or chest; bulging eyes; dark circles around the eyes; bone or joint pain; swollen stomach; shortness of breath; painless and bluish lumps underneath the skin; weakness or partial paralysis. |
Complete physical exam; 24-hour urine test; blood chemistry study;
cytogenetic analysis; bone marrow aspiration; CT/CAT scan;
immunohistochemistry study; neurological exam; x-ray; ultrasound. |
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Wilms’ Tumor:
The most common type of childhood kidney cancer, often curable. Usually affects one kidney (unilateral), but can sometimes affect both (bilateral).
Wilms' Tumor can grow up to 1 pound in weight without causing significant pain to a child.
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Special Note
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For children with the following diseases, regular screening for Wilms’ Tumor should be performed every three months until age 8: WAGR syndrome (Wilm’s Tumor, aniridia, ambiguous genitalia, and mental retardation); Beckwith-Wiedemann syndrome; hemihypertrophy; Denys-Drash syndrome; cryptorchidism; hypospadias.
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3-8
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Fever; swollen abdomen; blood in the urine; reduced appetite; weight loss; high blood pressure; constipation; stomach pain; nausea or vomiting.
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Complete physical exam; complete blood count; blood chemistry studies; liver function test; renal function test; urinalysis; ultrasound; CT/CAT scan; abdominal x-ray; biopsy. |
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Rhabdomyosarcoma:
The most common type of soft tissue sarcomas in children, which starts in muscle tissue and can occur anywhere in the body. This is a fast-growing, highly malignant tumor, and can spread to any part of the body.
Rhabdomyosarcoma is found in
four major sites: head and neck;
genitourinary tract; extremities; trunk (chest and lungs)
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Embryonal:
Most common type of rhabdomyosarcoma, usually found in young children around the head and neck or genitourinary tract. The more treatable form of the disease. |
1-10
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A noticeable lump or swelling is present in many cases of rhabdomyosarcma. Other symptoms depend on the location of the tumor.
Lump or swelling, firm and painless to touch, in the extremities, the groin and or the vaginal area; drooping eyelids, swelling of the eye, protruding eyeball, rapid vision change; hoarseness, difficulty in swallowing; persistent abdominal pain.
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Biopsy; chest x-ray; ultrasound; CT/CAT scan; MRI scan; blood and bone marrow tests; PET (positron emission tomography) scan. |
Alveolar:
More aggressive form of the cancer. Usually involves the muscles of the extremities such as arms and legs, or trunk (chest and lungs). |
<15
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Retinoblastoma:
Cancerous cell forming in the retina of the eye. It is the most common eye tumor in children. This cancer is curable if caught early. Although it is rare, if not treated quickly, retinoblastoma can spread or metastasize outside of the eye to the brain, the spinal cord, and the bones.
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Special Note
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<5
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Pupil of the eye appears white (instead of red) under flash photograph; crossed or misaligned eyes; pain or redness in the eye. |
Family history of retinoblastoma; eye exam with dilated pupil; CT/CAT scan; ultrasound exam; MRI. |
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When retinoblastoma occurs in both eyes, it is always inherited. Therefore, siblings of children with retinoblastoma in both eyes need to have regular ophthalmological eye exams as well.
It is important to note that for children with inherited retinoblastoma, the chance of developing other types of cancer in later years also increases. Regular complete physical exams are strongly recommended.
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Liver Cancers: Also known as hepatoma.
Well-known risk factors include: being male, having very low birth weight, history of hepatitis B or hepatitis C infection. The risk of developing liver cancer is greatest when the virus is passed from mother to child at birth.
Having other types of liver disease such as biliary cirrhosis or tyrosinemia also increases the likelihood of getting liver cancer.
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Hepatoblastoma: Generally self-contained liver cancer that usually does not spread outside of the liver. It can be inherited. Two important genetic conditions related to this type of cancer are: Beckwith-Wiedemann Syndrome and familial adenomatous polyposis. |
<3
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Painless lump in the abdomen; swelling or pain in the abdomen; weight loss for no known reason; early puberty in boys; nausea and vomiting. |
Complete physical exam; serum tumor marker test; complete blood count; liver function tests; abdominal x-ray; CT/CAT scan; ultrasound; MRI; biopsy. |
| Hepatocellular carcinoma: Often tends to spread to other parts of the body. Less frequently seen than hepatoblastoma. |
<18
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Bone Cancers:
Cancer that arises from inside the bone (primary bone cancer) is very rare. Primary bone cancer affects children more often than adults.
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Osteosarcoma:
The most common type of bone cancer. Usually develops at the growing edges of the long bones. Most often found around the knee area. The second most common site for these tumors is in the end of the upper arm bone close to the shoulder. This type of cancer tylically does not respond to radiation therapy. |
10-18
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Prolonged bone pain in areas such as: knee, shoulder, back, and other places. While persistent back or joint pain is common in adults, it should not be disregarded in children or viewed lightly .
Bone pain as a result of cancer progression may closely resemble the back pain that is common after heavy exercise. Whenever bone pain lasts more than a week, consult your physician.
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Radiological tests including: x-ray, bone scan, skeletal survey; surgical biopsy; blood test. |
Ewing's Sarcoma:
Can affect bones of the pelvis, thighs, upper arms and ribs. Normally responds to radiation therapy. |
