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in collaboration with
Daniel Orbach (Pediatrician specializing in oncology)
Parents, do you know the symptoms that can suggest pediatric cancer? This is not often the case, according to a survey carried out in England. Only 1 in 10 adults experience these sometimes subtle signs. What are the symptoms to be aware of, how to react? We talk about it with Dr Daniel Orbach, pediatrician at the Institut Curie.
Two thirds of adults are not sure they can detect a telltale sign of cancer in their own child. This is the finding established by the University of Nottingham and childhood cancer charities, after surveying 1,000 adults on the subject. And you, could you recognize an alarming sign?
Parents insufficiently informed about pediatric cancers
On average, according to the researchers, the participants recognized only 11 signs mentioned out of 42 in total. Just under half were aware that lumps or swellings, particularly in the breast or testicles, were potential symptoms of cancer. Blood in the urine or stool, changes in moles, and weight loss were other recognized signs.
But other, more subtle signs of cancer meant little to concerned parents:
- Early or late puberty;
- Developmental delay, even in a baby;
- Slow recovery after a bone injury such as an arm fracture;
- Difficulty swallowing…
According to the authors, the results carried out on the 42 equivocal signs showed the need for an education campaign on the signs of childhood cancer. “Raising awareness has been seen as a key strategy for early cancer diagnosis in the UK, but little attention has been given to childhood cancers”they wrote. “The perceived rarity of cancer in children constitutes a major barrier to early diagnosis (…) Although the number of cases may be low compared to cancers in adults, the cumulative risk from birth to the start of adulthood is comparable to that of other childhood illnesses” However, the authors warn.
The parent-doctor relationship, the key to detecting cancer
Consulted on the subject, Dr Daniel Orbach, pediatrician specializing in oncology at the Institut Curie, explains to us that it is however complicated to spot cancer, for parents or even for a general practitioner, at least in one case. consultation only.
“Childhood tumor is a very rare disease. It is considered that a general practitioner in his entire career will see on average only one child with cancer. In addition, the different cancers can have very different presentations. polymorphic, whether the tumor is in the eye, the stomach, in the brain or even in the bone. There are no “easy” or unique clinical signs that can say “Beware!” “.
According to him, spotting a sign of cancer has more to do with a monitoring attitude to adopt with your doctor than with a specific symptom:
“The most important message is above all to say that when your child has a symptom that you do not know about, then it is necessary to see your doctor again, or for him or her to reschedule you within 2- 3 weeks to check that it has really disappeared or if other examinations are necessary. However, in France, we too often experience medical nomadism. That is to say, when a symptom persists, the parents often take the decision to see another doctor. This is an error and represents a return to square one. If a doctor sees the same child again for the same symptom, then he will undertake more in-depth examinations. This saves time in the possibility of cancer.
The most evocative signs according to our expert
If it is therefore not possible to list all the symptoms which would suggest cancer, Dr Orbach nevertheless goes over the most common pediatric cancers and the signs which should nevertheless alert you and invite you to consult.
- A white spot in the retina, called leukocoria, is not a classic symptom and should prompt you to consult an ophthalmologist urgently (via your doctor, without waiting 3 months). This white spot may be a sign of retinoblastoma;
- Bone painwhich last more than 15 days, and are unilateral, in one leg for example, you should consult;
- Nocturnal pain must question you. “A migraine is functional, and does not last overnight. A brain tumor, on the other hand, will be painful at night”;
- Any symptoms that last more than 15 days without reason ;
- A balla desensitized nerve problem should also invite you to consult.
Regarding the lymph nodes, the starting point most suggestive of cancers, the pediatrician clarifies an essential point: “Parents often worry about an inflamed, painful lymph node with fever. However, in this case, 99% of these are lymph nodes linked to a simple virus. The cancerous node, on the contrary, grows slowly, is not inflamed or painful, and appears fixed and hard. In this case without any improvement, this can suggest multiple things including lymphoma.”
Last thing to know, tiredness in a child is not necessarily a sign: “We expect that cancer makes children very tired, but ultimately there are very few tired children. This can be misleading because the parent who sees an unusual bump says to themselves “yes but he is doing very well”. Data you need to know to better protect your children
As a reminder, in France each year, around 2,300 children and adolescents are newly diagnosed with cancer. Even if the 5-year survival rate now exceeds 80%, these cancers remain the leading cause of death from disease in children over 1 year old, we read on the website of the National Cancer Institute.
The 42 signs of cancer in children and the percentage of adults who recognized them
- Lump/swelling of the pelvis, testicles or breast: 46%
- Blood in urine or stool: 44%
- Changes in moles: 43%
- Chest wall or armpit lump/swelling: 41%
- Weight loss: 40%
- Abdominal distension/mass: 38%
- Lump/swelling in face, jaw and skull: 36%
- Persistent/recurrent headache: 32%
- Fatigue or persistent/recurrent fatigue: 32%
- Loss of appetite: 31%
- Persistent vomiting: 31%
- Excessive bleeding/bruising/rash/petechiae (a type of rash): 30%
- Convulsions or seizures: 29%
- Chest wall or armpit pain: 29%
- Unexplained swelling of bones or joints: 27%
- A change in bowel habits – constipation or diarrhea: 27%
- Persistent/recurrent/progressive abdominal pain or discomfort: 26%
- Difficulty urinating: 26%
- Vision problems: 26%
- Swollen glands: 26%
- Deterioration of balance, walking and speaking: 23%
- Persistent/recurring pain in bones or joints, worse at night: 23%
- Noticeable paleness of the skin: 22%
- Multiple infections or flu-like symptoms: 22%
- Unexplained bleeding after sex and between periods: 22%
- Fever and night sweats: 21%
- Shortness of breath: 21%
- Difficulty swallowing: 21%
- Lameness or unexplained weakness: 20%
- Persistent/recurring unexplained cries in young children: 19%
- Persistent/recurrent sore throat or hoarse voice: 18%
- Torticollis/head tilt or neck stiffness in young children: 18%
- Leukocoria: 18%
- Hearing loss: 17%
- Abnormal eye movements: 17%
- Abnormal facial movements: 16%
- Persistent earache: 16%
- Limited mouth opening: 14%
- Slow recovery after bone or joint injury: 14%
- Slow growth: 13%
- Developmental delay in young children under two years old: 11%
- Early or late puberty: 10%