Childhood cancer symptoms - what to look out for

While childhood cancer is relatively rare, it remains the leading cause of disease-related fatalities among children under 15 in the UK. Alarmingly, fewer than one-third of parents report feeling confident in identifying its symptoms.

According to Cancer Research UK, approximately 1,900 children aged 0-14 are diagnosed with cancer each year.

Thirteen-year-old Amelia Carroll, currently in remission, was diagnosed last year with acute myeloid leukaemia (AML). Her mother, Gemma, reflects on how the initial symptoms were easily dismissed.

Amelia exhibited extreme tiredness and shortness of breath after light exertion, which were attributed to a lack of fitness and post-school fatigue. It wasn’t until Amelia began developing bruises that Gemma sensed something was wrong—ten days later, Amelia received her leukaemia diagnosis.

What are the symptoms to look out for?

Professor Bob Phillips, a paediatric oncologist, emphasizes the importance of monitoring for clusters of symptoms that are persistent, worsening, or increasing in size. Parents should consult their physician if their child displays any of the following:

• Severe tiredness
• Noticeable paleness
• Unexplained bruising
• Lumps or bumps that are enlarging or do not diminish over time

Cancer can progress in children at a significantly faster rate than in adults due to their growth. Experts, including Phillips from the Children and Young People's Cancer Association (CCLG), advocate for a national initiative aimed at enhancing awareness and reducing diagnosis times.

This initiative includes a rule of three for healthcare professionals: If a child has exhibited three consistent symptoms, has visited their doctor three times, or has experienced three weeks of unexplained symptoms, a referral should be considered.

It is worth noting that survival rates have improved markedly since the 1970s, with eight out of ten children surviving beyond five to ten years post-diagnosis.

Amelia's experience

Amelia's journey with cancer commenced with a solitary red bruise that appeared suddenly, as recounted by Gemma. Just three days later, she developed additional bruises along both shins that were raised and painful.

"During a routine visit to the optician, they observed some burst blood vessels but were uncertain as to why," Gemma notes. Within a week and a half, doctors identified the specific type of leukaemia Amelia had, leading to her hospital admission for treatment.

"On the day of the diagnosis, I explained to her that she had cancer. She asked me if she was going to die. I assured her that the medical team was doing everything possible and had a comprehensive treatment plan in place to combat the cancer."

Currently in remission, Amelia undergoes regular bone marrow and blood tests every three months and has returned to school. Phillips asserts that while survival rates for childhood cancer in the UK exceed 80%, earlier diagnosis could result in reduced treatment intensity.

Improving diagnosis times

Across the UK, around 50% of children diagnosed with cancer receive their diagnosis within a two-week period, according to Phillips.

"While this is a prompt turnaround, we strive for the other half not to endure waits of 16, 18, 20, or even 25 weeks from their initial symptoms to diagnosis."

Data from Cancer Research UK indicates that over 400,000 new cancer cases are diagnosed each year in the UK, with only 54% receiving a diagnosis within the NHS 28-day target, as reported by the British Medical Journal (BMJ). Additionally, approximately 2,300 teenagers and young adults aged 15-24 are diagnosed annually.

Jake Swinscoe's story

Lynsey Swinscoe is the mother of Jake, who succumbed to soft tissue cancer at the age of 13. Jake was diagnosed in July 2023 with stage three fusion-positive alveolar rhabdomyosarcoma.

Prior to his diagnosis, Jake's initial symptoms—including nasal congestion and watery eyes—were attributed to hay fever, while his fatigue after school was considered typical end-of-term tiredness.

"It wasn't until he developed swelling across the bridge of his nose that we decided to consult a GP," Lynsey recalls. "At that stage, we didn’t connect his fatigue and hay fever symptoms."

A mass was eventually discovered in Jake’s nose and nasal cavity, leading to his diagnosis of soft tissue sarcoma. Following nine rounds of chemotherapy and proton beam radiation, Jake opted to discontinue treatment due to adverse effects, including seizures and severe illness.

Jake peacefully passed away at home on April 26, 2024, just two weeks shy of his 14th birthday.

"I believe the most significant aspect of Jake’s journey is that he wasn't afraid to die. We engaged in many discussions about mortality, and his primary concern was whether people would remember him after he was gone.

"This effort is dedicated to ensuring that Jake’s memory endures and that people recognize how remarkable he was. Raising awareness about cancer is integral to honoring his legacy."