Childhood cancer symptoms can be easily missed - here's what to look out for

While childhood cancer is relatively rare, it remains the leading cause of disease-related mortality among children under 15 in the UK. Alarmingly, fewer than one-third of parents express confidence in recognizing its symptoms.

Annually, approximately 1,900 children aged between 0 to 14 are diagnosed with cancer, as reported by Cancer Research UK.

Thirteen-year-old Amelia Carroll, now in remission, received her diagnosis of acute myeloid leukaemia (AML) last year. Her mother, Gemma, recounts that the initial symptoms were subtle and easily overlooked.

Amelia exhibited significant tiredness and experienced breathlessness after light exercise, both of which were attributed to lack of fitness and typical post-school fatigue. It was only when Amelia began developing unexplained bruises that Gemma realized something was amiss, leading to a diagnosis of leukaemia within ten days.

What are the symptoms to look out for?

Professor Bob Phillips, a paediatric oncologist, emphasizes the importance for parents to monitor for clusters of persistent or worsening symptoms. It is advisable to contact a healthcare professional if a child exhibits:

• Extreme tiredness
• Noticeable paleness
• Unexplained bruising
• Lumps that persist, grow, or do not resolve over time

In children, cancer can progress much more quickly than in adults, primarily due to their growth patterns.

Experts, including Phillips from the Children and Young People's Cancer Association (CCLG), are promoting a national campaign designed to elevate awareness and enhance diagnostic timeliness. One key component of this campaign is the "rule-of-three" for healthcare professionals: if a child presents three persistent symptoms, has visited their physician three times, or has endured three weeks of unexplained symptoms, a referral should be considered.

It is important to note that survival rates for childhood cancer have seen significant improvement since the 1970s, with approximately eight out of ten children surviving for five years or more following diagnosis.

Amelia's story

Amelia's experience with cancer began with an unexpected red bruise, according to Gemma. Within three days, she developed additional bruises down both shins, which were sore and raised.

"During a routine optician appointment, they noticed several burst blood vessels but were uncertain of the cause," Gemma explains.

Within ten days, doctors diagnosed the type of leukaemia Amelia had, and she was admitted to the hospital for treatment.

"On the day of her diagnosis, I spoke with her and she asked me, 'Do I have cancer?' I confirmed that she did and she wanted to know if she was going to die," Gemma recalls.

"I reassured her that the medical team was committed to her care with a comprehensive treatment plan aimed at combating the cancer."

Currently, Amelia is in remission, undergoing regular blood and bone marrow tests every three months, and has returned to school.

According to Phillips, the survival rate for childhood cancer in the UK exceeds 80%, though earlier diagnosis could result in less aggressive treatment regimens.

While around half of children diagnosed with cancer receive their diagnosis within two weeks, Phillips notes, "Although this is relatively fast, we aim to reduce the wait time for the other half, who may experience delays of 16 to 25 weeks from the first symptoms to diagnosis."

Cancer Research UK reports that there are over 400,000 new cancer diagnoses each year in the UK, with only 54% of patients receiving a diagnosis within the 28-day NHS target period, according to the British Medical Journal (BMJ).

Additionally, 2,300 teenagers and young adults (aged 15–24) are diagnosed each year.

Jake's story

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

Prior to his diagnosis, Jake's symptoms, including a stuffy nose and watery eyes, were initially attributed to hay fever, and his post-school sleepiness was thought to be a result of end-of-term fatigue.

"It was only when a swelling appeared across the bridge of his nose that we decided to consult the GP," Lynsey said. "At that time, we did not connect the fatigue and hay fever symptoms."

A mass was discovered in Jake's nasal cavity, leading to a diagnosis of soft tissue sarcoma. He underwent nine rounds of chemotherapy and proton beam radiation.

After experiencing complications, including seizures and severe malaise from chemotherapy, Jake chose to discontinue treatment.

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

"I believe the most significant aspect regarding Jake was that he was not afraid of death. We had many discussions about it, and his primary concern was, 'Will people remember me? Will I be forgotten?'

"That is why I am sharing our story, to ensure that Jake's memory endures and that people recognize the extraordinary person he was. In this effort comes the critical aspect of raising awareness, which I believe is his enduring legacy."