Within the framework of childhood cancer awareness month, the National Cancer Institute (INC) and the Argentine Society of Pediatrics held a conference entitled: When to suspect cancer in children and adolescents?

d Cancer Day was instituted in Luxembourg in 2000 and commemorated every February 15: every child or girl has the highest quality treatment possible. In this sense, he pointed out that inequality is a threatening issue and not only regarding childhood cancer.

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Families are not prepared or alerted to suspect that a child may have this problem.

Then, Dr Moreno presented a video in which she explained various aspects related to the topic, such as, for example, what are the factors that delay diagnosis and the most frequent non-specific signs and symptoms, which can allow the health professional to infer the existence of cancer in the patient.

  • Some data on the incidence of childhood cancer in Argentina
  • The objective of the early detection program for children with cancer
  • Improve the child’s prognosis and reduce premature mortality.
  • Provide the patient with less intense treatments with fewer complications.
  • Reduce organic and psychological sequelae.
  • Lower economic cost.
  • Factors delaying diagnosis

Another variable is usually the delay in the consultation of the parents. But, in Argentina, various studies concluded that it is not a determining variable. “Our parents consult many times,” stressed the specialist. And she added that this is essential information because detecting the first symptoms is a family task.

Knowledge and aptitude of the health team

Dr Moreno proposed that it is essential for each hospital to have, at the institutional level, an algorithm for monitoring the suspected diagnosis of the patient. Whether admitted for trauma, surgery or neurosurgery, there must be communication between the different areas with the pediatric oncology service as soon as there is a suspicion of pediatric cancer. On the other hand, the time that elapses between diagnosis and treatment also extends more than necessary due to a lack of drugs or supplies, and that cannot happen.

Most common nonspecific signs and symptoms of childhood cancer

Fever, purpura and anaemia

Patients who present any of these symptoms should be transferred urgently to a unit with intensive care. It is an infectious emergency, regardless of whether it is oncological or not. Before referral, all necessary measures must be taken: cultures, hydration, and initiation of antibiotic treatment.

Acute leukaemias can produce these types of symptoms. The highest incidence is observed between 3 and 5 years. The most common forms of presentation involve paleness, intermittent osteoarticular pain, tachycardia, fever, bleeding, and severe infections. Diagnosis is by bone marrow puncture or aspiration and lumbar puncture.

It can be thought that it is a tumour situation when:

  • The nodes are more significant than 2 or 3 cm.
  • They are not painful.
  • They adhere to deep planes.
  • They partially respond to treatment.
  • They last in time.

lymphomas

The highest incidence is seen after ten years of age. 48% of cases correspond to Hodgkin’s lymphoma and 52% to another type of lymphoma.

Among the forms of presentation, cervical, axillary, and inguinal lymphadenopathy, weight loss, itching, night sweats, prolonged fever, abdominal pain, diarrhoea, vomiting, and bloating stand out.

For the physical examination, it is necessary to consider the adenopathies and perform good palpation of the abdomen.

Diagnosis is made by biopsy.

In the case of lymphoma, the most appropriate treatment is chemotherapy. For high-risk patients, radiotherapy is diagnosed.

In all cases, Dr Moreno stressed that the material extracted through the biopsy must be studied by a pathologist with experience in childhood oncology.