Features of pediatric oncology. Cancer in a child: symptoms and treatment. Why do children get cancer? Children's Cancer Center

Oncological educational program: why children get cancer and how to recognize the first symptoms Since the beginning of autumn, every Monday on E1.RU there have been interviews with oncologist specialists who talked about cancer diseases different organs and their treatment. Today, on the last day of November, we are closing the “Oncological educational program” section and in the final publication we propose to talk about pediatric oncology: how children develop malignant tumors and can this be prevented or at least noticed in time? We asked these questions to the pediatric surgeon-oncologist of the Regional Children's clinical hospital N 1 to Sergei Tuponogov. – Sergei Nikolaevich, why do very young children get cancer? After all, they don’t have bad habits, like adults, and radiation and other environmental factors have not yet had time to affect them? Who is to blame for this - nature or parents? – Oncological diseases in children of the first years of life are mostly manifestations various violations, which occurred during the formation of its organs and tissues during pregnancy. This could have been caused by smoking of the mother or other relatives, others bad habits or the same radiation. The genetic factor is also very important. For example, in our center, two children were operated on for kidney cancer; they had the same father and different mothers. It turned out that their father passed on the gene that caused cancer to them. Therefore, it is quite difficult to say unequivocally who is to blame here. Of course, the child himself is not to blame for anything. There are genetic damages that occur during pregnancy in a mother who monitors her health very strictly. There is also something that is inherited initially, and this can be prevented if married couple at the stage of planning the birth of a child, consult with medical geneticist. And, of course, you should definitely consult a geneticist if children in the family have already suffered from cancer. We now know several syndromes when certain developmental defects in children are combined with cancer. In such families, parents need to take the birth of children and their future health very seriously. - Behind last years Are children getting cancer more often? – Yes, we have seen an increase in the incidence of children in the last 10-15 years. Every year in Yekaterinburg and Sverdlovsk region we detect about 150 cases cancerous tumors in children. But cancer today – and, probably, my oncologist colleagues have already told you about this – is not a death sentence at all. If a child’s tumor is detected in the first or second stage, when there are no metastases or growth into surrounding tissues, then there is a chance of full recovery very high. We cure 90% of children with such stages, and they continue to live full life. If cancer is discovered late, then, of course, it will be more difficult to help the child. But even here the percentage of recovered people is quite high - 70%. How younger child, the better his cancer is treated, says Sergei Tuponogov. – There is some difference in which children tolerate cancer more easily and their specific treatment? – The younger the child, the better his cancer is treated - he tolerates the treatment itself more easily and the long-term results are better. The older you get, the more it occurs. various problems. Added to this is the plus psychological factor, because our older patients already understand what is happening to them. – Does cancer have “favorite” childhood localizations? – In first place among children oncological diseases there are brain tumors. Next in frequency are tumors of the blood system - leukemia, lymphoma, lymphogranulomatosis, tumors of the kidneys and adrenal glands, liver, and bones. There are purely childhood tumors - nephroblastomas, which do not occur in adults. And in children they quickly penetrate into the retroperitoneal space. But children almost never have lung tumors or, if they do, they are benign. Cancers in children are treated differently than in adults. For children, this is a very short episode in life. After the operation, a more important and lengthy part of the treatment begins - chemotherapy. It is carried out in courses that sometimes take years. But the effect it gives in children is completely different than in adults: even metastases from the lungs go away during chemotherapy. – Sergey Nikolaevich, if we talk about early diagnosis cancer in children - what should parents pay attention to? After all, a child himself may not say that something hurts? – From the first months of a child’s life until he reaches adulthood for development malignant neoplasm may indicate increased weakness, depression, apathy, changes in appetite, changes in the child’s behavior, including increased aggressiveness, and causeless mood swings. You also need to pay attention to any pain: in the head, in chest, abdomen, bones, the appearance of any enlarged lymph nodes, or, as they also say, lumps, the appearance of any rashes on the body. Another reason to be concerned is increased bleeding or a tendency to bruise quickly. In all these cases, the child should be shown to a doctor. Unfortunately, it happens that parents, sending their children to several sections at once, regard their complaints as laziness and reluctance to study. But in fact, at this time they lose invaluable time when the child should not be taught, but treated. Chemotherapy in the treatment of childhood cancer can take years, but the effect is much better than in adults. For some reason, precisely in major cities parents, considering themselves educated and enlightened people, do not fulfill the most simple recommendations pediatricians. For example, it is widely accepted that after birth a child needs to have an ultrasound of his organs. abdominal cavity at 1 month, at 6 months, and then at 1 year. But parents don’t have time or they think that their child doesn’t need it because he’s healthy. And such a kid won’t complain about anything. In my opinion, ultrasounds should be done exactly at these times, which, by the way, are prescribed by the clinic. This way we can detect any tumor very early and remove it in time. After a year, ultrasound of the abdominal cavity must be repeated at least 2 times a year until the age of five - and this is even if the child has no complaints at all! After five years, it is enough to do an ultrasound once a year. And at approximately the same frequency, unless otherwise prescribed by the doctor, monitor general analysis blood and general urine analysis. – Sergei Nikolaevich, speaking of diagnostics, when reading the stories of children with cancer, you inevitably pay attention to such facts. For example, a child fell off a bicycle, hit his foot, and then a tumor was found right in that place. Is this a coincidence or can it be explained somehow? – In medicine there is such a term - “pointing finger symptom.” In such cases, you can remember this symptom or, as it can be called even more clearly, the “finger of fate.” But, in my opinion, everything is much simpler and more tragic. When a child falls off a bike and then complains about severe pain in a leg or arm, then this pain is caused, alas, not by a fall, but by a growing tumor. Adults just don't pay attention to it. And they remember about the child’s complaints only when they have already given him terrible diagnosis. We've all fallen off our bikes as children, and if those injuries caused cancer, where would we be now? – One more question, also born from reading numerous publications on the Internet on pediatric oncology. Why are children taken abroad for treatment? How is this treatment different from the one we provide? – Treatment in foreign clinics is not fundamentally different from that provided by Russian doctors. Yes, we don't have enough individual ones yet surgical techniques. Perhaps not all chemotherapy drugs are available somewhere or there are no drugs that are not registered in Russia. But still, in most cases, parents take children abroad for treatment for whom we have exhausted all our possibilities, and treatment abroad is also without guarantees, this is already a gesture of despair. You understand, pediatric oncology is a special branch of medicine. No parent will ever come to terms with the fact that their child can no longer be helped, and I cannot blame anyone for this. Treatment in foreign clinics is not fundamentally different from that provided by Russian doctors. With this interview we close the “Oncological educational program” section. Let us remind you that earlier we talked about one of the most common oncological diseases - skin cancer - with a professor at the Department of Oncology and Medical Radiology of the Ural State medical university Sergei Berzin, about oncological diseases of the blood - leukemia - with the chief hematologist of the Sverdlovsk region Tatyana Konstantinova, and he told us about lung cancer Chief Specialist Ekaterinburg Health Department radiology diagnostics Andrey Tsoriev. We devoted several publications to oncology gastrointestinal tract. We talked about its most terrible localization - pancreatic cancer - with Doctor of Medical Sciences Mikhail Prudkov, and about stomach cancer - with the city's chief surgeon Alexei Stolin. The head of the coloproctology department of the Special Clinical Hospital No. 1, Andrei Oshchepkov, told us about intestinal cancer, and the head of the thoraco-abdominal department of the Sverdlovsk Regional Oncology Center, Yuri Istomin, told us about the oncology of the most vulnerable organ - the esophagus. In addition, we wrote about typical “male” and “female” diseases: the chief urologist of the Sverdlovsk region, Igor Bazhenov, told us about " men's diseases", including prostate cancer and adenoma, and the head of the department of oncomammology of City Clinical Hospital No. 40 Sergei Demidov and the head of the department of obstetrics and gynecology of the Ural State Medical University Tatyana Oboskalova - about the most common and most terrible "female" oncological disease - breast cancer and other dangerous women's diseases. Finally, the chief oncologist of Yekaterinburg Denis Demidov told our readers about how to be properly examined without wasting time and money to identify signs of oncology, and why complex procedures such as MRI or colonoscopy do not always help with this, and the chief surgeon of Yekaterinburg Alexey Stolin talks about why there is no need to be afraid of oncological operations now.

What is cancer? Human body consists of trillions of living cells. Normal “respectable” cells grow, divide and die according to all biological canons. During the growing years of a person, these cells divide more intensively, and later, upon reaching adulthood, they only replenish the loss of dead cells or participate in healing processes.

Cancer begins when individual abnormal cells in a particular part of the body begin to grow and multiply uncontrollably. This general basis for all cancer diseases.

Childhood Cancer Cancer cells grow differently from normal cells. Instead of dying, obeying the dictates of time, cancer cells continue to grow and give rise to new ones atypical cells. These cells have another most unpleasant ability: they penetrate into neighboring tissues, literally growing into them with their tumor “claws”.

But what makes cancer cells so aggressive? Damage to DNA - the brain of the cell, which determines its behavior. Normal cell, if something happened to her DNA, either restores her, or dies. In a cancer cell, the DNA is not restored, however, the cell does not die, as it should have been normally. On the contrary, the cell, as if breaking free from its chain, begins to produce its own kind of absolutely unnecessary for the body cells with exactly the same damaged DNA.

People can inherit damaged DNA, but most damage is caused by failures in cell division or environmental factors. In adults, this may be due to some trivial factors, such as smoking. But most often the cause of cancer remains unclear.
Cancer cells often travel to different parts of the body, where they begin to grow and form new tumors. This process is called metastasis and begins as soon as cancer cells enter the bloodstream or lymphatic system.

Different types of cancer behave differently from each other. Tumors come in different sizes and respond differently to each treatment. This is why children with cancer need treatment that is tailored to their specific case.

How is cancer in children different from cancer in adults?

The types of cancer that develop in children are often different from those in adults. Childhood cancer pathologies are often the result of changes in DNA that occur very early, sometimes even before birth. Unlike adult cancer, childhood cancer is not as strongly linked to lifestyle or environmental factors.

With few exceptions, childhood cancers respond better to chemotherapy. A child's body tolerates it better than an adult. But subsequently, chemotherapy, as well as radiation therapy, can cause delayed side effects, so children who have survived cancer should be under close medical supervision for the rest of their lives.

What are the key statistics on childhood cancer?

Childhood cancer accounts for less than 1% of all cancer cases detected annually in the world's population. Over the past few decades, the incidence of childhood cancer has increased slightly.

Thanks to the improvement of cancer treatment methods, today more than 80% of cancer patients childhood live 5 or more years. If we take, for example, the 70s of the last century, then the 5-year survival rate was only about 60%.

However, the survival rate of cancer patients greatly depends on the type of cancer and a number of other factors. Cancer remains the second most common cause of childhood death after accidents.

The most common types of cancer in children

Leukemia

The term “leukemia” combines cancers of the bone marrow and blood. This is the most common type of cancer in children, accounting for 34% of all childhood cancer pathologies. The most common leukemias are acute lymphocytic leukemia and acute granulocytic leukemia. Common symptoms of these conditions include bone and joint pain, weakness, fatigue, bleeding, fever, and weight loss.

Brain tumors and other nervous system tumors

This cancer accounts for 27% and is the second most common cancer in children. There are many various types brain tumors, treatment methods and medical prognosis for which vary significantly. Most of them begin in the lower regions of the brain, such as the cerebellum and brain stem. Typical clinical picture includes headaches, nausea, vomiting, blurred vision, double vision, disturbances in gait and fine movements. In adults, cancer strikes more often upper sections brain.

Neuroblastoma

Neuroblastoma originates in nerve cells embryo or fetus and manifests itself in newborns or infants, less often in children over 10 years of age. The tumor can develop anywhere, but most often it occurs in the abdomen and appears as a small swelling. This type of cancer accounts for 7% of all cases of childhood cancer pathologies.

Wilms tumor

Wilms tumor affects one or (rarely) both kidneys. It is found, as a rule, in children 3-4 years old. Similar to neuroblastoma, it manifests itself with the same swelling in the abdominal area. May cause symptoms such as fever, pain, nausea and loss of appetite. Among other childhood cancers, Wilms tumor occurs in 5% of cases.

Lymphoma

Lymphoma is a group of cancers that begin in certain cells immune system- lymphocytes. Most often, lymphoma “attacks” lymph nodes or other clusters lymphoid tissue(tonsils, thymus gland), and Bone marrow, causing weight loss, fever, sweating, weakness and swelling of the cervical, axillary and inguinal lymph nodes.

There are two types of lymphoma, both of which can occur in both children and adults: Hodgkin lymphoma and non-Hodgkin lymphoma. Each of them accounts for 4% of general morbidity cancer in children. Hodgkin's lymphoma is most common in two age groups: from 15 to 40 years and over 55 years. In this sense, non-Hodgkin's lymphoma is more common in children, which is more aggressive, but responds well to treatment compared to similar cases in adults.

Rhabdomyosarcoma

Rhabdomyosarcoma affects muscle tissue. It can be found in the neck, groin, abdomen and pelvis, and in the extremities. Among all types of soft tissue sarcomas in children, rhabdomyosarcoma is the most common (3% in the overall picture childhood cancer).

Retinoblastoma

Retinoblastoma is eye cancer. In children it occurs in 3% of cases, usually under the age of 2 years. Detected by parents or an ophthalmologist thanks to following feature: Normally, when the pupil is illuminated, the eye appears red due to blood vessels back wall eyes, and with retinoblastoma the pupil appears white or pink. This can also be seen in the photograph.

Bone cancer

Of this group of cancers, osteosarcoma and Ewing's sarcoma are the most common in children.

Osteosarcoma is most common in adolescents and usually develops in areas where bone tissue grows most actively: near the ends long bones limbs. It often causes bone pain, worse at night or when motor activity, as well as swelling in the affected area.

Ewing's sarcoma develops less frequently than osteosarcoma (1% versus 3%). The most likely place of its habitat is the pelvic bones or chest wall(ribs and shoulder blades), as well as bones lower limbs.

Is it possible to prevent cancer in children?

Unlike adults, children do not have any lifestyle factors (such as smoking) that could contribute to the development of cancer. Scientists have linked childhood cancer to only a limited number of environmental factors that can cause cancer. One of them is radiation. And even then, in most cases, this applies to those cases where exposure to radiation is mandatory, for example, radiation therapy in the treatment of some other type of cancer (it turns out that they are treating one cancer, thereby causing another). Therefore, if a child develops cancer, parents should not reproach themselves, because They are unable to prevent this disease.

Very rarely, a child may inherit certain genetic mutations from his parents that make him susceptible to certain types cancer. IN similar cases An oncologist may recommend so-called preventive surgery, when an organ in which there is a high probability of developing a tumor is removed. Again, this happens very, very rarely.

Signs of cancer in children

Childhood cancer can be very difficult to recognize, mainly because its symptoms overlap with many common illnesses and injuries. Children often get sick and often have bumps and bruises, but all these manifestations of a “golden childhood” can mask early signs of cancer.

Parents should be confident that their child is undergoing regular medical examinations in the garden or school, and carefully monitor all unusual and persistent symptoms yourself. These symptoms include:

• unusual swelling or lumps;
• unexplained weakness and pallor;
• tendency to form hematomas;
• constant pain in a specific area of ​​the body;
• lameness;
• unexplained and persistent fever and soreness;
• frequent headaches, sometimes accompanied by vomiting;
• sudden visual disturbances;
• rapid weight loss.

Most of these symptoms, fortunately, turn out to be a sign of some kind of infectious disease or injury. However, parents should always be on guard. And those children who inherited unfavorable genetic changes from their parents should be under constant medical and parental supervision.

Treatment of cancer in children

The choice of treatment for childhood cancer depends mainly on its type and stage (extent of spread). The treatment program may include chemotherapy, surgery, radiation therapy and/or other treatments. In most cases, combination treatment is used.

With some exceptions, childhood cancer responds well to chemotherapy. This is due to his tendency to rapid growth, and most chemotherapy drugs act specifically on fast-growing cancer cells. Children's bodies generally recover better from high doses of chemotherapy compared to adults. Using more intensive treatment options offers a greater chance of eventual success, but at the same time increases the risk of short-term and long-term side effects. In this regard, the oncologist must do everything possible to balance the patient's need for intensive treatment with possible risk occurrence of unwanted side effects.

Survival rates for childhood cancer

So, according to statistics from the American Cancer Society, based on information obtained for the period from 2002 to 2008. 5-year survival rates for pediatric cancer patients for the most common types of cancer are as follows:

• leukemia - 84%;
• cancer nervous system, incl. brain - 71%;
• Wilms tumor (kidney cancer) - 89%;
• Hodgkin's lymphoma - 96%;
• non-Hodgkin's lymphoma - 86%;
• rhabdomyosarcoma - 68%;
• neuroblastoma - 75%;
• osteosarcoma (bone cancer) - 71%.

Of course, these indicators are generalized and cannot serve the only source for estimates and forecasts in each specific case. Much is determined by the type of cancer, as well as factors such as the child's age, the location and size of the tumor, the treatment received, and the responsiveness of the cancer cells to it.

Subsequent side effects

Treatment of childhood cancer requires special approach, based on careful medical monitoring of the patient after treatment. After all, the sooner they are identified possible problems, the easier it will be to eliminate them. A patient who has overcome cancer, in any case, runs the risk of experiencing a number of delayed side effects associated with the treatment undergone. These negative effects may include:

• lung problems (caused by certain chemotherapy drugs or radiation therapy);
• stunting and physical development(including the musculoskeletal system);
• deviations in sexual development and possible infertility;
• learning disabilities;
• increased risk of new cancer pathology.

Signs of cancer in infants

Sad statistics show that no one is protected from such a dangerous and sometimes incurable disease as oncology. This diagnosis is made not only to adults, but also to children, even infants. Sometimes it begins to develop in the womb and leads to the death of the fetus. But if immediately after birth doctors discover malignancy, then the child can still be saved by undergoing surgery on time, or by performing other treatment methods for recovery.

Signs of a possible disease in a newborn

If a child has cancer, then his behavior becomes characteristic and it is important for parents not to ignore these signs, but to consult an oncologist or pediatrician. Obvious signs include:

1. The child develops lethargy and indifference to games and toys.
2. Appetite disappears and sleep is disturbed.
3. The child is losing weight.
4. Celebrated for no reason.
5. Unreasonable nausea and vomiting, or constipation appears.
6. Frequent pain in the abdomen or bones.
7. Paleness not only of the face, but also of the whole body.
8. The stomach grows for no reason.
9. The nose often bleeds and bruises appear on the body.

All these signs may indicate the presence of a tumor, and it is important that neither parents nor pediatricians miss them, otherwise time may be lost. For every 100,000 children under 4 years of age, 10-15 children are diagnosed with cancer every year. It is important to determine its presence on early stages, then the probability effective treatment will be 95-97%. But experts note that only 10% of the total number of sick children are admitted to hospitals. And 70-75% are admitted to hospitals at stages 3 and 4 of the disease due to the inattention of parents and the inability to diagnose oncology by the local pediatrician.

Oncological diseases in children and their signs

Each cancer has certain signs that differ significantly depending on its nature and type. Here you can list the most common cancer diseases, which include:

1. Leukemia. The child may appear pale skin, lethargy, fatigue, nosebleeds, bruises. Then the baby becomes capricious and any movements cause him discomfort - the point is pain in joints and bones. The abdomen becomes enlarged due to damage to the spleen, liver, and lymph nodes. The child is also bothered by headaches, which he cannot talk about and only screams.
2. Tumor of the brain and spinal cord. Here the signs appear more clearly. Headaches in the morning, morning vomiting, convulsions.
3. Nephroblastoma. This is a kidney tumor, which is manifested by a dense formation in the abdomen, which you can feel with your hands yourself.
4. Neuroblastoma. These are malignant tumors of the sympathetic nervous system. Characterized by an enlarged abdomen, which can be felt, protrusion eyeball, if the tumor is in the neck, pain in the bones.
5. Retinoblastoma. Cancer cells affect the eyes. There is a glow and dilation of the pupil, squint, and pain in the eyes.
6. Rhabdomyosarcoma. A soft tissue tumor, which is quite common. Signs include tissue lumps, usually painless, abdominal pain, vomiting, and nasal discharge.
7. Bone tumor. The main symptom is bone pain, which manifests itself intensely at night. Since an infant cannot tell what is bothering him, parents have to cope with the baby’s nightly tantrums, while not a single medicine helps or their effect does not last long, which should alert parents.
8. Lymphoma. Lymphogranulomatosis or Hodgkin's lymphoma ranks 3rd among all tumors in children. This is the defeat of one or more lymph nodes what appears in the baby night sweats, temperature, skin itching, difficulty breathing, cough.

These are symptoms of cancer in children. Infants cannot tell their mother what and how it hurts, so mothers should carefully look at the child’s behavior while crying and often examine and palpate the baby for lumps.

Oncology in newborns

Most often, neuroblastoma is diagnosed in infants and children under one year of age. It develops from embryonic nerve tissue and it happens that cancer cells degenerate and become benign, or may even disappear completely. This is called ripening, when the cells did not have time to mature in the mother’s womb for some reason. But more often this tumor metastasizes and has to be treated with radioactive iodine, which accumulates in the tumor and destroys it.

In second place in newborns is a blood disease - leukemia, it is localized in the bone marrow and gradually displaces healthy tissues that produce blood elements. The child has frequent infectious diseases and vascular bleeding. It is treated with a bone marrow transplant, and before surgery, chemotherapy and radiation are given to maintain the life of the sick child.

In third place in childhood oncology are tumors urinary system. A kidney tumor begins to form in the embryonic period and in initial stage It is painless and can only be detected if it grows significantly. The only treatment for such formations is surgical - removal of the kidney and nearby tissues, and before the operation a course of chemotherapy is carried out for possible reduction. The presence of nephroblastoma in children is considered the most curable pathology.

No matter how sad the topic of childhood oncology is, it exists and only its timely detection can give the child a chance to be cured. This depends on the attentiveness and responsibility of parents and doctors, who cannot always give this terrible diagnosis to a child. You need to pay more attention to your child and not ignore even the slightest change in the baby’s condition and behavior. After all, cancer is not a death sentence - there is still an opportunity to fight for the life of your loved one.

There are answers to the question of why adults get cancer. For example, poor nutrition for a long time, bad habits, negative impact environment and heredity. To the question of why children get cancer, scientists and doctors are still looking for an answer. The two mentioned reasons most often influence the development of the disease in children. This is ecology and heredity. What else causes cancer in a child? About what types of diseases occur in children, about the causes, symptoms of diseases, diagnosis and modern methods treatment - more on this later in the article. So, in order.

Causes of cancer in children. Which?

Environmental influences and heredity. It is these two reasons that most often influence the development of cancer in children that scientists identify. What does it mean?

From how much good health parents have, the health of the unborn child will also depend. The statistics are inexorable. Children born 25-30 years ago were stronger than the current generation. This is affected, first of all, by the lifestyle of the parents.

The health of the unborn child largely depends on the parents

When planning pregnancy, doctors advise parents to give up bad habits and strengthen the body. In addition to addictions to nicotine and alcohol, there are factors that have a direct impact on children:

Poor quality maternal nutrition during pregnancy;

Working in hazardous work while pregnant;

Environmental impact;

Taking medications;

Radioactive radiation;

Previous abortions;

Premature birth;

Lack of breastfeeding.

The reasons for the development of cancer in children can also include the presence of infections and viruses in the blood of the expectant mother. The woman's age also matters. The younger expectant mother, the stronger the baby. Conversely, the older the woman who gave birth, the higher the chances of developing cancer in the child. The same can be said about men. Addiction to alcohol, nicotine, and in some cases to narcotic substances, will affect the future generation. And the age of the future father, like the mother, matters.

Ecology and genetic mutations

The environment in which the baby lives cannot be discounted. Poor environmental or living conditions can cause cancer in a child. In turn, unfavorable environment may contribute to genetic mutation. It will cause cancer. Currently, the state of water, air, and soil leaves much to be desired. The air in megacities is polluted by industrial production and exhaust gases. The soil is susceptible to contamination with heavy metals. In some regions, people live in houses built using radioactive materials.

And that's not it. There are other reasons that contribute to the development of cancer in children, which can also be attributed to external factors impacts:

Long-term use of medications;

Sunburn;

Viral infections;

Passive smoking;

Stressful situations.

Modern practices abroad

Important point. Modern genetics makes it possible to determine the presence of mutations and hereditary pathologies that can lead to the development of cancer in a child. What does it mean? In many Western countries, genetic testing is a common method for couples wishing to start a family. But even this method does not give one hundred percent certainty whether the disease will manifest itself or not.

Symptoms of oncology in children: what parents and doctors should pay attention to

What to do? What are the symptoms of cancer in children and how do they manifest themselves? Doctors talk about cancer alertness. This means that pediatricians and parents should be aware of simple symptoms, which may be harbingers of a serious illness. They must be careful.

It often happens that the first signs of cancer in children are disguised as common illnesses. There are many such cases. If the disease does not respond traditional methods treatment and proceeds atypically - this is already a reason to contact specialized specialists. They, in turn, will order tests for cancer. Parents' dislike of visiting clinics and standing in line to see a doctor often leads to big problems. Sometimes mothers don't pay enough attention to alarming symptoms, mistaking them for fatigue, overwork, ordinary indigestion or a cold that does not go away for a long time.

Fatigue, lethargy, apathy, loss of appetite and weight loss, heat, vomiting, swollen lymph nodes... This possible symptoms blood cancer in children.

Facial swelling, weakness, elevated temperature, sweating, pallor - signs of a malignant kidney tumor, neuroblastoma. Pain in the eye, the appearance of strabismus are symptoms of retinoblastoma.

Diagnosis: What cancer tests can be used to diagnose the disease in children?

Diagnosing diseases in a child is more difficult than in an adult. Symptoms are most often disguised as other, less dangerous illnesses. Sometimes the disease occurs without any symptoms at all, and is discovered by chance, when general examination. Diagnosis is also complicated by the fact that the child is not always able to correctly formulate a complaint - what, where and how much it hurts. Most often, malignant tumors in children are detected at the stage at which visible anatomical and physiological disorders occur.

To diagnose cancer in children, all research methods that are available in the world are used. modern medicine. For example:

General and special blood tests;

General urine analysis;

X-ray;

Ultrasonography;

Magnetic resonance imaging/computed tomography;

Puncture;

Radioisotope scanning.

For tracking genetic mutations, causing cancer, uses molecular biological research on DNA and RNA.

Pediatric oncology: classification of cancer in children

The classification of cancer in children distinguishes three types of cancer tumors:

1. Embryonic.

2. Juvenile.

3. Adult type tumors.

Embryonic tumors are a consequence of pathology in germ cells. In this case, the tissues of the formations are histologically similar to the tissues of the fetus or embryo. These include blastoma tumors: retinoblastoma, neuroblastoma, hepablastoma, nephroblastoma

Juvenile tumors. Children and adolescents are susceptible to them. Tumors arise as a result of the transformation of a healthy or partially altered cell into a cancerous one. The process during which healthy cells acquire malignant properties, called malignancy. This can affect both completely healthy cells and partially altered cells that do not show malignancy - such as polyps, stomach ulcers. Juvenile tumors include carcinomas, sarcomas, lymphomas, and Hodgkin's disease.

Adult-type tumors are a type of formation that is very rare in children. These include some types of carcinoma, neuroma, and skin cancer in children. But they are treated with great difficulty.

Oncology in children - types of diseases, statistics

The type that is most common among children is leukemia. This name combines cancer of the brain and blood. According to statistics, the share of blood cancer in pediatric oncology is 30%. As you can see, this is a considerable percentage. General symptoms blood cancer in children - fatigue, weakness, fever, weight loss, joint pain.

It ranks second in the frequency of diseases. 27% accounts for of this disease. Brain cancer in children often appears before the age of 3 years. There is a disruption in the development of the embryo in the prenatal period. The reasons may be:

Illnesses of a woman during pregnancy;

Bad habits such as smoking and drinking alcohol;

Complications during pregnancy or childbirth.

Neuroblastoma is a cancer that only affects children. The disease develops in the nerve cells of the fetus. It appears in newborns and infants, less often in older children. Accounts for 7% of all cancer cases.

A disease that affects one, or less often both, kidneys is Wilms tumor. Children under 3 years of age are susceptible to this disease. Often such a tumor is diagnosed at the stage when it manifests itself as abdominal swelling. Wilms tumor accounts for 5% of all such diseases.

Lymphoma is an oncological disease that affects the lymphatic system. This cancer “attacks” the lymph nodes and bone marrow. Symptoms of the disease include swelling of the lymph nodes, fever, weakness, sweating, and weight loss. This disease accounts for 4% of all cancers.

Rhabdomyosarcoma is a cancer of muscle tissue. Among soft tissue sarcomas, this type is the most common. Is 3% of total number cancer in children.

Retinoblastoma - Occurs in children under 2 years of age. The disease can be detected by parents or an ophthalmologist thanks to one distinctive feature manifestations of the disease. When illuminated, a healthy pupil is reflected in red. With this disease, the pupil is cloudy, white or Pink colour. Parents may be able to see the “defect” in the photograph. This disease accounts for 3%.

Bone cancer is a malignant bone tumor, osteosarcoma or Ewing's sarcoma. This disease affects people aged 15 to 19 years.

Osteosarcoma affects the joints where bone tissue grow fastest. Symptoms include painful joints, worsening at night or during periods of active movement, and swelling of the affected area.

Ewing's sarcoma, unlike osteosarcoma, appears less frequently and affects the bones of the pelvis, chest, and lower extremities. Osteosarcoma accounts for 3%, and Ewing's sarcoma - 1% of all childhood diseases.

Lung cancer in children is a type of oncology that is quite rare. The cause of this disease is often parents who are heavy smokers. Passive smoking is one of the causes of the disease. Lung cancer can also be caused by maternal smoking during pregnancy and lactation. The symptoms of the disease are very similar to those of bronchitis, asthma, allergies, and pneumonia. Because of this, cancer is found in neglected form. Parents and doctors should be alert to the following symptoms:

Loss of appetite;

Fast fatiguability;

Frequent coughing or coughing with sputum;

Severe headaches;

Swelling in the neck and face;

Shortness of breath.

Families affected by cancer need to be on guard and not miss initial manifestations diseases. Early diagnosis of any disease is the key to successful treatment.

Methods of treating cancer in children

Treatment of cancer in adolescents and children occurs in special clinics and children's cancer centers. The choice of method is mainly influenced by the type of disease and stage of the disease. Treatment may include chemotherapy, radiation therapy. In some cases, surgery is used. Combination treatment is most often used.

The peculiarity of childhood cancer is its rapid development along with the growing body. At the same time it is also his weak point. Most chemotherapy drugs target fast-growing cancer cells. Unlike an adult, children's body recovers faster and better after chemotherapy. This makes it possible to use intensive treatment methods, but there is a high likelihood of side effects. Therefore, the oncologist must compare the needs of the sick child and maximum dose impact, at the same time - as gentle as possible, which will minimize the impact of negative consequences.

In second place in terms of use is radiation therapy. Radiotherapy is used in combination with surgery or chemotherapy. Using targeted radiation, doctors achieve tumor shrinkage. This makes it easier to remove later. Sometimes only radiation therapy is used, without subsequent surgery.

New techniques are widely used. Low-traumatic surgical interventions, for example, selective blockage of blood vessels (embolization) feeding the tumor. This leads to their significant reduction. Other methods are also used:

Cryotherapy;

Hyperthermia;

Laser therapy.

In some cases, hemocomponent therapy is also used.

Children's Center and Institute named after. P. A. Herzen

Institute of Oncology named after. P. A. Herzen is one of the oldest centers in Russia for the diagnosis and treatment of cancer tumors. Founded in 1903. Currently, this oncology institute is one of the largest government agencies similar profile. He is also widely known at home and abroad.

Children's cancer center, organized on the basis of the institute, conducts successful treatment cancer diseases. In an institution equipped with last word techniques, advanced technologies are used to combat this difficult disease.

At the Institute of Oncology. Herzen developed a technique combination treatment oncological diseases, a method for individual prediction of the response of cancer tumors to therapy, work is underway to create the latest special drugs. Organ-preserving, functionally sparing operations are widely used. This can significantly increase the life expectancy of cancer patients.

In the center you can undergo comprehensive diagnostic examination, get expert advice. If necessary, highly qualified treatment of malignant tumors will be carried out here using modern techniques and the latest equipment.

A little conclusion

Now you know for what reasons a disease such as cancer can occur in children. As you can see, there are a lot of them. We also looked at the symptoms of such ailments. In addition, the article describes methods of their treatment. The main thing to cure a child is to carry out early diagnosis and choose the right treatment.

Cancer education: why children get cancer and how to recognize the first symptoms

A pediatric oncologist surgeon told how children are treated in Russia and abroad.

In the “Oncological educational program” section, the site published several interviews with oncologists who talked about cancers of various organs and their treatment. In this publication, we propose to talk about pediatric oncology: how malignant tumors appear in children and whether it can be prevented or at least noticed in time. We asked these questions to Sergei Tuponogov, a pediatric oncologist at the Regional Children's Clinical Hospital No. 1.

– Sergei Nikolaevich, why do very young children get cancer? After all, they don’t have bad habits, like adults, and radiation and other environmental factors have not yet had time to affect them? Who is to blame for this - nature or parents? class="_">

– Oncological diseases in children in the first years of life are mostly manifestations of various disorders that occurred during the formation of their organs and tissues during pregnancy. This could be triggered by smoking of the mother or other relatives, other bad habits, or the same radiation.

The genetic factor is also very important. For example, in our center, two children were operated on for kidney cancer; they had the same father and different mothers. It turned out that their father passed on the gene that caused cancer to them. Therefore, it is quite difficult to say unequivocally who is to blame here. Of course, the child himself is not to blame for anything.

There are genetic damages that occur during pregnancy in a mother who monitors her health very strictly. There is also something that is inherited initially, and this can be prevented if a married couple, at the stage of planning the birth of a child, consults a medical geneticist. And, of course, you should definitely consult a geneticist if children in the family have already suffered from cancer.

We now know several syndromes when certain developmental defects in children are combined with cancer. In such families, parents need to take the birth of children and their future health very seriously.

– Have children become more likely to get cancer in recent years? class="_">

– Yes, we have seen an increase in the incidence of children in the last 10–15 years. Every year in Yekaterinburg and the Sverdlovsk region we identify about 150 cases of cancer in children.

But cancer today – and, probably, my oncologist colleagues have already told you about this – is not a death sentence at all. If a child’s tumor is detected in the first or second stage, when there are no metastases or growth into surrounding tissues, then the chance of a complete recovery is very high. We cure 90% of children with such stages, and they then live a full life. If cancer is discovered late, then, of course, it will be more difficult to help the child. But even here the percentage of recovered people is quite high - 70%.

– Is there any difference in which children tolerate cancer and their specific treatment more easily? class="_">

– The younger the child, the better his cancer is treated - he tolerates the treatment itself more easily and the long-term results are better. The older you get, the more different problems arise. Plus, there is a psychological factor added to this, because our older patients already understand what is happening to them.

– Does cancer have “favorite” childhood localizations? class="_">

– Brain tumors rank first among childhood cancers. Next in frequency are tumors of the blood system - leukemia, lymphoma, lymphogranulomatosis, tumors of the kidneys and adrenal glands, liver, and bones. There are purely childhood tumors - nephroblastomas, which do not occur in adults. And in children they quickly penetrate into the retroperitoneal space. But children almost never have lung tumors or, if they do, they are benign.

Cancers in children are treated differently than in adults. For children, this is a very short episode in life. After the operation, a more important and lengthy part of the treatment begins - chemotherapy. It is carried out in courses that sometimes take years. But the effect it gives in children is completely different than in adults: even metastases from the lungs go away during chemotherapy.

– Sergey Nikolaevich, if we talk about early diagnosis of cancer in children, what should parents pay attention to? After all, a child himself may not say that something hurts? class="_">

– From the first months of a child’s life until he reaches adulthood, the development of a malignant neoplasm can be indicated by increased weakness, depression, apathy, changes in appetite, changes in the child’s behavior, including increased aggressiveness, and causeless mood swings. You also need to pay attention to any pain: in the head, chest, abdomen, bones, the appearance of any enlarged lymph nodes, or, as they also say, lumps, the appearance of any rashes on the body. Another reason to be concerned is increased bleeding or a tendency to bruise quickly.

In all these cases, the child should be shown to a doctor. Unfortunately, it happens that parents, sending their children to several sections at once, regard their complaints as laziness and reluctance to study. But in fact, at this time they lose invaluable time when the child should not be taught, but treated.

For some reason, it is in large cities that parents, considering themselves educated and enlightened people, do not follow the simplest recommendations of pediatricians. For example, it is widely accepted that after birth a child should have an ultrasound of the abdominal organs at 1 month, at 6 months, and then at 1 year. But parents don’t have time or they think that their child doesn’t need it because he’s healthy. And such a kid won’t complain about anything.

In my opinion, ultrasounds should be done exactly at these times, which, by the way, are prescribed by the clinic. This way we can detect any tumor very early and remove it in time. After a year, ultrasound of the abdominal cavity must be repeated at least 2 times a year until the age of five - and this is even if the child has no complaints at all! After five years, it is enough to do an ultrasound once a year. And at approximately the same frequency, unless otherwise prescribed by the doctor, monitor a general blood test and a general urinalysis.

– Sergei Nikolaevich, speaking of diagnostics, when reading the stories of children with cancer, you inevitably pay attention to such facts. For example, a child fell off a bicycle, hit his foot, and then a tumor was found right in that place. Is this a coincidence or can it be explained somehow? class="_">

– In medicine there is such a term - “pointing finger symptom.” In such cases, you can remember this symptom or, as it can be called even more clearly, the “finger of fate.” But, in my opinion, everything is much simpler and more tragic. When a child falls off a bicycle and then complains of severe pain in his leg or arm, then this pain is, alas, caused not by the fall, but by a growing tumor. Adults just don't pay attention to it. And they remember about the child’s complaints only when he has already been given a terrible diagnosis. We've all fallen off our bikes as children, and if those injuries caused cancer, where would we be now?

– One more question, also born from reading numerous publications on the Internet on pediatric oncology. Why are children taken abroad for treatment? How is this treatment different from the one we provide? class="_">

– Treatment in foreign clinics is not fundamentally different from that provided by Russian doctors. Yes, we still do not have enough individual surgical techniques. Perhaps not all chemotherapy drugs are available somewhere or there are no drugs that are not registered in Russia. But still, in most cases, parents take children abroad for treatment for whom we have exhausted all our possibilities, and treatment abroad is also without guarantees, this is already a gesture of despair. You understand, pediatric oncology is a special branch of medicine. No parent will ever come to terms with the fact that their child can no longer be helped, and I cannot blame anyone for this.

Let us remind you that earlier we talked with Sergei Berzin, professor of the department of oncology and medical radiology of the Ural State Medical University, with Tatyana Konstantinova, the chief hematologist of the Sverdlovsk region, and Andrey Tsoriev, the chief specialist of the Yekaterinburg Health Department for radiation diagnostics, spoke about us.

We devoted several publications to gastrointestinal oncology. We talked about its most terrible localization with Doctor of Medical Sciences Mikhail Prudkov, and with the chief surgeon of the city Alexei Stolin. Andrey Oshchepkov, head of the coloproctology department of SOKB No. 1, told us about it, and Yuri Istomin, head of the thoraco-abdominal department of the Sverdlovsk Regional Oncology Center, told us about it.

In addition, we wrote about typical “male” and “female” diseases: the chief urologist of the Sverdlovsk region Igor Bazhenov told us about, and the head of the department of oncomammology of City Clinical Hospital No. 40 Sergei Demidov and the head of the department of obstetrics and gynecology of the Ural State Medical University Tatyana Oboskalova - about the widespread and most terrible and.

Finally, the chief oncologist of Yekaterinburg, Denis Demidov, told our readers how to identify signs of oncology, and why complex procedures such as MRI or colonoscopy do not always help, and the chief surgeon of Yekaterinburg, Alexey Stolin, talked about how.

Text: Tatiana VLADIMIROVA
Photo: Anton BASANAYEV; Artyom USTYUZHANIN / website