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

Unlike cancer in adults, pediatric oncology has its own features and differences:

  1. The vast majority of tumors that occur in children are
  2. Cancer in children is less common than in adults
  3. In children, non-epithelial tumors predominate over epithelial
  4. In pediatric oncology, there are immature tumors capable of maturation
  5. Specific to some malignant tumors in children is their ability to spontaneously regress.
  6. There is a genetic predisposition to certain tumors, in particular retinoblastoma, bone chondromatosis, and intestinal polyposis.

Cancer Causes in Children

The cause of any cancer in children is a genetic malfunction in one of the healthy cells of the body, which leads to its uncontrolled growth and appearance.

But a number can cause this genetic malfunction in a cell. But here, too, children's tumors have peculiarities. Unlike adults, children do not have lifestyle-related risk factors such as smoking, alcohol abuse, or work in hazardous work. In an adult, in most cases, the appearance of malignant tumors is associated with the influence of external risk factors, and are more important for the appearance of a tumor in a child.

That is why, if a child has developed a malignant disease, his parents should not blame themselves, since it was most likely beyond their power to prevent or prevent this disease.

Factors that increase a child's risk of developing cancer:

1. Physical factors

The most common physical risk factor is long-term exposure to a child solar radiation or hyperinsolation... Also, this includes the effects of various ionizing radiation from medical diagnostic devices or due to man-made disasters.

2. Chemical factors

This primarily includes secondhand smoke. Parents need to protect their child from exposure to tobacco smoke. The child's malnutrition is also a chemical factor. The use of products with GMOs, carcinogens, the use of food in fast food restaurants. All this entails a decrease in the proper amount of vitamins and microelements in the child's body and the accumulation of carcinogenic substances in it, which, in the modern world, are found in abundance not only in food, but also in water and air.

In addition, there is another chemical risk factor, which is often dangerous for children. Many scientific studies have proven the relationship of long-term use of certain drugs, such as barbiturates, diuretics, phenytoin, immunosuppressants, antibiotics, chloramphenicol, androgens, with the development of cancer in children.

3. Biological factors

Biological factors include chronic viral infections, such as: Epstein-Barr virus, herpes virus, hepatitis B virus. Many foreign studies have established an increase in the risk of cancer in children with viral infections.

4. Genetic risk factors

Currently, pediatric oncology numbers about 25 hereditary diseases that increase the risk of developing tumors in a child... For example, Tony-Debre-Fanconi disease dramatically increases the risk of developing leukemia.

Bloom's syndrome, ataxia-telangiectasia, Bruton's disease, Wiskott-Aldrich syndrome, Kostmann's syndrome, neurofibromatosis also increase the risk of developing cancer in children. The risk of developing leukemia in children with Down syndrome and Klinefelter syndrome increases.

Against the background of Pringle-Bourneville syndrome, in half of the cases, a tumor called heart rhabdomyoma develops.

In addition to risk factors, there are several theories about the causes of cancer in children.

One of the theories belongs to a German doctor Julius Kongheim... His embryonic theory is based on the presence in children of ectopic cells, primordia, which have the ability to degenerate into malignant cells. That is why teratomas, neuroblastomas, hamartomas and Wilms' tumors do not have the usual malignant structure. These are rather malformations, the blastomatous nature of which arises only as a result of malignant degeneration of cells.

The second theory belongs to the scientist Hugo Ribbert... According to his theory, a focus of chronic inflammation or radiation exposure serves as a background for the onset of tumor growth. That is why it is so important to pay attention to chronic inflammatory diseases in childhood.

Cancer symptoms in children

Childhood oncological diseases in the early stages almost always proceed unnoticed by the parents of the sick child.

This is because the symptoms of cancer in children are similar to many of the symptoms of harmless childhood illnesses, and the child is unable to clearly articulate his complaints.

Also, injuries are common in children, manifested by various bruises, abrasions, bruises, which can lubricate or hide the early signs of cancer in a child.

For the timely detection of an oncological diagnosis, it is very important for the parents of the child to follow the obligatory passage of regular medical examinations in kindergarten or school. In addition, parents should pay close attention to the appearance in the child of various persistent and unusual symptoms for him. Children are at risk, as they can inherit genetic changes in the structure of DNA from their parents. Such children should undergo regular medical examinations and be under the vigilant supervision of their parents.


If a child develops warning symptoms, immediately consult a pediatrician or pediatric oncologist.

Signs of cancer in children include many symptoms, but we will focus on the most common ones:

1. Unexplained appearance of weakness, accompanied by rapid fatigability.

2. Pallor of the skin.

3. Unreasonable appearance of swelling or seals on the child's body.

4. Frequent and unexplained rises in body temperature.

5. Formation of serious hematomas at the slightest trauma and weak blows.

6. Persistent pain localized in one part of the body.

7. Uncharacteristic for children, forced position of the body, when bending, while playing or sleeping.

8. Severe headaches accompanied by vomiting.

9. Sudden visual impairment.

10. Rapid, unreasonable weight loss.

If you find one or more of the above symptoms in your child, do not panic, almost all of them can accompany various infectious, traumatic or autoimmune diseases. But this does not mean that when such symptoms appear, you should self-medicate.

For any signs that alert you, immediately contact your pediatrician or pediatric oncologist.

Diagnosis of Cancer in Children

It is very difficult to diagnose the presence of a malignant tumor in a child. This is due to the fact that the child cannot clearly formulate his complaints. A peculiar course and ambiguous manifestations of pediatric oncology in the early stages also play a role.

All this complicates the process of detecting and differential diagnosis of cancer in children from other common childhood diseases. It is because of this, in most cases, that an oncological diagnosis is made when the tumor is already beginning to cause various anatomical and physiological disorders in the body.


In the presence of alarming symptoms, in order to avoid medical errors, already at the first stage of examining a sick child, the suspected oncological diagnosis should be reflected in the diagnosis, in addition to other suspected diseases.

A huge responsibility lies with the district pediatrician or pediatric surgeon, they are the first to examine the child and offer an algorithm for further actions. At the initial appointment with a pediatrician, it is not always possible to immediately detect a tumor, therefore, the detection and diagnosis of cancer in children is much more successful when several types of screening tests are carried out at once.

In modern medicine, for the diagnosis of oncological diseases in children, they use all available screening and diagnostic methods, such as.

What is cancer? The human body is made up of trillions of living cells. Normal "respectable" cells grow, divide and die according to all biological canons. In the years of growing up, these cells divide more intensively, and later, upon reaching adulthood, they only make up for the loss of dead cells or participate in the healing processes.

Cancer begins when certain abnormal cells in a specific part of the body begin to grow and multiply uncontrollably. This is a common basis for all cancers.

Childhood Cancer Cancer cell growth is different from that of normal cells. Instead of obeying the dictates of time, cancer cells continue to grow and give rise to all new atypical cells. These cells have one more unpleasant ability: they penetrate into neighboring tissues, literally germinating in them with their tumor "claws".

But what makes cancer cells so aggressive? Damage to DNA - the brain of a cell, which determines its behavior. A normal cell, if something happened to its DNA, either restores it, or dies. In a cancer cell, DNA is not restored; however, the cell does not die as it should normally. On the contrary, the cell, as if breaking off the chain, begins to produce cells that are absolutely unnecessary for the body with exactly the same damaged DNA.

Humans can inherit damaged DNA, but most of the damage is caused by malfunctions in the process of cell division or due to exposure to environmental factors. In adults, this may be some trivial factor, such as smoking. But more often than not, 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 the lymphatic system.

Different types of cancer behave differently from each other. Tumors come in different sizes and respond differently to a given treatment. This is why children with cancer need treatment that is appropriate for their particular 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 occurred very early, sometimes even before birth. Unlike adult cancers, childhood cancers are not as strongly linked to lifestyle or environmental factors.

With a few exceptions, childhood cancers respond better to chemotherapy. The 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 had cancer should be under close medical supervision for the rest of their lives.

What are the key statistics for childhood cancer?

Cancer in children accounts for less than 1% of all cancers detected annually in the world's population. Childhood cancer incidence has increased slightly over the past few decades.

Thanks to the improvement of cancer treatment methods, today more than 80% of pediatric cancer patients live for 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 is highly dependent on the type of cancer and a number of other factors. Cancer remains the second most common cause of death in children after accidents.

Most common cancers in children

Leukemia

The term "leukemia" includes cancer of the bone marrow and blood. It is the most common type of cancer in children, accounting for 34% of all childhood cancers. 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.

Tumors of the brain and other tumors of the nervous system

This cancer accounts for 27% and is the second most common in children. There are many different types of brain tumors, and the treatments and medical prognosis for which vary greatly. Most of them start in the lower regions of the brain, such as the cerebellum and brainstem. Typical clinical presentations include headaches, nausea, vomiting, blurred vision, double vision, gait disturbances, and small movements. In adults, cancer often affects the upper parts of the brain.

Neuroblastoma

Neuroblastoma arises in the nerve cells of the 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 looks like a slight swelling. This type of cancer accounts for 7% of all cases of childhood cancer.

Wilms tumor

Wilms' tumor affects one or (less often) both kidneys. It is found, as a rule, in children 3-4 years old. Similar to neuroblastoma, it is manifested by the same swelling in the abdomen. 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 of the immune system - lymphocytes. Most often, lymphoma "attacks" the lymph nodes or other clusters of lymphoid tissue (tonsils, thymus), as well as the bone marrow, causing weight loss, fever, sweating, weakness and swelling of the cervical, axillary, and inguinal lymph nodes.

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

Rhabdomyosarcoma

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

Retinoblastoma

Retinoblastoma is an eye cancer. In children, it occurs in 3% of cases, as a rule - under the age of 2 years. It is found by parents or an ophthalmologist due to the following feature: normally, when the pupil is illuminated, the eye appears red due to the blood vessels in the back wall of the eye, and in retinoblastoma, the pupil appears white or pink. This can also be seen in the photograph.

Bone cancer

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

Osteosarcoma is most common in adolescents and usually develops in places where bone tissue grows most actively: near the ends of the long bones of the limbs. It often causes bone pain, worse at night or with physical activity, and swelling in the affected area.

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

Can cancer be prevented 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 only a limited number of environmental factors that can cause cancer to childhood cancer. One of them is radiation. And even then, in most cases, this applies to those cases when exposure to radiation is mandatory, for example, radiation therapy in the treatment of any other type of cancer (it turns out that they are being treated for one cancer, thereby causing another). Therefore, if a child develops cancer, parents should not reproach themselves, because they cannot prevent this disease.

It is very rare for a child to inherit certain genetic mutations from their parents that make them susceptible to certain types of cancer. In such cases, an oncologist may recommend a so-called preventive surgery, when an organ is removed, in which there is a high probability of developing a tumor. Again, this is very, very rare.

Signs of cancer in children

Childhood cancer is sometimes very difficult to recognize, mainly because its symptoms overlap with many common diseases and injuries. Children often get sick, often walk around in bumps and bruises, but all these manifestations of the "golden childhood" can mask the early signs of cancer.

Parents need to make sure their child gets regular health checkups in kindergarten or school, and carefully monitor any unusual or persistent symptoms on their own. These symptoms include:

  • unusual lumps or lumps;
  • unexplained weakness and pallor;
  • tendency to form bruises;
  • constant pain in a certain part of the body;
  • lameness;
  • unexplained and persistent fever and soreness;
  • frequent headaches, sometimes with vomiting;
  • sudden visual disturbances;
  • rapid weight loss.

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

Cancer treatment 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, a combination treatment is used.

With a few exceptions, childhood cancers respond well to chemotherapy. This is due to its propensity for rapid growth, and most chemotherapy drugs act precisely on fast-growing cancer cells. A child's body as a whole recovers better from high doses of chemotherapy than an adult. Using more intensive treatment options has a greater chance of ultimate success, but also increases the risk of short- and long-term side effects. In this regard, the oncologist must do everything possible to balance the patient's need for intensive treatment with the possible risk of unwanted side effects.

Survival rates for childhood cancer


Many forms of childhood cancer are completely curable Over the past decades, significant progress has been made in the treatment of cancer in children, many of which are now completely curable. However, certain types of cancer are treated much worse than others. In this chapter, we present 5-year survival rates for childhood cancer patients. Immediately, we note that most children live for much more than 5 years, and many are completely cured. It's just that oncologists have chosen exactly the 5-year period as a universal indicator that helps them compare the prospects for resolving various clinical cases. Another point that is important to take into account is the fact that to calculate these indicators, data were taken for a period longer than the indicated 5 years, and improvements in the treatment of cancer in recent years give every reason to assert that today the indicators of 5-year survival should be more higher.

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

  • leukemia - 84%;
  • cancer of the 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 as the only source for estimates and projections in each specific case. Much is determined by the type of cancer, as well as factors such as the age of the child, the location and size of the tumor, the treatment received and the responsiveness of cancer cells to it.

Subsequent side effects

The treatment of childhood cancer requires a special approach based on close medical supervision of the patient after the treatment. After all, the sooner possible problems are identified, the easier it will be to eliminate them. A patient who has overcome cancer, in any case, runs the risk of getting a number of delayed in time side effects associated with the transferred treatment. These negative effects can include:

  • lung problems (caused by certain chemotherapy drugs or radiation therapy);
  • growth retardation and physical development (including the musculoskeletal system);
  • deviations in sexual development and possible infertility;
  • learning disabilities;
  • increased risk of new oncopathology.
CHILD ONCOLOGIST
INDEPENDENT ASSOCIATION OF CHILD PSYCHIATORS AND PSYCHOLOGISTS

Compiled by Ph.D. I.P. Kireeva
Edited by the President of the NADPP A.A. Northern

Bristol-Myers Squibb Oncology product

You can get detailed information about anticancer drugs Bristol-Myers Squibb in the Russian Representative Office of the Company.

INTRODUCTION

Oncological diseases occupy a central place among the problems of clinical medicine. Advances in modern therapy have led to the fact that an increasing number of patients are experiencing long periods after the start of treatment, and a significant contingent can be classified as recovered. This is especially true of the main variant of the tumor process in childhood - leukemia: every year the number of children with remissions of more than five years is growing; medicine and society as a whole are faced with previously non-existent cases of practical recovery in acute leukemia. At the same time, it turned out that only one antitumor treatment with the appointment of disability, which is given to all children with cancer, does not completely solve the problems that have arisen. The results of treatment of disabled children with oncological diseases, the so-called "level of quality of life" are determined not only by the severity of the underlying disease, but also by the psychological state, possible mental disorders both in the patient himself and in his family members. in practical health care in our country, almost no attention is paid. The problem of chronically ill children includes the following main aspects:

Mental disorders associated with a long and severe course of a physical illness;
the impact of the disease on the mental development of the child;
the influence of stress and psychotherapy on the development of the disease;
the influence of the family on the condition of a sick child and the influence of a chronically ill child on the psychological climate in the family.

L.S. Sagidullina (1973) revealed syndromes of lesions of the nervous system in 38.8% of children with acute leukemia. I.K.Shatz (1989), who studied children with acute leukemia, found mental disorders in all: in 82.6% of children they manifested themselves at the borderline level and were represented by asthenic, dysthymic, anxious, depressive and psychoorganic syndromes. Psychotic disorders were observed in 17.4% of patients. With age and duration of the disease, the proportion of depressive states increased, psychotic disorders predominated in adolescents. We (I.P. Kireeva, T.E. Lukyanenko, 1992) summarized the survey data of 65 children 2-15 years old with acute leukemia. Mental disorders in the form of asthenia were detected in all patients. More complex mental disorders requiring special correction were observed in 46 children (70.8%). What is the clinic of the most common mental disorders in children with cancer?

WHAT IS ASTENIA IN A CHILD WITH TUMOR DISEASE

Common to all patients is the asthenic symptom complex, which, being one of the least specific forms of response to exogeny, can accompany the disease throughout its entire course, can manifest itself only during periods of deterioration of the somatic state, during intensive chemotherapy, with concomitant infections. The severity of the asthenic symptom complex is proportional to the severity of the somatic condition; in remission, its manifestations are smoothed out.

Often, asthenic syndrome precedes the first manifestations of the underlying disease. In these cases, when collecting anamnesis, it is revealed that a few weeks, months before the onset of cancer, the child became more lethargic, tired, capricious, resentful, tearful, was a sleepy day, slept restlessly at night. These mental disorders in the prodromal period often do not attract attention or are mistakenly interpreted by parents and doctors as a psychogenic provocation of the underlying disease ("I got sick because of troubles at school," "because I was worried"), although in fact it had the place that has arisen in the prodromal period of the disease is an increased aggravated response to everyday events.

Let us examine in detail the manifestations of asthenic syndrome. The main symptom, without which it is impossible to diagnose asthenia, is physical fatigue, which increases in the evening. This is expressed in complaints of patients about the inability to complete tasks in physical education lessons, the need to lie down after a short walk, in complaints of weakness: "arms, legs are weak." Mental fatigue is less pronounced or absent altogether.

In addition to asthenia itself (ie "lack of strength"), functional somatovegetative disorders are necessarily present in asthenic syndrome. These include sleep disorders (prolonged falling asleep with an influx of painful memories of the past or disturbing ideas about the future, an increase in the need for sleep), decreased appetite, the appearance of sweating, persistent dermographism, etc.

The third obligate manifestation of asthenic syndrome is emotional (irritable) weakness. This is a pronounced lability of mood with sharp changes: either increased or decreased. An elevated mood is often in the nature of sentimentality with irritability and anger, while a low mood is of tearfulness with capriciousness, discontent with others. A change in such states has an insignificant reason, and a decrease in mood prevails. Increased sensitivity to all external stimuli (the so-called "mental hyperesthesia"): a loud voice is deafening, it seems to the child that the mother or paramedics are "shouting" at him all the time, the knock of a slamming door is perceived as a shot, the seams on the clothes seem to be rough, the bright light of the lamp in the dressing room blinds. Reduced pain threshold: injections are felt more painful than in a healthy state.

Other neurotic and behavioral disorders can join asthenic syndrome. For example, on the eve of or during medical procedures, "hysteria", vomiting, refusal to eat, loss of neatness, speech skills, behavioral disturbances up to the refusal of vital medical procedures. This forces doctors to postpone the procedure or carry out them under anesthesia, which has side effects that are not indifferent to weakened children.

Below we give (I.K.Shatz, 1991). The questionnaire is intended for children from 8 years of age. With younger children and with children of any age who are not physically able to fill out the questionnaire on their own, an interview form is used, during which the doctor fills out the questionnaire (sometimes with the help of parents). When answering on scales I-VI, one, the most suitable answer is selected, points on scales I-VI are summed up, giving a quantitative characteristic of the severity of asthenia: 18-13 points - severe asthenia, 12-7 points - moderate asthenia, 6-1 - fatigue reaction ... Scoring characteristics allow assessing the dynamics of the state before and after treatment. Answers on scales VII-IX are not quantitatively assessed, and when answering one question, several items can be marked. These disorders can be symptoms of both asthenia and somatic suffering itself, but taking them into account is important for the general characteristics of the child's condition.

CHILDREN'S DEPRESSION

More than a third of children with oncological diseases have states of neurotic and depressive types with an almost constant decrease in mood. These children are always whiny or gloomy, they lose interest in games and communication with peers. Often there is an increased interest in their illness - patients who are not old enough to orient themselves in medical terminology, measures related to treatment, are interested in the course of treatment, listen to the conversations of others about the disease, express concern for their health. Often, patients are in very difficult relationships with their parents: they are waiting for their arrival, but they are always unhappy with how they fulfill their requests, conflict with their parents, blame them or themselves for their illness. These conditions are characterized by functional disorders of the functions of internal organs that cannot be explained by the underlying disease, persistent disturbances in appetite and sleep, night fears, "hysterics" of the type of affect-respiratory attacks, hysterical seizures.

Below we give (I.K.Shatz, 1991). The scale is filled in by the doctor based on the clinical observation of the child. For each of the subscales, the most appropriate description of the impairment for the given child and the corresponding score are recorded. Additionally, the content characteristics of anxiety and fear are recorded. The scale makes it possible to obtain standard qualitative descriptions of the emotional state and their quantitative estimates for individual subscales and in general. The latter is expressed by the quotient of dividing the algebraic (taking into account the sign) sum of the points scored by the number of subscales (8).

Along with the assessment of the dynamics of the individual state, the scale makes it possible to monitor the effectiveness of psychotropic drugs and psychotherapy used in treatment, to compare the emotional state in different clinical groups, taking into account not only the severity, but also the characteristics of emotional disorders.

OTHER MENTAL DISORDERS

In some patients (in about a tenth of cases), with a sharp deterioration in the somatic state, transient psychoses develop with dimness of consciousness. Stunning and delirium are common.

In cases of mild stunning (annubilation), the child has difficulty comprehending, slowness of all reactions, emotional indifference, and limitation of perception. The child looks lethargic, as if "stupid, stupid", absent-minded. With a sharp irritation (raising the voice with a question, pain), consciousness clears up for a while. With the deepening of stunning, its next stage develops - somnolence, in which the child becomes, as it were, drowsy, and being brought out of this state by an external stimulus (loud voice, bright light, pain) can give an answer to a simple question and again fall into pathological drowsiness. In a severe general condition, stunning can reach the degree of sopor with the absence of speech contact and with the preservation of the reaction only to very strong stimuli (flash of light, loud sound, pain), in response to which non-articulated vocal and undifferentiated protective motor reactions appear. Finally, with a progressive deterioration of the general condition, a coma (switching off of consciousness) occurs with a weakening, and then with the disappearance of unconditioned reflexes, disorders of respiratory and cardiac activity. Each subsequent stage of stunning is about half as long as the previous one, and doctors have less and less time for resuscitation measures, if any.

Delirious disorders occur against the background of severe asthenia or shallow stunning, mainly in the evening and night hours. With delirious episodes, the child becomes restless, fears, he has deceptions of perception, more often in the form of visual illusions, especially the type of pareidolia, when in the wallpaper pattern, cracks on the wall, fabulous creatures, people's faces, a wolf's face grinning teeth appear. Visual hallucinations may occur, auditory hallucinations are frequent (ringing, rumbling, calls by name, voices of familiar guys). Evening delirious episodes are often misjudged as childhood fears of the dark.

In patients with hereditary burden of epilepsy and in patients with organic brain damage, epileptiform disorders are possible: seizures, twilight stupefaction, dysphoria. Organic psychosyndrome develops as a result of organic damage to the brain substance (cerebral hemorrhage, tumor, or as a consequence of severe intoxication, hypoxia) and is characterized by a slightly reversible weakening of memory, a decrease in intelligence of varying degrees (up to acquired dementia).

The occurrence, form and severity of mental disorders is influenced by a whole complex of exogenous and endogenous factors. The most powerful causal factor is psychological. The sudden onset of a serious illness is perceived by children as a "tragic deprivation of everything", as it leads to many months of hospitalization away from school, friends, separation from home, severe treatment, which is accompanied not only by frequent painful procedures, but also by a change in appearance with the appearance of obesity, baldness. It is also traumatic for sick children that they observe the suffering of other patients, learn about their death. It should be noted that if earlier it was believed that the concept of death was available only to school-age children, then recent studies (D.N. Isaev, 1992) show that this concept can arise already between 2-3 years and even very young children can experience a related with him anxiety, which due to the inability to verbally express his fear is manifested by changes in behavior, fears of physical injury, loneliness.

In addition to the psychological factor in the occurrence of mental disorders, the endogenous factor of predisposition to mental illness, the somatic factor associated with the underlying disease and its complications, and the iatrogenic factor due to the side effects of drug and radiation therapy of the underlying disease are important. In the foreign literature, quite a few publications are devoted to the psychoorganic syndrome, which manifests itself months and years after radiation therapy, psychoorganic syndromes are also considered in cytostatic treatment.

Mental disorders in blood diseases, therefore, have a mixed: psychogenic, exogenous-symptomatic, exogenous-organic origin. The pathogenesis of mental disorders is poorly understood and is associated with disorders of cerebral metabolism, discirculatory changes in the brain, phenomena of cerebral tissue edema.

The question arises as to how to carry out the treatment of mental disorders that complicate the therapy of the underlying disease, which have an adverse effect on the "lifestyle", and according to some data, possibly on its duration. Both according to the literature and according to our data, the isolated use of psychotherapy is not effective enough. The use of psychotropic drugs turned out to be difficult. I.K.Shatz (1989) recommends to use mesepam, sibazone, phenazepam and azafen in the treatment of patients with acute leukemia. Literature data on the interaction of psychotropic drugs with antineoplastic, hormonal drugs, the effect of psychotropic drugs on hematopoiesis are either absent or contradictory. When we used psychotropic drugs, even at low doses, side and perverse reactions often occurred. In some patients, a positive effect was observed with the use of tranquilizers, nootropics, herbal medicine.

Psychotherapeutic tactics also remain underdeveloped. One example is the question of patient orientation in the diagnosis of cancer. Foreign authors emphasize that the patient must know everything he wants about his present and future, that he needs to know the diagnosis. The severe psychological stress that occurs when reporting an oncological disease is prevented with the help of targeted psychotherapeutic work carried out by both doctors and psychologists and social workers. Abroad there is special literature for patients with leukemia, breast tumors, etc., educational work is being carried out among the population. In our country, almost no literature is published for patients, there is no special training for psychotherapists, social workers to work in oncological institutions. Domestic doctors believe that an oncological diagnosis should not be reported, as this will only increase fear and uncertainty.

Meanwhile, it turned out that many children suffering from cancer, especially adolescents, already know their diagnosis at the first stages of treatment. In this case, children find themselves in a particularly traumatic situation due to the fact that they do not discuss the diagnosis they know with parents or doctors who are convinced that they have managed to hide it from the child. And the point here is not only in the "leakage of information" about the diagnosis. C.M. Binger et al. (1969) believe that despite attempts to protect a hopelessly ill child from knowledge of the prognosis of his illness, anxiety of adults is transmitted to children due to a violation of the emotional climate and mutual understanding in the family.

A long-term illness changes not only the mental state, but also the development of the child, leading to the appearance of pseudo-compensatory formations of the type of "conditional desirability of the disease" or "flight into illness" with fixation on it, which ultimately can lead to character breakdown within the framework of pathocharacterological or neurotic personality development. Children who have already undergone cancer develop "post-traumatic stress disorder": recurring nightmares and floods of memories of illness, treatment, increased sensitivity to trauma, irritability, aggressive behavior, lifelong excessive dependence on parents in violation of contacts with peers. Loneliness is often a consequence of a previous illness.

In the course of our attempts to conduct play psychotherapy in the department, we constantly observed the consequences of mental deprivation: the development of social and communication skills in children was delayed. They did not know how to express their own wishes, were not familiar with games appropriate for their age, their interest in communicating with peers was reduced or completely absent, and the range of interests narrowed. To the question "what would you like to play?" either they could not answer, or the list of games was limited to bingo and drawing. This made it difficult to use traditional techniques adopted in our country in psychotherapeutic work.

The use of psychotherapeutic techniques created abroad is even more difficult. This is partly due to the fact that in our country psychotherapy was developed by psychiatrists, within the framework of the "medical model" (VN Tsapkin, 1992), in which the treatment process is understood as the elimination of "target symptoms". Abroad, psychotherapy is developed mainly not by doctors, but by humanitarians, psychologists within the framework of the "psychological model", which is based on psychoanalytic or other religious and philosophical concepts that require either "faith" or many years of study and are not really familiar to domestic specialists. In addition, these techniques are not always accepted by patients, since working in a "psychological model" includes working with negative experiences with their temporary intensification and requires a certain psychological education of the patient, the presence of a request for psychological help. Hence the need to develop effective psychotherapeutic tactics is clear. The possibility of creating effective psychotherapeutic techniques is indirectly confirmed by thirty years of research by the Washington Institute of Mental Health (1988), which led to the conclusion that "psychotherapeutic intervention is usually beneficial, and that different types of psychotherapy are almost equally effective" (M.B. Parloff, 1988).

FAMILY OF A CANCER SICK CHILD

The next aspect of our conversation concerns the family. It is known that the mental well-being of a child, his behavior depends on the mental state of loved ones to an even greater extent than on his physical state. Starting from school age, and sometimes even earlier, children realize that their illness has become a shock for their loved ones, and react to the situation in accordance with the attitude of their parents towards it. In sick children, in addition to high levels of anxiety, internal conflicts associated with misunderstanding by adults are revealed. Children feel abandoned, pathological relationships with the family are formed: either the despotic behavior of a sick child with complete disregard for the interests of the family, or an indifferent attitude towards the environment with care for their problems, or, finally, complete dependence on parents with a sense of guilt in front of them, the perception of the disease as "punishment" for their "bad" behavior. Children whose families lead a normal life, maintain habitual social contacts, feel more confident and retain emotional ties with their family members (J.J. Spinetta., L. Maloney, 1978).

However, most of the parents, whose children suffer from life-threatening diseases, have mental disorders (Kireeva I.P., Lukyanenko T.E., 1994). Mental disorders in parents are primarily due to a chronic traumatic situation, overwork, financial, housing and other everyday problems, in particular because oncology departments are usually remote from the place of residence, and a sick child needs constant care from loved ones, especially in our conditions of shortage junior and nursing staff.

Mental disorders in parents are manifested by the drop in working capacity, lack of appetite, sleep disorders and the functions of internal organs that occur in most of them. Psychological testing of parents reveals a high level of "situational anxiety", indicating the dominance of anxiety and dissatisfaction in the state of mind. The lowered mood often reaches despair, sometimes with the refusal to treat the child from doctors, with attempts to seek help from healers, psychics, which sharply worsens the prognosis of the disease. Correction of mental disorders in parents, therefore, is necessary not only to restore their well-being and working capacity, but also because without psycho-corrective help, the family cannot form an adequate attitude to the child's illness and treatment.

CONCLUSION

The given data indicate the need for:
1) organization of interdisciplinary research on the problem of mental and personality disorders in children suffering from life-threatening diseases and in their families;
2) conducting scientific research aimed at developing the most effective drug tactics in the treatment of mental disorders in children with cancer;
3) organization of psychosocial care for children with cancer and their families.

At the same time, only psychologists and psychiatrists working in the health care system will not be able to solve all the problems. They need help, the participation of teachers, social workers, cultural and religious figures, seeking cooperation not only with the sick, but also with their families, relatives and the society in which these people live.

LITERATURE

Adjuvant psychological therapy for cancer // Medical Market. - 1992, No. 8.-P. 22-23.

Gindikin V.Ya. Review of the book "Psychosomatics in clinical medicine. Psychiatric and psychotherapeutic experience in severe somatic diseases." Ed. E. Benish and I. E. Meyer. Zap. Berlin-Heidelberg-New York, 1983 // Journal of Neuropathology and Psychiatry. S. S. Korsakov. - 1987, Issue. 2. - C, 297-299.

Guskova A.K, Shakirova I.N. The reaction of the nervous system to damaging ionizing radiation (Reviews / Journal of Neuropathology and Psychiatry named after S.S. Korsakov. - 1989, Issue 2.- P. 138-142.

Isaev D.N. Formation of the concept of death in childhood and the reaction of children to the process of dying // Review of Psychiatry and Medical Psychology. V.M. Bekhterev. - 1992, No. 2. - C.17-28.

Kireeva I.P., Lukyanenko T.E. Psychosocial assistance in pediatric hematology oncology // Rehabilitation of children with disabilities in the Russian Federation. - Dubna, 1992 .-- S. 76-77.

Kireeva I.P., Lukyanenko T.E. Psychiatric aspects in pediatric somatology // Scientific conference of young scientists of Russia, dedicated to the 50th anniversary of the Academy of Medical Sciences: abstracts. Moscow, 1994 .-- S. 287-288.

Psychodiagnostic methods in pediatrics and child psychoneurology. Tutorial. Ed. D.N. Isaev and V.E. Kagan. - S.-PTB. PMI, 1991.- 80 p.

Sagidullina LS Damage to the nervous system in acute leukemia in children: Author's abstract. dis. Cand. honey. sciences. - M., 1973 .-- 21 p.

Shats I.K. Mental disorders in children with acute leukemia: Author's abstract. dis. Cand. honey. sciences. - L., 1989 .-- 26 p.

Tsapkin V.N. Unity and diversity of psychotherapeutic experience // Moscow psychotherapeutic journal. - 1992 .-- S. 5-40.

Binger C.M., Ablin A.R., Feurste R.C. et al. Childhood leukemia: emotional impact on patients and family // New Engl.J. Med. - 1969, Vol. 280. - P. 414-418.

Parloff M.B. Psychotherapy and research: an anaclitic depression // Psychiatry. - 1988, Vol. 43. - P. 279-293.

Spinetta J. J., Maloney U. The child with cancer: patterns of communication and denial // J. Consult. Clin. Psychol. - 1978, Vol. 46., No. 6.- P. 1540-1541.


Is an oncological disease that manifests itself in childhood. According to statistics, this form of the disease occurs in 15 children out of 1000.

Classification of cancer in children

Most often, in childhood, they encounter cancer of the hematopoietic organs. We are talking about leukemia, malignant lymphomas, lymphogranulomatosis. The probability of this is about 70%. The data are called hematological malignancies.

More rarely, formations are formed in the central nervous system, bone and soft tissues. The most rare should be considered "adult" types of cancer - from 2 to 4% (tumors of the skin, genitals).

Thus, treatment depends entirely on what type of cancer the child has. Therefore, it is necessary to consider each of them separately.

Cancer Causes in Children

The cause of all diseases of an oncological nature should be considered a genetic breakdown in any of the cells. It is she who provokes uncontrolled growth, as well as the multiplication of tumor cells. It is also characteristic that, if in older people it is possible to determine a number of risk factors that are able to provoke such mutations, then in the case of children, minor genetic abnormalities that have been passed on from their parents become a catalyst for cancer.

Many people have similar anomalies, but not all of them provoke the development of malignant tumors. The risk indicators that affect the child himself (radiation, smoking, negative environmental background) do not really matter much.

It should be borne in mind that almost all diseases of a genetic nature, namely Down's or Kleinfelter's syndrome, as well as Fanconi, are associated with an increased risk of cancer.

Cancer symptoms in children

Leukemia

In children, leukemia manifests itself in:

    significant fatigue and weakness in the muscle area;

    pallor of the skin;

    loss of appetite and body index;

    excessively active degree of bleeding;

    painful sensations in the area of ​​bone tissue and;

    a change in the size of the abdomen, which becomes a consequence of the fact that some organs become larger;

    changes in the size of the lymph nodes in the cervical region, groin and axillary region;

    the formation of shortness of breath;

    dysfunction of vision and balance while walking;

    hemorrhage or redness on the skin.

For leukemia, it is characteristic that all the symptoms do not appear simultaneously, but separately. It can start with all sorts of violations, which are formed in a different order. In some children, this may be a change in the color of the skin and a holistic malaise, in the rest - disturbances in walking and problems with visual functions.

Tumors of the brain and spinal cord

Formations that form in the brain appear most often in children between the ages of five and ten. The degree of danger of this ailment is in direct proportion to the area of ​​location and the final volume. Unlike older people, in whom cancer develops in the large hemispheres, in children, cerebellar tissue is affected, as well as the brain stem.

Signs that indicate the presence of formations in the brain are as follows:

    very severe migraine, which occurs mainly in the morning and becomes more intense during or when trying to tilt the head. For those who do not yet know how to speak, painful sensations manifest themselves in a state of anxiety or crying. A small child holds his head and actively rubs his face;

    vomiting in the morning;

    dysfunction of coordination of movements, gait, eyes;

    a change in behavior, while the baby refuses to play, withdraws into himself and sits like a stunned one, without making any attempts to move;

    a state of apathy;

In addition, in children there is a change in the size of the head, seizures and all kinds of mental disorders, for example, personality changes, manic ideas, can form.

If we talk about formations in the spinal cord, then they are characterized by complaints of unpleasant sensations in the back, which become more intense in the lying position and less strong in the sitting position.

In children, resistance is revealed when bending the body, a change in walking, scoliosis is revealed, the degree of sensitivity in the area of ​​damage by cancerous tissues decreases. Also, a positive Babinsky sign is formed (reflex reaction of extension of the big toe in case of irritation of the skin), impaired functioning of the sphincters, bladder or anus.

Wilms tumor

This formation is also called nephroblastoma and is a malignant tumor of the kidney. This type of cancer is most often encountered by children under the age of three. The disease affects one kidney, more rarely both. In most cases, there are no complaints of malaise. Nephroblastoma is detected at random during a routine examination. When palpating in the early stages, painful sensations are not formed. If we talk about later stages, then in this case the asymmetry of the peritoneum is obvious due to the tumor, which squeezes the organs in the neighborhood. The baby's weight decreases, appetite disappears, temperature is detected,.

Neuroblastoma

This type of oncology can only be in children. In 85-91% of cases, this occurs before the age of five. Cancer can be found in the abdominal region, chest, cervical and pelvic regions, and often affects bone tissue.

Depending on the location, signs that indicate the presence of neuroblastoma should be designated:

    discomfort in the bones, obvious lameness;

    weakness, fluctuations in body temperature, pale skin, extreme sweating;

    disruption of the intestines and bladder;

    swelling in the eyes, face, or neck.

The diagnosis can be made based on the results of a special analysis of blood, urine, puncture and ultrasound.

This is a malignant formation that manifests itself near the tissues of the retina of the eye. Children under six years of age face this form of oncology. In a third of cases, both the right and left eyes are susceptible to malignant cells.

In the baby, he begins to blush and ache, strabismus is formed. At the same time, in the area of ​​the eye, a specific glow is evident, which occurs due to an increase in the tumor behind a certain part of the eye. As a result, it is visible through the pupil. In some patients, this provokes an absolute loss of vision.

To detect retinoblastoma, an eye examination is performed under anesthesia. Additional diagnostic measures are X-ray examination, ultrasound, computed tomography, as well as a blood test and a puncture of the back.

Rhabdomyosarcoma

This is a malignant formation in the area of ​​either muscle or connective tissue. Formed in children in infancy, preschool and school age. Rhabdomyosarcoma affects part of the head and cervical spine, more rarely - the urinary organs, limbs of the upper and lower order, even more rarely - the trunk.

Signs of rhabdomyosarcoma:

    the formation of a slight swelling of a high degree of pain;

    dysfunction of vision and changes in the size of the eyeball;

    the urge to vomit, pain in the abdominal cavity and constipation (if the oncology has affected the peritoneum);

    the appearance of jaundice may be evidence of the presence of an ailment in the bile ducts.

According to research, about 60% of patients are cured.

Osteosarcoma

The most common oncological disease in the elongated and humerus bones, as well as the hips in adolescents.

The main manifestation of this type of cancer should be considered soreness in the affected bone cover, which becomes more active at night. At the initial stage, the pain can be identified as shorter. Obvious swelling is detected only after two to three weeks.

An accurate diagnosis can be made on the basis of X-rays and computed tomography.

Ewing's sarcoma

This formation, like osteosarcoma, affects the bones of the arms and legs of the baby's tubular type. In certain cases, cancerous cells affect the area of ​​the shoulder blades, ribs, or clavicle. Especially the presented form of the disease is common in children aged 11 to 16 years.

Signs that indicate the presence of a mass are similar to those seen in osteosarcoma. But in this case, there is a significant increase in body temperature indicators, a loss in the weight index. In the later stages, sudden and absolute soreness is formed.

Hodgkin's lymphoma

Lymphogranulomatosis is a form of lymphatic tissue cancer. Most often it is formed in adolescents, that is, after 13-14 years.

The presented form of oncology has little or no symptoms. With Hodgkin's lymphoma, one or more painless lymph nodes may become enlarged, and may disappear or form again. In some children, cutaneous, active sweating occurs, the temperature and the rate of fatigue increase.

Diagnosis of Cancer in Children

The problem of diagnosis arises due to the fact that the child's well-being may seem positive even at the later stages of the development of the disease. Formations are very often identified randomly as part of a preventive examination.

The final diagnosis in most cases can only be made after a biopsy. Based on its results, the variant of malignant formation is determined and the stage of the disease is identified. The selection of the method of treatment depends on this. When hematopoiesis forms in the organs, a bone marrow puncture should be considered a similar biopsy.



The treatment of malignant tumors in children is carried out by pediatric oncologists and oncohematologists. Such treatment is carried out in special oncological departments of large children's hospitals and in research institutes.

After he was discharged from the hospital, the baby must undergo compulsory observation by a specialist in the children's department in one of the specialized dispensaries. In order to cure cancer of the organs of the hematopoietic type, pediatric specialists use exclusively conservative therapy - chemotherapy and radiation. In the treatment of all other types of cancer in children (called "solid tumors"), surgery is used for additional purposes.

The current treatment is carried out according to programs of an international nature - treatment protocols that are worked out separately for each type of ailment. Even the slightest deviation from the protocols leads to a deterioration in the total achieved within the framework of the treatment. The possibility of an absolute cure is guaranteed by a high degree of sensitivity of the formations in childhood to specific agents.

After the main course of treatment, patients need long-term therapy and rehabilitation, which is exclusively aimed at maintaining optimal health. At such moments, the entire responsibility for the health of the baby and caring for him is completely on the shoulders of the parents. The results of treatment depend on the thoroughness of the implementation of all the advice of a specialist.

Therefore, it is imperative to be aware of all the symptoms that can accompany any form of childhood cancer and to follow each of the recommendations given by the specialist. This will be the key to recovery.


Education: graduated from residency at the Russian Scientific Oncological Center named after N. N. Blokhin "and received a diploma in the specialty" Oncologist "



Fifteen episodes for every one hundred thousand child lives annually. In terms of fifteen years of childhood, this means that out of one hundred thousand peers, almost two hundred children fall ill with cancer every year.

There is also more optimistic statistics, according to which the majority of childhood cancers are amenable to successful treatment. This applies to tumors detected at the very initial stage of their development. In the case of advanced diseases, the likelihood of a favorable outcome decreases significantly.

To our great regret, the number of children who fell ill with cancer and were admitted to the clinic at the very beginning of the detection of the disease is no more than 10% of the total number of cases. In order for parents to be able not to miss the first alarming signals and to show the child to the doctor in a timely manner, they must know the symptoms of the main childhood cancers.

Classification of cancer in children

Malignant tumors in children are:

  1. Embryonic.
  2. Juvenile.
  3. Tumors of the adult type.

Embryonic

Tumors of this group are the result of a pathological process in the germ cells.

As a result, the uncontrolled growth of mutated cells occurs, the histology of which, nevertheless, indicates their similarity with the tissues and cells of the fetus (or embryo).

This group consists of:

  • Blastoma tumors:,.
  • A number of fairly rare germ cell tumors.

Juvenile

This group of cancerous tumors occurs in children and adolescents as a result of the formation of cancer cells from completely healthy or partially altered cells.

Malignancy can suddenly touch a polyp, a benign neoplasm, or stomach ulcer.

Juvenile tumors include:

  • carcinoma;

Adult tumors

This type of ailment is rare in childhood. These include:

  • carcinomas (nasopharyngeal and hepatocellular);

Why do children get sick?

Until now, medicine has not established the exact causes of oncology in children. We can only assume that the following points are the prerequisites for the development of cancerous tumors:

  • Genetically determined predisposition. Some types of oncological diseases (for example, retinoblastoma) can be traced in several generations of the same family, although this does not exclude the possibility of the birth of healthy offspring. Cancer is not inherited.
  • Influence of carcinogenic factors. This concept combines the pollution of the environment (soil, air and water) with a large amount of industrial waste, the effects of radiation, the effects of viruses, as well as the abundance of artificial materials in the environment of modern apartments.
  • Carcinogenic factors, affecting the sex cells of the parent couple, damage them and thereby contribute to the abnormal intrauterine development of the fetus, the emergence of a large number of congenital malformations and embryonic cancerous tumors.

Symptoms and signs of cancer by type

Early recognition of anxiety symptoms guarantees not only a complete recovery of the child, but also allows treatment with the most gentle and inexpensive methods.

In this section of our article, we present a list of symptoms that characterize different types of childhood cancers.

If similar symptoms are found, the parents of a sick baby should be shown to a qualified specialist as soon as possible.

Leukemia

Synonyms for this malignant disease of the hematopoietic system are the terms "" and "". It accounts for more than a third of the total number of childhood cancers.

At the first stage of development of leukemia, first the displacement, and then the replacement of healthy bone marrow cells with cancerous ones occurs.

The symptoms of leukemia are as follows:

  • fast fatiguability;
  • lethargy and muscle weakness;
  • anemic skin;
  • lack of appetite and a sharp decrease in body weight;
  • increased body temperature;
  • frequent bleeding;
  • painful sensations in diarthrosis and bones;
  • a significant increase in the liver and spleen, entailing an increase in the abdomen;
  • frequent vomiting;
  • shortness of breath;
  • tangible enlargement of the lymph nodes located in the armpits, on the neck and in the groin;
  • visual disturbances and unbalanced walking;
  • a tendency to form bruises and redness of the skin.

Brain and spinal cord cancer

Cancer brain tumors appear in children 5-10 years old and reveal themselves in the following symptoms:

  • intolerable morning headaches, aggravated by coughing and when turning the head;
  • bouts of vomiting on an empty stomach;
  • impaired coordination of movements;
  • imbalance in gait;
  • visual disturbances;
  • the appearance of hallucinations;
  • complete indifference and apathy.

Brain cancer is characterized by the appearance of seizures, obsessions, and mental disorders. A sick child's head may increase in size. If you do not show it to the doctor in time, after six months of continuous headaches, signs of mental retardation will begin to appear with an inevitable decrease in intelligence and physical abilities.

Spinal cord cancer symptoms:

  • back pain that worsens while lying down and subsides while sitting;
  • difficulty bending the body;
  • violation of gait;
  • pronounced scoliosis;
  • loss of sensitivity in the affected area;
  • incontinence of urine and feces due to poor sphincter function.

Wilms tumor

This is the name for nephroblastoma or kidney cancer (most often one, sometimes both). This ailment usually affects babies under the age of three.

Due to the complete absence of complaints, the disease is discovered quite by accident, usually during a routine examination.

  • There are no pains at the initial stage.
  • In the late stage, the tumor is extremely painful. Compressing the adjacent organs, it leads to the asymmetry of the abdomen.
  • The kid refuses to eat and loses weight.
  • The temperature rises slightly.
  • Diarrhea develops.

Neuroblastoma

This cancer only affects the child's sympathetic nervous system. In the overwhelming majority of cases, it is observed in children under the age of five. The localization of the tumor is the abdomen, chest, neck, small pelvis, bones are often affected.

Typical signs:

  • limping, complaints of bone pain;
  • excessive sweating;
  • prostration;
  • blanching of the skin;
  • high temperature;
  • disruption of the intestines and bladder;
  • swelling of the face, pharynx, edema around the eyes.

Retinoblastoma

This is the name of a malignant tumor of the eye retina, characteristic of infants and preschoolers. The third part of all cases involves the retina of both eyes. In 5% of children, the disease ends in complete blindness.

  • The affected eye turns red, the baby complains of severe pain in it.
  • Some children develop strabismus, others - a symptom of a glowing "cat's eye" due to the protrusion of the tumor beyond the border of the lens. It can be seen through the pupil.

Rhabdomyosarcoma

This is the name given to a cancerous tumor of the connective or muscle tissue that affects infants, preschoolers and schoolchildren. Most often, the site of localization of rhabdomyosarcoma is the neck and head, somewhat less often - the urinary organs, the region of the upper and lower extremities, and less often the trunk.

Signs:

  • painful swelling at the site of the lesion;
  • "Rolling out" of the eyeball;
  • a sharp decrease in vision;
  • hoarse voice and difficulty swallowing (if localized in the neck);
  • prolonged abdominal pain, the presence of constipation and vomiting (with damage to the abdominal cavity);
  • yellowness of the skin (with cancer of the bile ducts).

Osteosarcoma

It is a cancer that affects the long (humerus and thigh) bones of adolescents. The leading symptom of osteosarcoma is pain in the affected bones, which tends to intensify towards night. At the onset of the disease, pain is short-lived. A few weeks later, visible swelling appears.

Ewing's sarcoma

This ailment, typical for adolescents 10-15 years old, is a scourge for the tubular bones of the upper and lower extremities. There have been rare cases of damage to the ribs, shoulder blades and collarbones. To the symptomatology characteristic of, is added a sharp weight loss and fever. The later stages are characterized by intolerable pain and paralysis.

This is a cancer of the lymphatic tissues or, typical for adolescents.

The photographs show children with cancer of the lymphatic tissue.

Symptoms:

  • painless and slightly enlarged lymph nodes that disappear, then reappear;
  • sometimes itchy skin, profuse sweating, weakness, fever.

Diagnostics

The satisfactory state of health of babies, which is characteristic even for the late stages of cancerous tumors, is the main reason for their late recognition.

Therefore, regular preventive examinations play a huge role in the timely detection and treatment of the disease.

  • At the slightest suspicion of a cancerous tumor, the doctor prescribes a number of laboratory tests (blood, urine) and studies (MRI, ultrasound,).
  • The final diagnosis is based on the results of a biopsy (sample of tumor tissue). Histology helps determine the stage of the cancer. The tactics of further treatment depend on the stage. For cancer of the hematopoietic organs, a bone marrow puncture is taken.

Treatment

  • Treatment of childhood cancers is carried out in specialized departments of children's clinics and research centers.
  • The impact on cancerous tumors of the hematopoietic organs is carried out by methods and. All other types of tumors are treated surgically.
  • After discharge from the clinic, a long course of therapeutic treatment follows, followed by rehabilitation.

Consequence

Pediatric oncology is better treated than adult oncology.

Today, doctors manage to save 90% of children with kidney cancer, over 76% - with oncology of soft tissues and bones, and retinoblastoma is 100% cured. This is a consequence of the enormous potentialities of young organisms.

The likelihood of a complete cure, of course, directly depends on the timeliness of the treatment started, but there are cases of healing of patients even with the fourth stage of cancer.

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