In general, you have to think about the degree of symptoms (how bad they are), how long they are lasting, and if they are continuing to get worse over time. For example, while you shouldn't think that your child has cancer every time that he has a fever, if the fever is lasting more than 14 days and you and your doctors don't know why, then a complete blood count (CBC with differential) to screen for cancer and other tests would be a good idea.
Other examples of symptoms that might indicate a childhood cancer include:
- vomiting that persists for more than 7 days and is worse when your child wakes up in the morning, wakes your child up at night, or is associated with a headache. For children with common headaches, a red flag that it might be something more serious than a simple migraine would be if the headaches continued to get worse over time, becoming either more severe or more frequent. Brain tumors might also cause other neurological symptoms, such as trouble walking, seizures or sudden changes in their personality.
- bone pain or muscle pain that doesn't follow a known injury and doesn't improve in a few weeks. These types of pain are different than the usual 'growing pains' that children get at night, which usually doesn't cause pain in a specific spot, is helped by massage, doesn't limit your child's activities, and tends to be chronic (occurring on and off for months or years). Also remember that chronic back pain is not very common in younger children and can be a sign of a spinal cord tumor.
- a persistent cough or trouble breathing that doesn't respond to usual treatments for infections or asthma.
- an enlarging mass, whether it is in the abdomen, neck, arms or legs.
A swollen gland that isn't going away after a few weeks can be a sign of cancer, but you would usually expect other symptoms, such as a lingering fever or weight loss or swollen glands in more than one part of their body (such as their neck and groin). Even without other symptoms, a swollen gland might be a worry in older teens though, who are at risk for lymphoma.
Still, a visit to your Pediatrician if your child has a swollen gland that isn't going away would be a good idea. Your doctor might investigate for other causes, including infections like Cat Scratch Disease, and might do a TB test, complete blood count and chest xray to rule out more serious causes.
Talking to Your Pediatrician About CancerMost importantly, no matter what symptoms your child has, tell your Pediatrician if you are worried that your child could have cancer. It might be that you do have a reason to be concerned, or your doctor might be able to reassure you that your child is not at risk, either with a good history and physical examination, or a few screening tests.
1) Young G. Recognition of common childhood malignancies. Am Fam Physician - 1-Apr-2000; 61(7): 2144-54