Childhood cancer is different from adult cancer. Most adults are epithelial cancers (more than 90%). For example, the outermost layer of body tissues is epithelium, including colorectal cancer, liver cancer and lung cancer. It must be accumulated for a long time to get sick; Most cancers in children are mesodermal or embryonic cancers, such as leukemia, sarcoma and neuroblastoma. Generally speaking, leukemia accounts for 1/3 of childhood cancers, brain tumors account for 1/5, and there are other kinds of tumors.
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Dr. Liu Yanlin specially reminded parents that if they raised other children in the family, or their parents themselves suffered from rare hereditary cancers (such as adrenal epithelioma), multiple or bilateral tumors (such as nephroblastoma), adult tumors (such as thyroid cancer), or many family members suffered from the same or similar cancers, especially sarcomas and brain tumors, they should be slightly vigilant. But don't be too nervous, because more than 90% of childhood cancers are accidental, and heredity accounts for less than 10%. If you want to know whether your child or yourself is at risk of hereditary cancer, you can take the initiative to discuss with pediatric hematology oncologists, and if necessary, you can refer them to doctors or experts in genetic medicine for genetic counseling.
Early symptoms of childhood cancer If parents feel that their children's blood or tumor is suspicious, they can first find a community pediatrician for physical assessment, including examination of lymph nodes, liver and spleen. Generally speaking, the cervical lymph node mass caused by bacterial or viral infection will disappear within 2 weeks. If the response is still not satisfactory after 1 ~ 2 weeks of observation or treatment, it is recommended to ask a sub-specialist in pediatric hematology oncology department for further evaluation. How should parents pay attention to the early symptoms of childhood cancer?
Symptoms of leukemia or bone marrow dysfunction
There is something wrong with some functions in the blood. If there are not enough red blood cells, it will cause anemia and fatigue. Leukocyte deficiency is easy to have a fever; If there are not enough platelets, it is easier to bleed, and the skin will appear purple spots, or it will be bruised after a slight collision.
Symptoms caused by the tumor itself
If you can see it directly, such as retinoblastoma with tumor in the eye (which is quite rare in clinic), when people take pictures, the flash can easily lead to red eye. However, because the retina of such patients is covered by tumor, white pupil may appear in the photographic results, that is, white pupil (except for tumor, sometimes white pupil appears in the optic nerve). It is suggested that if the child's photo shows white pupils, please call an ophthalmologist as soon as possible. In addition, occasionally there are tumors that grow on the skin, such as histiocytosis or neuroblastoma, but the probability is very low.
However, most abnormalities are caused by the compression of nerves by tumors. For example, it interferes with the nerves, and the movements that the child has learned suddenly become obviously worse. For example, if he walks well, he suddenly can't walk, or he goes to the toilet himself and suddenly fails. This may be caused by the tumor affecting the urinary nerve. In principle, children's development is constantly improving. Parents should pay special attention if they have learned and suddenly stop learning.
Abdominal tumor
You will feel more relaxed when you take a bath. Mommy can touch the children's bellies. If in doubt, you will feel a tumor, usually hard or irregular in surface, but it may also be just feces in the intestine. If necessary, you should take it to the hospital and ask a doctor to evaluate or arrange an examination.
Understand four common childhood cancers There are four common cancers in children, including leukemia, brain tumor, lymphoma and solid tumor without brain tumor. The following are the key points of parents' explanation and observation.
1 Leukemia (hematologic cancer) is mostly acute lymphoid.
Leukemia is a kind of cancer. The leukemia that children often suffer from is acute lymphoblastic leukemia, and about 1/5 is acute myeloid leukemia. From birth to adulthood, bone marrow is responsible for hematopoiesis. Hematopoietic stem cells produce a lot of blood cells to supply the body's needs, such as lymphocytes in white blood cells, which will make the body resistant. There are billions to tens of billions of white blood cells circulating in the ordinary human body. If there is a problem, abnormal continuous division and proliferation will produce many abnormal white blood cells, which will interfere with normal bone marrow hematopoiesis and blood function. Normal people's blood contains 4 million to100000 white blood cells, and leukemia patients will increase by 2 times or more.
Because white blood cells continue to divide, it will destroy the bone marrow structure and make it impossible for blood cells to be made. Good white blood cells are insufficient, and there will be fever and infection; Insufficient red blood cells can lead to anemia and fatigue, and children's lips will be whiter; Insufficient platelets, blood coagulation will cause problems, and purple spots are easy to appear.
As long as children's cancer is actively treated, most of them can survive, and the cure rate is as high as 70% to 80%. In the early days without medical insurance, there were fewer drugs, and many children could not get good medical care after getting cancer. Nowadays, there are many drugs to choose from. As long as you are confident and fully cooperate with the doctor, the treatment effect is still quite good. Hematological tumors are mainly treated with chemotherapy and back acupuncture. The treatment time is about 2 ~ 3 years, and the success rate can reach 80%. If you want to have a good effect, the premise is that every treatment step should be done correctly as far as possible, you must accept a formal treatment plan, and you must not interrupt or use folk remedies. Because the examination of leukemia needs bone marrow extraction and back acupuncture treatment, it must be followed up all the time during the treatment, starting with bone marrow examination and evaluating whether it is necessary to adjust drugs. Parents may be afraid of these treatments, but they are all fairly safe tests conducted by experienced teams, and bone marrow and spinal fluid will regenerate after extraction.
Brain tumor ranks first among children's solid tumors.
Brain tumor is the first solid tumor in children. Because tumors grow in different parts, there will be different treatments and prognosis. Surgery is the most important treatment for brain tumors. No matter whether it is big, middle or cerebellum, a special team of children's neurosurgery is needed to perform surgery, which can reduce the injury during the operation. Especially for children with bigger brains than adults, brain tumor surgery takes longer than adults, which requires great care and patience. Nevertheless, sometimes there may be risks such as bleeding during operation, which may oppress other important parts of the brain, leading to complications such as aphasia and local paralysis. Basically, the surgical team will try to strike a balance, hoping to clean up the cancer cells, but not over-cleaning.
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Cancer ≠ incurable disease, four common childhood cancers 1. Observe the baby's development, such as whether to follow the progress of seven sitting and eight climbing. If there are obvious abnormalities, you should ask a pediatrician or a pediatric neurologist for evaluation.
2. The child's development is slow, and his recovery has made no progress, even getting worse. It may be caused by nerve tumor or other nervous system diseases. You should ask a doctor to help you evaluate and consider further examination.
3. Sometimes the brain tumor continues to grow, and the brain pressure will increase, causing the sick child to vomit all the time. If gastroenteritis 1 or 2 days ends, brain tumor patients will continue.
4. The baby with normal development becomes more and more unstable when walking, and its function becomes worse, or there are neurological symptoms such as mouth deviation, eye deviation and temperament change.
As for clinicians who suspect that children have brain tumors, they will use magnetic resonance imaging in the examination to obtain clearer brain images, and there is no risk of exposure to radiation. But it is not easy for children to lie down and check 1 hour. Sometimes parents are advised to cooperate with the examination time, let the children play a little tired first, and then take medicine when necessary to help children under 3 ~ 5 years old sleep and cooperate with the examination. In recent years, some hospitals have gradually started to offer "children's medical consultation" service. First, children can reduce their fears and have a smooth examination through game therapy.
After the diagnosis, some symptoms will be treated. For example, if you continue to vomit, you will use drugs to help stop vomiting first, and the most important thing is to have surgery quickly. Then according to the pathological examination results of brain tumors, you will plan whether you need to cooperate with radiotherapy and chemotherapy. Besides active treatment, children's cognitive function and endocrine function should be followed up continuously. After all the treatments are completed, it is necessary to make regular follow-up visits for about 3 months. If the situation is stable, the interval of follow-up visits should be gradually extended. In addition, long-term rehabilitation treatment should be arranged according to the recovery of neurological function.
Lymphoma virus invades, causing swelling.
Lymphoma can occur anywhere with lymph, and can be divided into Hodgkin's lymphoma (about 3% of childhood cancers) and non-Hodgkin's lymphoma (8-9% of childhood cancers). Lymph is the place where white blood cells gather and plays a role in regional defense. For example, if the virus invades the throat, the lymph on the neck may become swollen; When a hand is cut, axillary lymph nodes may also be swollen, because white blood cells are dealing with these foreign enemies.
Parents should pay more attention if they touch a lump on their neck, behind their ears, under their armpits or groin when taking a bath for their baby. Children often have throat infections, and small lymph nodes are common. But if it is greater than 1.5 cm, it feels hard and the swelling time is more than 2 weeks. It is recommended to take children to be evaluated and examined by doctors. If it is suspected to be a lymphoid tumor, it is recommended to perform surgery and take out the tissue for testing to confirm the diagnosis.
Most children's lymphomas are treated with chemotherapy, and a few also need radiotherapy. The survival rate is over 80%. But it still depends on the type of tumor. If it is Hodgkin's lymphoma, the cure rate can reach 90%. If it is not Hodgkin's lymphoma, it is about 70% to 80%. What is more difficult to deal with is that tumors grow in special parts, such as the central nervous system, which will increase the difficulty of diagnosis and treatment.
The survival rate of solid tumor neuroblastoma other than brain tumor is about 60%
Solid tumors that are not brain tumors, including neuroblastoma, hepatoblastoma and nephroblastoma, belong to primitive embryonic tumors, and the treatment is mainly surgery, chemotherapy and radiotherapy.
In fact, the choice of treatment depends on the patient's age and the size and type of tumor. According to the tumor images, the clinical and tumor characteristics of sick children and low, medium and high-risk people are usually evaluated, and then different intensities of treatment are given. In terms of cure rate, taking the common neuroblastoma as an example, the long-term survival rate is about 60%, the neuroblastoma in the middle and low risk group accounts for about half of the total, and the survival rate can reach over 80% to 90%, while that in the high risk group is only about 30%.
What should parents do if their children have cancer? Dr. Liu Yanlin pointed out that children are unfortunately suffering from cancer. At first, parents' mood fluctuated greatly, and even self-reproach or husband and wife accused each other. Since most childhood cancers are accidental and random, there is no need to blame anyone. Husband and wife must work together to calm their emotions and strengthen their knowledge and understanding of the disease. At the same time, we should actively cooperate with the medical team, be open and honest, and work out the most suitable treatment plan.
During the treatment of children, parents should pay attention to the following matters:
1. Family resources should be well allocated, such as finance, insurance, parental care time, nanny or elder support, and transportation to and from the hospital.
2. Remember to pay attention to and take care of other children at home.
3. If necessary, you can consider seeking the assistance of other family members, and the extended family will support the small family.
There are many rumors on the internet. Don't believe anything you see. You can take screenshots and let the doctor help you make a correct judgment.
5. Accept standard treatment plan.
6. The website of Children's Cancer Foundation provides dietary advice for children with cancer, and there are nutritionists in the hospital team. Through talking with parents, you can give guidance according to your friends' tastes. Among them, protein must get enough food, and some children are picky eaters, so parents should pay more attention. Meat and vegetables are very important, and nutritional supplements can be used to strengthen nutrition when necessary.