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Pediatric cancer: warning signs and symptoms

As parents, we spend a lot of time worrying about every aspect of our children’s lives — especially their health. Some parents will, at some time, worry about the possibility of a child developing cancer. Is this fear realistic? Just how common is pediatric cancer?

In terms of health, the most dangerous time for a child is early in life, and especially around the time of birth. Cancer is extremely rare in newborns and even the first year, but that is when more than 11,000 children will die each year due to complications of pregnancy, congenital anomalies, prematurity and their consequences. Sadly, another 1,500 will lose their lives due to Sudden Infant Death Syndrome (SIDS).

That is why pediatricians recommend safe sleep for all children — in their own crib with a well-fitting mattress and no blankets, pillows or toys. After a child’s first birthday, injury — not cancer — is actually the leading cause of death in children. Most injury is preventable. Parents can protect their children by insisting on seat belts, watching them when in or near the water, as well as by keeping guns locked, unloaded and out of reach.

Nonetheless, pediatric cancer remains a leading cause of death caused by an illness and claims the lives of far too many children. In the United States, 43 children are diagnosed with cancer every day. It is estimated that in 2017, there were 15,270 children and adolescents, up to age 19, diagnosed with cancer. Unfortunately, nearly 12 percent will die from their disease. With intense treatments, including life-saving therapies developed at the Sylvester Comprehensive Cancer Center and Holtz Children’s Hospital at Jackson, specialized physicians are working diligently to bring those numbers down.

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Dr. Warren Alperstein is a pediatric hematology/oncology fellow at the Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital.

These numbers, while worrisome, are not intended to cause anxiety, but rather to bring awareness and clarity. Most childhood complaints are transient and result from common illnesses. Cancer is a rare diagnosis, yet it is imperative for parents to be aware of the most common signs and symptoms and to seek expert help when needed.

Leukemia/lymphoma and brain tumors remain the most frequent childhood cancer diagnoses.

Leukemia and lymphoma are cancers of the white blood cells and can present in a multitude of ways such as unintentional and severe weight loss over months, night sweats (that soak through the pillows), unexplained fatigue, fevers, unusual bruising/nosebleeds, large lymph nodes, difficulty breathing, and pain. If your child develops any of these symptoms, he or she should be evaluated by a pediatrician as a first step.

You should know that these symptoms do not predict cancer. More often, viral syndromes and other conditions may be diagnosed, but it is important to be aware of these potential symptoms and communicate them to your child’s doctor.

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Dr. Judy Schaechter is the chair of the department of pediatrics at the University of Miami Health System.

Brain tumors can be undetectable at first, but as they grow larger, they can cause symptoms such as changes in behavior, excessive sleepiness or irritability, and headache or vomiting without other “common” viral illness symptoms. Neuroblastomas (tumors of the adrenal glands) and Wilm’s tumor, a malignancy starting in the kidney, are typically seen in the young children and often present with abdominal masses. One easy way to check your child is to feel his or her belly during bath time. This can be turned into a “tickling” game.

Despite the gravity of a cancer diagnosis, increasingly, pediatric cancer doctors and scientists are achieving ever-higher survival rates. The 5-year survival rate for most common childhood cancers combined has risen from 58 percent in 1975 to 85 percent in 2012. Hence, there is much reason for optimism and every reason to continue research in childhood cancer.

Survival rates are continuing to increase due to continued research efforts. Because pediatric cancer is a rare disease, any one institution — no matter how large — will typically not see very many patients annually. Pediatric cancer institutes throughout the country have created national consortiums, such as the Children’s Oncology Group, which pools research and clinical resources. These combined efforts have contributed greatly to the progress we have made.

At the Sylvester Comprehensive Cancer Center, part of the University of Miami Health System, and Holtz Children’s Hospital at Jackson’s new oncology wing, our pediatric patients are offered enrollment in multiple clinical trials and innovative therapies to families facing such illnesses. New technologies and therapies, including immunotherapy, may make the difference for individual children and keep us progressing forward.

As parents, we need to be aware of any changes in our children’s health. Concerned families should start with a thorough evaluation by their general pediatrician. Consultation by an expert pediatric hematologists/oncologist will put some worried parents at ease, or start needed treatments that will more quickly get a child back to their usual routine — at home, at school and at play. A healthy childhood is and will always remain our goal.

Dr. Warren Alperstein is a pediatric hematology/oncology fellow at the Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital. Dr. Judy Schaechter is the chair of the department of pediatrics at the University of Miami Health System. For more information, visit