Could your child’s exhaustion be a sign of cancer: The symptoms to watch out for

Cancer in children is a worldwide health problem, and several thousand families are affected every year. Unlike many adult cancers, which are frequently the product of extended lifestyle or environmental exposures, childhood cancers are most often the consequence of genetic mutations that occurred early in life. This makes them unpredictable and unavoidable, hence the need for early identification and diagnosis is important.

“September is dedicated as Childhood Cancer Awareness Month, and the 2025 theme ‘Diagnosis’ aims to emphasize the significance of early detection,” says Dr Anuradha Murthy, MD, Senior Consultant Surgical Pathologist, Metropolis Healthcare Ltd., Mumbai. Recognizing symptoms such as sudden fatigue, prolonged fever, bruising, or unusual swelling could prove vital in helping prompt earlier intervention.

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The earlier the recognition, the earlier the diagnosis and treatment.

1. Why childhood cancer is different:

• The cancers are being studied in depth, with investigations keeping in view India's extensive socio-economic, genetic, lifestyle, and environmental heterogeneity


• Childhood cancers differ from adult cancers, with some geographic distribution suggesting environmental or local causations


• About 5–10% of childhood cancers have a genetic etiology (either inherited or acquired)



• There are no specific screening tests apart from germ cell tumours, where biomarkers are useful


• Genetic tumour syndromes need specific testing and genetic counselling


• Symptoms are non-specific, leading to delays in diagnosis

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  3. Early warning signs parents must watch out for:



• Unexplained weight loss


• Unusual fatigue or tiredness


• Frequent headaches


• Fever without infection


• Vomiting repeatedly


• Swellings or lumps


• Bone pain


• Title change or vision


• Sudden, unexplained bruising
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  When mass lesions are present, the child attends the clinic. Not all swellings are malignant, and reassurance and support are given at every stage.

• Haemopoietic/lymphatic tumours


• Central nervous system/spinal cancers


• Retinal cancer


• Histiocytic tumours


• Musculoskeletal cancer


• Neuroblastoma


• Kidney and liver tumours


• Other solid organ cancers and gastrointestinal malignancies


• They are virus-related and require accurate investigation.


• Tumour malignancies, embryological, developmental, and genetic also present in clinics and should be thoroughly investigated.
  5. How doctors diagnose childhood cancer:


• Imaging tests and clinical examination


• Surgical evaluation


• Genetic and laboratory evaluation


• Immunologic testing, flow cytometry, cytology (routine & liquid-based)


• Histopathology (digital pathology)


• Immunocytochemistry


• Molecular tests such as next-generation sequencing (NGS) and liquid biopsies

  Diagnostic and prognostic features are now being reported in a standardized fashion, enabling better data mining. Digital pathology and artificial intelligence will assume greater roles in the future.

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• Every case diagnosed is not just a number but an individual patient during personalized medicine


• Cases are categorized according to WHO collaborative studies, revised at intervals by newly recognized entities


• Each case is registered by individual centres and reported to the Indian Cancer Registry in an attempt to build national incidence estimates
  7. Why access matters:


• Good multidisciplinary teams, specialty pediatric/hemato-oncologists, advanced radiation protocols, and support systems are found at good centres with excellent outcomes


• Strong transplant facilities are present now, but early and accurate diagnosis still matters


• Socioeconomic status and non-access to specialized facilities create an urban-rural inequality


• About 80–85% of cancer in children occurs in developing countries, with survival rates as low as 10%

  FAQ

  Q: What makes childhood cancer different from adult cancer?
  A: Childhood cancers are typically a result of genetic mutations that occur early in life, whereas adult cancers often result from prolonged lifestyle or environmental exposures.

  Q: Why is early diagnosis of childhood cancer challenging?
  A: Symptoms of childhood cancer are non-specific, there are no general screening tests, and specific genetic testing and counselling may be required.

  Q: What are some early warning signs of childhood cancer?
  A: Signs include unexplained weight loss, unusual fatigue, frequent headaches, fever without infection, repeated vomiting, swellings or lumps, bone pain, change in vision, and sudden, unexplained bruising.

  Q: What types of cancer commonly affect children?
  A: Common types include haemopoietic/lymphatic tumours, central nervous system/spinal cancers, retinal cancer, histiocytic tumours, musculoskeletal cancer, neuroblastoma, kidney and liver tumours, and other solid organ and gastrointestinal malignancies.

  Q: How do doctors diagnose childhood cancer?
  A: Diagnosis involves imaging tests, clinical examinations, surgical evaluations, genetic and laboratory tests, immunologic testing, histopathology, immunocytochemistry, and molecular tests like next-generation sequencing and liquid biopsies.

  Q: Why is access to specialized care important for childhood cancer?
  A: Access to good multidisciplinary teams, specialized paediatric/hemato-oncologists, advanced treatment protocols, and strong transplant facilities greatly influences outcomes. Socioeconomic status and access to these specialized facilities can create significant disparities in survival rates.