Information for the public

Symptoms of cancer in children and young people

Being referred to a specialist does not mean that you have cancer. Very few people who are referred to a specialist actually have cancer. However, it is important that you are checked quickly to find out. If you do have cancer, spotting it early can mean treatment is easier and more likely to be successful.

The types of cancer that affect children and young people can be can quite different from those in adults. Some cancers, such as neuroblastoma, retinoblastoma and Wilms' tumour affect mainly young children (under 5). Others, such as leukaemia, lymphoma, sarcoma and brain or central nervous system cancer, can affect people of any age. This section includes information for children (under 16) and young people (under 24). Some young people may be offered adult tests and referrals; this will depend on their age, the type of cancer suspected and the services in the local area.

Cancer in children and young people is rare. It can be very difficult to spot because many of the symptoms are the same as those for less serious conditions. If your child has symptoms that you are concerned about, the GP should take into account your concerns and your knowledge of your child. Your child may be offered an appointment with a specialist (such as a paediatrician) if you continue to have concerns about their symptoms, even if it's very unlikely that cancer is the cause.

If the GP thinks that your child should be referred to a specialist to check for possible cancer, they should discuss the decision with you and your child, if appropriate, and discuss with you the information that should be given to your child.

Lumps or swellings

Abdomen

If your child or a young person has a lump or swelling in their abdomen (the part of the body between the chest and hips) and the GP thinks it is caused by a swollen liver and spleen, they should be offered an appointment to see a specialist immediately (within a few hours) to check for leukaemia (which is cancer of the white blood cells). If the GP thinks it is caused by a swollen spleen only, they may be offered an appointment to see a specialist within 2 days to check for lymphoma (cancer of the lymphatic system, which includes things like the lymph glands that help to fight infection). The GP will also check for other symptoms, such as fever, night sweats, shortness of breath, itchy skin, or weight loss that can't be explained by anything else, which might help them decide whether to refer them.

If your child has a lump or swelling in their abdomen and the GP doesn't think it is caused by anything else, they may be offered an appointment to see a specialist within 2 days to check for neuroblastoma (which is a cancer of the nervous system) or Wilms' tumour (a type of kidney cancer).

Neck, armpits and groin

If your child or a young person has lumps caused by swollen glands in their neck, armpits or groin, and the GP doesn't think they are caused by another problem, they may be offered an appointment to see a cancer specialist within 2 days to check for lymphoma. The GP will also check if they have other symptoms of lymphoma, such as fever, night sweats, shortness of breath, itchy skin or weight loss.

More than one body area

If they have swollen lymph glands in more than one body area, they may be offered a blood test to check for leukaemia (cancer of the white blood cells) – this should be done within 2 days.

Soft tissue

Soft tissue is the soft, supporting tissue of the body, including fat, muscles, tendons, ligaments and blood vessels. A rare type of cancer called a soft tissue sarcoma can occur in these tissues, most commonly in the arms and legs. If your child or a young person has a lump in their soft tissue that is getting bigger, and the GP doesn't think it is caused by anything else, they may be offered a scan (carried out within 2 days) to check for soft tissue sarcoma. If an ultrasound scan suggests that soft tissue sarcoma is possible, or if the scan results are uncertain and there is still concern that cancer is possible, your child or the young person may be offered an appointment to see a cancer specialist within 2 days.

Blood in the urine

If your child has blood in their urine that can't be explained by another cause, the GP may offer them an appointment to see a specialist within 2 days to check for Wilms' tumour.

Bruising, unusual paleness or rash

If your child or a young person has a skin rash of small red or purple spots (known as petechiae), and the GP doesn't think it is caused by anything else, they should be offered an immediate appointment (within a few hours) with a specialist to check for leukaemia.

If your child or a young person has bruising that isn't caused by anything else (such as an injury) or an unusual paleness to their skin (pallor), they should be offered a blood test, which should be done within 2 days, to check for leukaemia.

Bone pain or swelling

If your child or a young person has bone pain that is long‑lasting, they should be offered a blood test, which should be done within 2 days, to check for leukaemia.

If they have bone pain or swelling and the GP doesn't think it is caused by anything else, they may be offered an X‑ray, which should be done within 2 days, to check for bone sarcoma (a rare type of bone cancer). If the X‑ray suggests bone sarcoma is possible, they may be offered an appointment with a specialist within 2 days.

Eye check results

Your child might have an eye check as part of a developmental check, or because you are worried about your child's eyes or sight. As part of the check your GP may use an instrument called an ophthalmoscope to see inside your child's eye and check the 'red reflex' (which is the red‑coloured reflection of light from inside the eye).

If your child does not have a red reflex in one or both eyes, your GP may offer them an appointment to see an eye specialist (an ophthalmologist) within 2 weeks to do further checks for a type of eye cancer called retinoblastoma.

General symptoms

Some symptoms that might be caused by cancer are not specific to a body area, such as weight loss, severe tiredness or fever. Sometimes general symptoms occur alongside other symptoms or signs of cancer.

Your child or a young person may be offered a blood test (carried out within 2 days) to check for leukaemia if they have long‑lasting tiredness, a fever, bleeding or an infection that hasn't got better or keeps returning and the GP doesn't think they are caused by anything else.

Your child or a young person may be offered an appointment to see a cancer specialist within 2 days to check for lymphoma if they have swollen lymph glands. The GP will also take into account if they have other, general symptoms such as fever, night sweats, itchy skin or weight loss, which might help them decide whether to refer them.

Some general symptoms are caused by problems with the brain and nervous system. If your child or a young person has problems with their movements, strength, balance and coordination, or confusion and tiredness, and the GP has assessed them and thinks that they might have a new problem with their brain or central nervous system, they may be offered an appointment to see a specialist within 2 days to check for cancer.

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