WHAT IS CANCER

The cell is the building block of life and cancer is a disease of the cell.

Each cell contains a set of instructions telling it to carry out a certain function within the body. Some cells are programmed to build our organs, others our bones and muscles and some are on standby to heal a wound, fight infection or replace diseased cells. There are over 200 different types of cells and so there can be over 200 different types of cancer. Whilst cells may do different things, they all divide and reproduce in similar ways.

During division and reproduction, a healthy cell will make an exact copy of itself. One cell becomes two, two become four, four become eight and so on. When our bodies are growing, cells divide more rapidly. A healthy cell reproduces a certain number of times before it dies naturally but will die prematurely if it is damaged or finds itself in the wrong place (for example, a liver cell finds itself amongst bone cells).

Sometimes the division and reproduction process goes wrong and abnormal cells are produced. These cells are unable to carry out their instructions and are called cancer cells. They continue to reproduce and group together to form solid tumours, causing problems by pressing onto surrounding organs and tissues.

The most common childhood cancers are solid tumours and leukaemias.

Solid Tumours

Sometimes the division and reproduction process of our cells goes wrong and abnormal cells are produced. These cells are unable to carry out their instructions and group together to form solid lumps called tumours. Tumours can be either benign (non cancerous) or malignant (cancerous).

Cells in a benign tumour cannot spread to other parts of the body but they can keep growing at the original site and press on surrounding organs and tissues. Cells in a malignant tumour are able to spread beyond the original tumour site into surrounding tissue or to other parts of the body. Malignant cells travel throughout the body in the bloodstream or the lymphatic system and begin to divide and grow to form a tumour in another area. This is called secondary metastatic cancer.

Malignant tumours are classified by stage and grade and you may have heard these words being used. The stage relates to how far the cancer has spread in the body and the grade describes the type of cells contained within the tumours.

Cancer stages:
Stage 1: the cancer is small and localised, has not spread beyond the original site
Stage 2 or 3: the cancer has spread into surrounding tissues/structures
Stage 4: the cancer has spread to other parts of the body (secondary or metastatic cancer)

Leukaemia

The most common type of cancer in children is leukaemia. These are cancers of the bone marrow. The bone marrow is a spongy material found in the centre of some of our bones. All of our blood cells are produced in the marrow. There are three types of blood cells:

  • red blood cells that carry oxygen 
  • white blood cells that fight infection 
  • platelets that clot the blood (control bleeding) 

Red, white and platelet cells grow from stem cells within the bone marrow.

Leukaemia occurs when the marrow creates a large number of immature blood cells. These cells cannot perform their functions properly because they cannot grow to maturity. The word leukaemia refers to white cells as the disease usually affects their production. Acute Myeloid Leukaemia affects the early white myeloid blood cells and Acute Lymphoblastic Leukaemia affects the lymphoblasts (early lymphoid white blood cells).

The large number of immature cells inhibits the production of healthy, mature blood cells. This reduces the body's ability to fight infection. Production of red cells and platelets is lessened too and this can result in anaemia and significant bruising.

Diagnosis

You may have noticed that your child was more tired than usual, lacking in energy, quiet and withdrawn. Perhaps he or she was complaining of headaches or pain or just saying to you, 'I don't feel well.'

Taking your child to your family doctor to have these symptoms checked was the first step. A referral to the hospital to see a paediatrician, or perhaps a paediatric oncologist or a haematologist followed and now you have received news you never expected or wanted to hear: a diagnosis of cancer for your child.

Right away the doctors are recommending tests. There can be a confusing number of these with unfamiliar names and purposes. For information about diagnostic tests, visit the webpage on this site.

Why do we have so many tests?

Tests are needed to give an accurate diagnosis of the cancer. As we mentioned earlier, there are many different types of cancer so the specialists need to know exactly what type of cancer your child has so they can determine the best treatment. The information gained from tests can then be shared amongst the medical team looking after your child. The tests will also determine the stage and the grade of the cancer and provide an overall assessment of your child's general health.

Waiting for tests to be scheduled, completed and for the results to come back can be difficult because you want the best outcome for your child and for treatment to start right away. It is hard to be patient but all the necessary information is needed from the tests to ensure the correct diagnosis is made and the most appropriate and effective treatment is given to your child.

Tests and diagnostic procedures

Your child may not have all of these procedures but we provide an overview for your information.Some of these tests may be conducted only once or, as your child goes through treatment, certain tests may be done more frequently to monitor the effectiveness of the treatments.

You may ask to see (and have copies made) of the results of any tests conducted. You may also request that results be sent to your GP too so he or she has a complete record of your child's diagnosis and treatment. A team of specialists (a multi-disciplinary team) will be caring for your child in hospital so having records all in one place, with your GP, can be helpful in the future.

Treatments

Your specialist will advise a treatment plan based upon all of the information gathered from tests and surgery.

If English is not your native language or you have a hearing difficulty, ask the Hospital to provide an interpreter or someone to assist you. It is extremely important that you fully understand all aspects of the treatment your child will receive.

There are currently three main ways of treating your child's cancer: Surgery where the tumour is removed in a surgical operation (localised at the cancer site)

  • Chemotherapy where cancer cells are killed with anti-cancer drugs (systemic, whole body)
  • Radiotherapy where high energy rays are used to kill cancer cells (localised at the cancer site)

There is no one single treatment plan that fits everyone because we are all unique individuals. Your child will receive an individualised treatment plan based upon the stage and grade of their cancer and their overall health. Your child may receive a combination of treatments, for example chemotherapy and radiation or a Bone Marrow Transplant. Don't be afraid to ask questions about the treatment plan:

  • What are the names of the drugs to be used and the dosage frequency? 
  • What side effects can be expected, both short and long term? 
  • Who will be administering treatment and where in the hospital will it be given? You may accompany your child to treatment and don't hesitate to query the medication being given, checking the labels to be sure it is for your child (whilst mistakes are rare, they can happen). 

Your specialist will meet with you to discuss the treatment plan and he or she should:

  • Describe the plan in easy-to-understand terms 
  • Outline the benefits, risks and potential side effects of treatments 
  • Describe any other types of treatments that may be appropriate 
  • Repeat the information as many times as necessary so that you completely understand 
  • Explain the consent process (you will need to provide your parental consent to the treatment)

Don't be afraid to ask questions because the only silly questions are those not asked. Make lists of questions prior to appointments and take someone with you who can write notes while you discuss your child's case with the specialist. You can de-brief later with your family and refer to the notes taken.

View Treatment options

crowd