A young child wearing a pink headscarf during a medical consultation at the hospital.

Childhood cancers are a group of diseases that occur in children and adolescents and can originate in different organs and tissues. They differ from adult cancers in terms of their clinical characteristics, biological behavior, genetic profiles, and treatment approaches.

Although childhood cancers are relatively rare, early diagnosis is important to ensure that appropriate treatment can be initiated without delay. However, the initial symptoms of these diseases are often nonspecific. Complaints such as fever, fatigue, bone pain, headache, or enlarged lymph nodes may also occur in common childhood infections and non-cancerous conditions.

Therefore, when evaluating possible childhood cancers, it is important to consider not only individual symptoms but also their duration, severity, whether they are progressive, and whether they occur alongside other clinical findings.

Not every episode of fever, headache, or enlarged lymph nodes indicates cancer. Nevertheless, unexplained, persistent, or progressively worsening symptoms should be evaluated by a pediatrician.

Why Can Childhood Cancers Be Difficult to Recognize in the Early Stages?

One of the main reasons childhood cancers can be difficult to identify at an early stage is that their symptoms often resemble those of common childhood illnesses.

For example, acute leukemia, one of the most common types of childhood cancer, may present with symptoms such as fever, fatigue, pallor, bone pain, and recurrent infections.

Initially, these symptoms may be mistaken for infections, anemia, or rheumatic diseases.

Similarly, brain tumors may present with headaches and vomiting, lymphomas with enlarged lymph nodes, and bone tumors with persistent bone pain.

Since these symptoms are much more commonly caused by non-cancerous conditions, advanced diagnostic testing is not necessary for every complaint. However, when symptoms do not improve despite treatment, recur, or progressively worsen, the diagnosis may need to be reassessed.

What Are the Symptoms of Childhood Cancer?

The signs and symptoms of childhood cancer vary depending on the type of cancer and the organ or tissue affected.

The following findings may be associated with certain childhood cancers:

Signs and Symptoms	Potentially Associated Cancer Types
Persistent fatigue and pallor	Leukemia and other conditions affecting the bone marrow
Unexplained bruising or bleeding	Leukemia
Bone pain accompanied by fever	Leukemia, Ewing sarcoma
Persistent or progressively worsening bone pain	Osteosarcoma, Ewing sarcoma, leukemia
Recurrent vomiting accompanied by headaches	Brain tumors
Progressively enlarging, unexplained lymph nodes	Hodgkin lymphoma, non-Hodgkin lymphoma
White reflection in the pupil (leukocoria)	Retinoblastoma
Palpable abdominal mass or swelling	Wilms tumor, neuroblastoma, non-Hodgkin lymphoma, germ cell tumors
Unexplained weight loss and night sweats	Certain types of lymphoma
Persistent or unexplained ear discharge	Rarely, rhabdomyosarcoma or Langerhans cell histiocytosis

Most of these symptoms can also occur in non-cancerous conditions. This table is intended to highlight findings that may require medical evaluation and should not be used as a diagnostic tool on its own.

Can Headaches in Children Be a Sign of a Brain Tumor?

Headaches are among the most common complaints during childhood.

The vast majority of headaches in children are not caused by brain tumors. However, in certain cases, accompanying symptoms may indicate the need to investigate a condition involving the central nervous system.

In children with brain tumors, headaches may occur alongside nausea, vomiting, visual disturbances, balance problems, or other neurological symptoms.

Which Headache Symptoms Should Be Considered Warning Signs?

Medical evaluation is recommended if a child experiences any of the following:

Headaches that progressively increase in severity or frequency
Headaches accompanied by recurrent vomiting, particularly when symptoms are more pronounced in the morning
Vision loss, double vision, or newly developed visual disturbances
Loss of balance or difficulty walking
Weakness in the arms or legs
Newly developed seizures
Behavioral changes or altered consciousness accompanying headaches

A detailed medical history and neurological examination are important when evaluating headaches.

Brain imaging may be recommended when clinically indicated. Magnetic resonance imaging (MRI) is generally preferred when investigating suspected brain tumors in children, depending on the clinical situation.

Not every child with a headache requires computed tomography (CT) or MRI.

Is Enlarged Lymph Nodes in Children a Sign of Cancer?

Enlarged lymph nodes, medically known as lymphadenopathy, are a common clinical finding in children.

Lymph nodes, particularly those in the neck, may become enlarged during upper respiratory tract infections.

Most cases of lymph node enlargement are caused by infections or normal immune system responses.

However, certain characteristics may indicate the need for further evaluation.

Which Enlarged Lymph Nodes Should Be Investigated?

Medical evaluation by a pediatrician is important in the following situations:

Lymph nodes that continue to increase in size
Enlargement that persists for an extended period
Lymph nodes that feel hard or fixed to surrounding tissues
Enlarged lymph nodes above the collarbone (supraclavicular lymphadenopathy)
Accompanying unexplained fever, weight loss, or night sweats
Enlargement of the liver or spleen
Additional symptoms such as significant fatigue, pallor, or unexplained bruising

When evaluating enlarged lymph nodes, factors such as location, consistency, growth rate, and accompanying symptoms are just as important as their size.

If necessary, diagnostic methods such as blood tests, ultrasonography, or biopsy may be used.

Not every enlarged lymph node requires a biopsy. The decision to perform a biopsy is made based on the clinical evaluation.

Can Bone and Joint Pain in Children Be a Sign of Cancer?

Bone and joint pain in children may occur during periods of growth, following physical activity, or during various infections.

However, bone pain can also be one of the initial symptoms of certain childhood cancers.

Bone pain may occur particularly in conditions such as leukemia, osteosarcoma, and Ewing sarcoma.

Bone involvement in certain other tumors, such as neuroblastoma, may also cause pain.

Which Types of Bone Pain Should Be Evaluated?

Bone and joint pain with the following characteristics should be medically evaluated:

Persistent or progressively worsening pain
Pain that wakes the child from sleep at night
Pain that continues in a specific area
Pain accompanied by swelling or a palpable mass
Unexplained limping
Difficulty walking or moving
Pain accompanied by fever, fatigue, pallor, or weight loss

In particular, persistent bone pain affecting a specific area and becoming increasingly severe over time should not be ignored.

What Conditions Can an Abdominal Mass in Children Indicate?

Swelling or a palpable mass in a child’s abdomen can develop for various reasons.

Constipation, enlarged organs, and several benign conditions may cause abdominal fullness or the sensation of a mass.

However, certain childhood tumors may also present as an abdominal mass.

Wilms Tumor

Wilms tumor is one of the malignant tumors originating in the kidneys in children.

In some patients, it may be noticed as painless abdominal swelling or a palpable mass.

Sometimes, parents first notice an unusual abdominal swelling while dressing or bathing their child.

Neuroblastoma

Neuroblastoma is a childhood tumor that can develop from tissues associated with the sympathetic nervous system.

When it develops in the abdominal region, it may present with swelling, pain, or a palpable mass.

What Should Be Done If an Abdominal Mass Is Detected?

If unexplained abdominal swelling, firmness, or a palpable mass is noticed in a child, medical evaluation is necessary.

If the mass is accompanied by recurrent abdominal pain, weight loss, loss of appetite, or deterioration in the child’s general condition, evaluation should not be delayed.

Physical examination and appropriate imaging techniques are used during the diagnostic process.

What Symptoms Can Intrathoracic (Mediastinal) Masses Cause in Children?

The mediastinum is the anatomical region located between the two lungs within the chest cavity.

It contains structures such as the heart, major blood vessels, trachea, and lymph nodes.

Mediastinal masses in children may develop due to either benign or malignant conditions.

Certain lymphomas may particularly affect the lymph nodes within the chest. Some tumors originating from nerve tissue, such as neuroblastoma, can also develop in the chest cavity.

Symptoms of Mediastinal Masses

Persistent cough
Shortness of breath
Wheezing
Chest pain or a feeling of pressure
Swelling in the face and neck
Breathing difficulties that worsen when lying down

Large masses within the chest may compress the airways or major blood vessels.

Significant shortness of breath, sudden swelling of the face or neck, or the development of breathing difficulties requires urgent medical evaluation.

Can Changes in Blood Counts Be a Sign of Childhood Cancer?

A complete blood count (CBC) is one of the basic laboratory tests used to evaluate various medical conditions in children.

Changes in blood cell counts may occur in certain childhood cancers.

Leukemia, in particular, can affect red blood cells, white blood cells, and platelets.

Anemia

Anemia refers to a decrease in the number of red blood cells or the hemoglobin level.

Children with anemia may experience pallor, fatigue, reduced exercise tolerance, and shortness of breath.

However, iron deficiency is one of the most common causes of anemia during childhood. Anemia alone does not indicate cancer.

Thrombocytopenia

Thrombocytopenia refers to a decrease in the platelet count.

It may cause easy bruising, nosebleeds, bleeding gums, or small red-purple spots on the skin.

Changes in White Blood Cell Counts

White blood cell counts may increase or decrease in certain diseases.

In leukemia, the white blood cell count may be high, low, or within the normal range.

Therefore, leukemia cannot be diagnosed based solely on the white blood cell count.

What Is Pancytopenia?

Pancytopenia refers to a simultaneous decrease in red blood cells, white blood cells, and platelets.

This condition can occur in various diseases affecting the bone marrow.

Although leukemia and certain cancers involving the bone marrow are among the possible causes, infections, medications, and non-cancerous bone marrow disorders can also lead to pancytopenia.

Changes detected in a complete blood count should be evaluated together with the child’s clinical condition and other diagnostic findings.

Why Is Early Diagnosis Important in Childhood Cancer?

Diagnostic and treatment methods for childhood cancers have improved significantly in recent years.

Today, many effective treatment options are available.

However, treatment outcomes vary depending on the type of cancer, its biological characteristics, disease stage, and the patient’s overall health.

Early medical evaluation can help establish an accurate diagnosis and ensure that an appropriate treatment plan is developed without unnecessary delay.

Nevertheless, not all childhood cancers cause symptoms during their early stages, and there is no universally applicable screening test for all types of childhood cancer.

For this reason, it is important for parents to recognize potential warning signs and share any unusual changes with their child’s pediatrician.

When Should Children Be Taken to a Doctor?

Parents are advised to seek medical evaluation if the following symptoms are unexplained, persistent, or progressively worsening:

Unexplained and persistent fever
Significant fatigue and pallor
Easy bruising or unusual bleeding
Persistent or progressively worsening bone pain
Unexplained limping
Progressively enlarging lymph nodes
A noticeable abdominal mass or swelling
Progressive headaches accompanied by recurrent vomiting
White reflection in the pupil
Unexplained weight loss

IMPORTANT: If a child develops severe breathing difficulties, altered consciousness, a newly developed seizure, or sudden neurological impairment, emergency medical care should be sought immediately.

Accurate Evaluation and a Multidisciplinary Approach to Childhood Cancer

The signs and symptoms of childhood cancers may resemble those of many common childhood illnesses.

Therefore, one of the most important aspects of early diagnosis is the careful evaluation of unusual and persistent symptoms.

The diagnostic process may require collaboration between specialists in pediatrics, pediatric hematology and oncology, radiology, pathology, and other relevant medical disciplines.

The treatment plan is also tailored to the type of disease and the individual needs of the child.

Not every symptom in childhood indicates cancer. However, unexplained, progressive, or persistent symptoms should be evaluated in a timely manner.

At LÖSANTE Hospital, the diagnosis, treatment, and follow-up of childhood cancers are approached with consideration for children’s physical and psychosocial needs.

Online Appointment

You can book an online appointment for healthcare services offered at LÖSANTE.

Book an Appointment →

Have Questions?

Contact us for more information about our healthcare services.

Contact Us →

Clinical Signs and Symptoms of Childhood Cancers