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Intro to Childhood Cancer - Coggle Diagram
Intro to Childhood Cancer
Conditions by age
7-16yrs
Brain
Lymphoma
Bone
0-6yrs
Wilms Tumour
Brain
Neuroblastoma
Leukaemia
What is cancer?
Metastasis: clumps of cancer cells that break off and travel via lymphatic and blood to sites forming 2nd growths
Benign: doesn't invade adjacent structures or metastasize
Cancer: abnormal cell growth with potential to invade other parts of the body
Main Cancer Groups
Hodgkin's Lymphoma: 4%
Non Hodgkin's Lymphoma: 4%
Myeloid Malignancies: 8%
Neuroblastoma: 5%
CNS (incl. Brain Tumours): 25%
Acute Lymphoblastic Leukaemia: 20%
Wilm's Tumour (incl. ERWT): 5%
Rhabdomysarcoma: 5%
Incidence Childhood Cancers
Marked improvement in prognosis in last 30yrs
Childhood cancer- chronic illness not invariably fatal one
Childhood cancer = 0.5% of all cancers in Ireland
Late effects: adverse long term complications of childhood cancer + tx
Cure rate 90%
Increase in occurrence of secondary malignancy post successful tx of primary
Aetiology Childhood cancer
Identified patterns of inheritance.
Syndromes: down syndrome, kleinfelters syndrome, beckwith-wiedemann syndrome
Genetic (oncogenes) alteration
Immunodeficiency: AIDS/ Post transplant
Unknown
Siblings and Off-spring: retinoblastoma
What does cure mean?
Relapse: disease recurs
Event free survival: no serious sequalae/ effects from tx./ disease
Remission: free from disease
Disease free survival: free from disease
Long Term Survivor: survived at least 5 yrs from last indications of disease & is at least 2 yrs from end of therapy
Classification
Sarcoma: connective tissue (bone,cartilage,fat,nerve)
Lymphoma/Leukaemia: haematopoietic cells (lymph glands,blood)
Carcinoma: epithelial cells (breast,prostate,lung,pancreas,colon)
Germ cells: pluripotent cells (testes,ovary)
Blastoma: immature precursor cells/ embryonic tissue
Risk Factors
Environment
Pregnant women exposure radiological tests
Power lines
Maternal exposure to low level radiation link with Thyroid & Leukaemia
Radon
Low risk in adults
Viral
Epstein Bar Virus: Burkitts lymphoma, Hodgkins lymphoma, Naso Pharngeal carcinoma
Hep B/C: liver
HIV: Kaposi's sarcoma
Drugs During Pre-Natal Period
Immunosuppressant agents
Diethylstilbesterol
Radio-isotopes
Smoking, marijuana
Symptoms
Unusual mass: swelling/lump
Unexplained paleness or tiredness
Vision: blurring, strabismus
Anaemia- malignant invasion of bone marrow
Mobility: gait limp
Sudden tendency to bruise: low platelets
Headache/ vomitting
Nose bleeds/ gum bleeds/ heavy periods
Pain: not common late sign
Fever- prolonged, unexplained
Petechiae- extremities
Diagnosis
Inx: clinical assessment, biopsy, bloods, imaging
Delivery of dx
Very stressful time
plan of tx.
Referral
Investigations
Lumber puncture
Imaging
Biopsy: stage & classification
Bone marrow aspirate
Lab test: blood count/chemistry, renal/liver function
Treatment:
Chemo: day case, inpatient, home
Radio: 3-5 weeks daily
Surgery:
Haematopoietic Stem Cell Transplant
Active/ Palliative