I remember Charles (name changed) very well. He was my patient when I was training to become a paediatrician.

Patients with cancer usually stayed on the ward for a long time and we usually grew fond of them. Charles had retinoblastoma (cancer of the eye).

He came to the hospital with advanced disease and we sadly lost him.

During my training, there were times when caregivers or parents who were told that their wards had cancer protested and said their children could never get cancer.

It usually took repeated counseling to get them to accept the diagnosis and agree to treatment.

Their reaction was quite understandable. Cancer is a hard pill to swallow.

But as unpleasant as it sounds, the harsh truth is that children can get cancer too. Fortunately, the majority of childhood cancers are curable when detected early and treated.

Cancer is the abnormal multiplication of cells in the body. The cells in the body are programmed to be able to regulate their multiplication and growth.

They are also programmed to repair unwanted changes in the DNA and get rid of cells with such changes that cannot be repaired.

A cell can lose its ability to do this due to mutations in that cell or as a result of an existing genetic condition that makes the cell susceptible to errors during multiplication.

But when cell multiplication and growth get out of control, cancer can occur.

So though the direct cause of cancer largely remains unknown, there are certain risk factors that can increase a child's chance of getting cancer.

These risks include infection by viruses like HIV and Epstein Barr virus, conditions like Down syndrome, as well as exposure to ionising radiation and pesticides.

Majority of patients however don't have any identifiable risk factor.

Signs and symptoms seen in a cancer patient depend on the type of cancer.
Kidney cancers (nephroblastoma) usually present with enlargement of or a mass in the abdomen, bloody urine and hypertension.

Eye cancer (retinoblastoma) can present with a white spot in the pupil, a new squint, impaired vision, blindness, and protrusion of the eye.

Cancer of the blood (Leukemia) usually presents with persistent or recurrent fever, weight loss, abnormal bleeding, anemia, and bone pain.

Brain cancer can occur in children too and may present with persistent headaches, nausea, vomiting, problems with walking and balance, speech, and visual impairment.

Lymphoma can present as a painless swelling of the lymph nodes or as a swelling of the jaw or testes.

A type of cancer that is usually seen in toddlers is retinoblastoma.

This has a variety of symptoms and they include persistent diarrhea, fever, hypertension, bleeding tendencies, bulging eyeball, and darkening around the eyes. Bone cancer is usually seen in adolescents.

Liver cancer can occur too, though uncommon.

The diagnosis of cancer is made after thorough questioning (history taking), careful examination of the patient, and a variety of tests.

The duration of treatment depends on the type of cancer and how advanced the disease is.

Regular follow up is necessary for patients even after achieving a cure. Sometimes, relapse occurs.

A lot of cured children are however able to continue their education and engage in regular activities.

Contrary to what some people believe, cancer is not infectious. Children with cancer and their families should be shown love and given financial support.

In this month of September, as we create awareness on childhood cancers, let us remember that early detection and early treatment helps to achieve complete cure.

Let us remember that cancer is not infectious.

Let us remember that children with cancer should be shown love and are not to be stigmatised.

Let us remember to say a prayer for them and their families.

The author, Dr Gloria Amponsah-Kodua is a Paediatrician at Tafo government hospital, Kumasi.

Acknowledgement: Dr Eugene Agyei Aboagye and Dr Lily Gloria Tagoe.