In Singapore, about 120 new cases
of childhood cancers are diagnosed
in children less than 15 years of age
each year. The most common types
of cancers seen in children are listed
in the chart below.
With advances in the understanding of cancer biology, intensive multi-agents drug therapy and applying state-of-the -art therapy including haemopioetic stem cell transplant, childhood cancers are highly curable today. For common cancers, including leukaemia, lymphoma, germ cell tumour and Wilm’s tumour, the cure rates are 80 per cent. Brain and bone cancers are moderately curable at 60 per cent.
Although some children may have
genetic conditions that predispose
them to developing tumours, the
exact causes of cancer in the majority
of children are unknown. It is also
important to remember that cancer is
Some signs and symptoms of common
childhood cancers are highlighted
Leukaemia occurs when the bone
marrow produces abnormal numbers
of immature white blood cells called
blast cells. As so many abnormal cells
are being produced, the marrow
cannot make enough normal white
blood cells to fight infection, red blood
cells to carry oxygen and platelets
that help in clotting. As a result, the
symptoms of leukaemia include
recurrent fevers, loss of energy and
appetite, pallor and easy bruising.
The symptoms will vary depending
on the location of the tumour and
the age of the child. In a young baby,
the head may rapidly increase in size.
Older children may have headaches,
vomiting and drowsiness due to
increased pressure on the brain by
the growing tumour. The child may
develop weakness, unsteadiness when
walking, clumsiness, double vision and
squinting if certain parts of the
brain are affected by the tumour.
These are tumours that start in the
lymph glands. The symptoms include
swellings in the neck, armpit, groin,
chest and abdomen, which are where
lymph glands are located. There may
also be recurrent fevers, pallor and loss
of weight and appetite.
This is a cancer of the eye and usually
occurs in very young children under
two years of age. They may present
with squinting or a white mass seen
through the lens of the eye.
This is a cancer occurring in the kidney.
The child usually presents with a
swelling in the abdomen which may be painful. Occasionally, the child may
pass blood in the urine.
The treatment options available will
depend on the type of cancer being
treated. For example, surgery is
usually necessary for solid tumours,
but chemotherapy is the treatment
of choice for leukaemia because the
cancer cells are already present in the
blood circulating throughout the body.
Surgery is required for most solid
tumours. However, if the initial
position or size of the tumour makes
the operation a high-risk procedure,
chemotherapy or radiotherapy may
be given first to reduce the size of the
Radiation destroys cancer cells by
injuring their ability to divide. Special
equipment directs rays to the tumour
site for a few minutes at a time. This
is done five times a week for two to
six weeks depending on the type
of tumour. Side effects include skin
irritation and pigmentation, which are
This involves the use of drugs that
interfere with cell division and stop the
growth of tumour cells. They circulate
throughout the body and can kill
cancer cells far away from the original
This is the mainstay of leukaemia
therapy. Some chemotherapy drugs
are given by injection while others can
be taken orally.
Side effects include hair loss, nausea
and vomiting, loss of appetite, mouth
ulcers and increased risk of infection.
However, steps can be taken to
prevent or reduce them.
Cord Blood/Bone Marrow
This is used mainly for high-risk
leukaemia or relapsed leukaemia,
but can be used to treat other
types of cancer as well. High doses of chemotherapy with or without
radiotherapy are given to kill cancer
cells. However, the body’s normal
blood stem cells are also destroyed
by the intensive treatment. Healthy
blood stem cells from a donor are then
transplanted into the body to replace
the destroyed normal cells.
Cord blood is a good alternative
source of stem cells. There is an active
cord blood transplant programme in
KK Women’s and Children’s Hospital
(KKH). The Singapore Cord Blood Bank
is also sited in KKH.
The Children’s Cancer
Programme at KK Women’s and
The Children’s Cancer Centre in KKH
offers a holistic, comprehensive
range of services to treat children
with cancer, as well as support the
emotional needs of their families.
Multidisciplinary teams consist of
paediatric oncologists, paediatric
oncology surgeons, paediatric neurosurgeons
and oncology-trained nurses.
Our inpatient ward has 20 beds with
4 Bone Marrow Transplant rooms,
manned by a dedicated team of
doctors and nurses trained in the care
of children with cancer. There is also
a 13-bedded Day Therapy Centre for
outpatient treatment and a pharmacy
which dispenses oncology drugs.
We work closely with social workers
from the hospital and the Children’s
Cancer Foundation (CCF) to offer
psychosocial support to patients and
their families. The diagnosis of cancer
in a child is always a devastating one
for both the child and family. We hope
to work together with our patients and
their families to achieve the common
goal of conquering childhood cancer.
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