Leukemia and Blood Cancer

Most of the symptoms of leukemia can be symptoms of other conditions. Most of the time, these symptoms are not caused by leukemia. If you see any of the symptoms of leukemia in your child, it is important to take your child to see their doctor so they can find the cause of the symptoms and begin treatment, if needed.

Most of the time, the symptoms of leukemia are caused by problems in your child’s bone marrow, which is where this type of blood cancer begins. Symptoms may include:

• Weakness
• Fatigue (extreme tiredness)
• Feeling dizzy
• Feeling lightheaded or faint
• Headaches
• Feeling cold
• Pale skin
• Having a hard time breathing, or shortness of breath
• Frequent infections (often due to low white blood cell count)
• Frequent fevers
• Easy bruising
• Bleeding gums
• Frequent, sometimes severe, nosebleeds
• Easy bleeding, or a hard time getting bleeding to stop
• Pain in the bones or joints
• Not wanting to eat
• Weight loss
• Swollen lymph nodes
• Swollen abdomen (belly)
• Seizures
• Vomiting
• Swelling of the face and arms

Again, although many of these symptoms are likely to be caused by something other than leukemia, it is still important to have your child checked out by their doctor. Most cases of childhood leukemia are found because a child had symptoms that made their parent take them to the doctor.

At this time, most diagnoses are symptom-based as there are no widely used screening tests for doctors to find leukemia before it causes symptoms. 

Take your child to see their doctor if your child has any of the symptoms of leukemia. If you are unsure, you may call your doctor’s office and speak to someone about the symptoms to see if you should make an appointment for your child. 

The exact cause of childhood leukemia is unknown. There are some risk factors that may make it more likely for a child to get leukemia, such as:

• Some inherited (passed down through families) syndromes, such as Down syndrome or Li-Fraumeni syndrome.
• Inherited immune system disorders, such as Bloom syndrome, Ataxia-telangiectasia, Wiskott-Aldrich syndrome, and Schwachman-Diamond syndrome.
• Family history. Having a brother or sister with leukemia seems to give a child an increased chance of getting the condition.
• Previous exposure to chemotherapy.
• High levels of radiation exposure.
• Having previous treatments to suppress their immune system.

If your child has symptoms related to leukemia, your child’s doctor may:

• Perform other tests to figure out what is causing the symptoms. (Most often, the symptoms that are linked to leukemia have other causes, but it’s still important to let your child’s doctor know if any of these symptoms show up.) If your doctor finds that your child has leukemia, more tests will be performed to find out what kind of leukemia it is and how it should be treated.
• Want to see your child as soon as possible. It’s better to begin treatment for leukemia as early as possible. The sooner you begin treatment with your child, the better the outcomes tend to be.
• Ask you to provide a brief medical history for your child, including more information about the symptoms, how long your child has had the symptoms, and if your child has been exposed to any of the potential risk factors for leukemia. Your child’s doctor may also ask you if your child has a family history of cancer, especially leukemia.
• Conduct a physical exam. Your child’s doctor will check your child’s lymph nodes, gums, and belly.
• Ask for samples of your child’s blood and bone marrow to confirm any diagnosis. The doctor may also want additional blood tests to measure chemicals in the blood to see if and how well certain body systems are working. These blood tests are not used to diagnose leukemia, rather, they are used to help find and prevent damage to other body parts due to the disease. Your child may also be tested for blood infections. If your child has leukemia, they will have a weakened immune system. It will be important to catch any infections and start fighting them as soon as you can as your child will have a harder time fighting disease.
• Refer you to see a pediatric oncologist [on-CALL-oh-jist], which is a doctor that specializes in childhood cancer.
• Ask for more tests to help see where the leukemia is, and to help stop it from spreading. These tests may include a lumbar puncture or spinal tap. In a spinal tap, your child’s doctor will look for leukemia cells in the cerebrospinal [suh-REE-broh-SPY-nuhl] fluid, which is the liquid that surrounds the brain and spinal cord. For your child’s safety, it is very important to have this test performed by an expert.

Childhood leukemia is usually treated by a pediatric oncologist, a specialist in childhood cancers. However, there may be several other doctors and specialists on your child’s healthcare team, depending on the nature and severity of your child’s cancer.

Some treatment options include:

• Chemotherapy, the main treatment for childhood leukemia. Your child is given anti-cancer drugs, either by a shot or by pill, to help kill the cancer.
• Stem cell transplant is sometimes performed after chemotherapy if your child’s cells, which are used to create blood, have been killed by chemotherapy. A stem cell transplant can help your child form their own blood again.
• Targeted drugs are drugs that attack specific parts of the cancer cell.
• Immunotherapy uses medicine to help your child’s immune system identify and fight cancer cells.
• Radiation therapy is when high-energy electromagnetic radiation, like x-rays or gamma rays, is used to kill cancer cells. It is rarely used in the treatment of leukemia. 

Because doctors aren’t sure what causes childhood leukemia, they don’t know how to prevent it. 

Leukemia [loo-KEE-mee-uh] is a type of blood cancer. Blood cancer is a disease that can affect that blood cells, bone marrow, lymph [limf] nodes, and other parts of the lymphatic [lim-FAT-ik] system within your child’s body. There are other types of blood cancer that affect children and teenagers, but. However, leukemia is the most common cancer among them.

Leukemia affects the early blood-forming cells. Usually, it will affect the white blood cells, but it can still affect other types of blood cells. Leukemia can either be fast- (acute) or slow- (chronic) growing. Most cases of childhood leukemia are acute, or fast-growing. Most children are diagnosed with acute lymphocytic [lim-FO-sit-ik] leukemia (ALL) or acute myeloid [my-EL-oid] leukemia (AML).

There are a few different types of leukemia. Each type has different treatment options and different outlooks. As treatments have improved over the years, the chances of survival keep getting better.

Make sure to talk to your doctor about your child’s cancer. Some questions you may want to think about when talking to your child’s doctor are:

• Does my child have ALL or AML?
• Is there anything I can do now to improve my child’s outcome?
• What are the chances that we can cure my child’s type of leukemia?
• Do we need to do any other tests or exams to help us decide on the best treatment option for my child?
• Should we get a second opinion, or see any other doctors? If so, can you suggest someone?
• How much experience do you have treating this type of leukemia?
• What are our treatment choices? What do they mean, and how will they affect my child?
• When should we start treatment? How long will treatment last? What will it be like? Where will it be done?
• What do I need to do with my child to make sure they are ready for treatment?
• Are there any risks of treatment? If so, what are they?
• Are there any side effects of treatment? If so, what are they?
• Are there any long-term effects to treatment? If so, what are they?
• How will treatment affect my child’s life? Will it affect their ability to keep learning, growing, and developing?
• What if the treatment doesn’t work? Will we still have options? What are they? 
• What if leukemia comes back? Will we still have options? What are they?
• Will my child still be able to have children?
• Are there any clinical trials that we may want to think about to treat my child?

If you do not know the answers to these questions, please talk to your child’s doctor about them to make sure you have these questions answered as soon as possible.

Also, make sure to write down any of your own questions, and make sure to talk to your child’s doctor about them. Remember, there are no silly or stupid questions.