September Cancer Awareness Month Part I : Childhood Cancer, Leukemia, Lymphoma and Thyroid Cancer Awareness
Childhood Cancer- A general term used to describe a range of cancer types and non cancerous tumors found in children. May also be called pediatric cancer.
Types of Childhood Cancer (Children under 15)
Leukemia:(34% of childhood cancers)
Acute Lymphoblastic Leukemia (ALL)
Acute Myeloid Leukemia (AML)
Brain and CNS Tumors including tumors of the spinal cord: (27% of childhood cancers)
Brain Stem Glioma
Central Nervous System
Desmoplastic Infantile Ganglioglioma
Atypical Teratoid Rhabdoid Tumor
Neuroblastoma: (7% of childhood cancers) – A tumor of immature nerve cells that often starts in the adrenal glands, which are located on top of the kidneys and are a part of the body’s endocrine (hormonal) system.
Wilms Tumor: (5% of childhood cancers) – A type of kidney tumor
Non- Hodgkin Lymphoma: (4% of childhood cancers) and Hodgkin Lymphoma:(4% of childhood cancers) – Cancers that begin in the lymph system.
Rhabdomyosarcoma: (3% of childhood cancers) – A type of tumor that begins in the striated muscles, which is a part of the skeletal voluntary muscles that people can control. Other rare soft tissues sarcomas also occur.
Retinoblastoma: (3% of childhood cancers) -An eye tumor.
Osteosarcoma: (3% of childhood cancers) and Ewingsarcoma (1% of childhood cancers) – Tumors that usually begin in the bone.
Germ Cell Tumors- Rare tumors that begin in the testicles in boys and ovaries in girls, even more rarely the tumor can begin in other places in the body, including the brain.
Pleuropulmonary Blastoma- A rare kind of lung cancer.
Hepatoblastoma and Hepatocellular Carcinoma- Liver tumors.
Cancer in Teens and Young Adults Ages 15-19
Hodgkin Lymphoma (16% of teen cancers) and Non-Hodgkin Lymphoma (8% of teen cancers)
Germ Cell Tumors- including testicular cancer and ovarian cancer (16% of teen cancers)
CNS Tumors (10% of teen cancers)
Thyroid Cancer (7% of teen cancers)
Melanoma (7% of teen cancers)
ALL (Acute Lymphoblastic Leukemia) (6% of teen cancers)
Soft-tissue Carcinoma (7% of teen cancers)
Osteosarcoma (5% of teen cancers)
AML (Acute Myeloid Leukemia) (5% of teen cancers)
Ewingsarcoma (2% of teen cancers)
Other Cancers (12% of teen cancers)
Signs and Symptoms of Childhood Cancer:
- Continued and unexplained weight loss
- Headaches, often with early morning vomiting
- Increased swelling of persistent pain in the bones, joints, back and legs
- Lump or mass, especially in the abdomen, neck, chest, pelvis or armpits
- Development of excessive bruising, bleeding, or rash
- Constant infections
- A whitish color behind the pupil
- Nausea that persists or vomiting without nausea
- Constant tiredness or noticeable paleness
- Eye or vision changes that occur suddenly and persist
- Recurring or persistent fevers of unknown origin
Prevention– Because specific causes have not been found for each individual type of childhood cancer the way to prevent childhood cancer is still unknown.
Leukemia- Cancer that starts in the tissue that forms blood. Bone marrow makes abnormal white blood cells (leukemia cells). Unlike normal cells leukemia cells don’t die when they should. They may crowd out normal white blood cells, red blood cells and platelets. Making it hard for normal blood cells to do their work.
Types of Leukemia-
Types are classified as either chronic or acute.
Chronic leukemia-usually gets worse slowly and there may not be any symptoms until the cancer advances. Early in the disease the leukemia cells can still do some of the work of normal white blood cells.
Acute leukemia– usually gets worse quickly and often symptoms are noticeable in the beginning stages. Leukemia cells cannot do any of the work of the normal white blood cells.
4 Common Types Of Leukemia
Chronic Lymphocytic Leukemia (CLL): Affects lymphoid cells. It accounts of over 15,000 new cases of leukemia each year. Most often occurs in people over 55. It rarely affects children.
Chronic Myeloid Leukemia (CML): Affects myeloid cells. It accounts for 5,000 new cases of leukemia. It affects mainly adults.
Acute Lymphocytic (Lymphoblastic) Leukemia (ALL): Affects lymphoid cells. Accounts for 5,000 new cases of leukemia. It is most common in young children but can also affect adults.
Acute Myeloid Leukemia (AML): Affects myeloid cells. Accounts for more than 13,000 new cases of leukemia. It can occur in both adults and children.
Signs and Symptoms of Leukemia:
The symptoms of leukemia depend on the number of leukemia cells and where these cells collect in the body. People with chronic leukemia may not have symptoms. People with acute leukemia usually will feel sick
- Swollen lymph nodes that don’t hurt (especially in neck or armpit)
- Fevers or night sweats
- Frequent infections
- Feeling weak or tired
- Bleeding and bruising easily (bleeding gums, purplish patches in the skin or tiny red spots under the skin)
- Swelling or discomfort in the abdomen (from a swollen spleen or liver)
- Weight loss for no reason
- Pain in the bones or joints
Prevention- Most cases cannot be prevented. The cause of leukemia is still unknown.
Lymphoma- Cancer of the lymphatic system(part of the immune system).
Types of Lymphoma :
Lymphoma Hodgkin (Hodgkin’s Disease)
Lymphoma Hodgkin- Childhood
Lymphoma Non-Hodgkin- Childhood
Hodgkin Lymphoma (Hodgkin’s Disease)- One category of lymphoma.
Classical Hodgkin Lymphoma (CHL)- is diagnosed when characteristic abnormal lymphocytes, known as Reed-Sternberg cells are found. CHL can be divided into 4 different subtypes:
1. Nodular Sclerosis Hodgkin Lymphoma- Most common form of CHL (80%). Most common in young adults especially women. Often involves the lymph nodes in the chest.
2. Lymphocyte-rich Classical Hodgkin Lymphoma- Not as common (6%). Most common in men. Usually involves areas other than the chest.
3. Mixed Cellularity Hodgkin Lymphoma- Often occurs in older adults. Commonly found in the abdomen.
4. Lymphocyte-depleted Hodgkin lymphoma- Least common subtype of CHL (1%) Most common in older adults, people with HIV and people in non industrialized countries.
Another type : Not a part of the CHL group
Nodular Lymphocyte-predominant Hodgkin Lymphoma- Not common (5%). Often found in lymph nodes in the neck or groin. Most common in younger patients.
Signs and Symptoms
- Painless swelling of lymph nodes in the neck, underarm, or groin area that doesn’t go away in a few weeks.
- Unexplained fever that does not go away
- Night sweats ( usually drenching)
- Pruritus (generalized itching that may be severe)
- Pain in the lymph nodes associated with alcohol intake
Prevention: The cause is unknown so there is no way to prevent the disease.
Lymphoma- Hodgkin- Childhood
Nodular Lymphocyte Predominant Hodgkin Lymphoma- More common for males and younger patients. Usually found in the neck, underarm or groin.
Classical Hodgkin Lymphoma- Most common type of Hodgkin in adolescents and young adults. Tumors are often bulky. Most often it begins in the lymph nodes in the neck, chest or abdomen. It may also spread to the lungs.
Mixed Cellularity Hodgkin Lymphoma- Most common in children ages 10 years or younger. Usually begins in the lymph nodes in the abdomen or in the spleen.
Lymphocyte Rich Hodgkin Lymphoma- This type is rare. It may be hard to distinguish from Nodular Lymphocyte Predominant Hodgkin lymphoma. It usually begins in the lymph nodes in the neck, underarm or groin. It sometimes involves the spleen and nodes in the chest.
Lymphocyte Depleted Hodgkin Lymphoma- This type is very rare. It is an aggressive type that is uncommon in children. It is usually more wide spread, involving lymph nodes as well as the bones and bone marrow.
Signs and Symptoms
- Painless swelling of the lymph nodes in the neck, underarm, or groin that doesn’t go away in a few weeks
- Coughing or trouble breathing
- Unexplained fever that doesn’t go away
- Unexplained weight loss
- Night sweats
Prevention- There is no prevention.
Non-Hodgkin Lymphoma (NHL)
Most subtypes of NHL are classified as either indolent or aggressive.
Indolent (Low-grade) NHL- Grows slowly. Often the disease has spread by the time it is diagnosed.
Aggressive (High-grade) NHL- Usually needs more intensive chemo-therapy. These lymphomas are often curable.
NHL is grouped by what cell the lymphoma started in. There are two major groups.
B-cell Lymphoma- More common, accounts for 90%.
T-cell Lymphoma- Less common, accounts for 10%
Subtypes of B-cell Lymphoma:
Diffuse Large B-cell lymphoma (DLBCL) – Most common (30%). It is an aggressive form that involves organs other than lymph nodes.
Mantle Cell Lymphoma- Not as common (7%). Often appears in people over 60. It involves the bone marrow, lymph nodes, spleen and gastrointestinal system.
Small Lymphocytic Lymphoma- Accounts for 5%. It is closely related to a disease called B-cell Chronic Lymphocytic Leukemia(CLL). It is considered an indolent lymphoma
Mediastinal Large B-cell Lymphoma- An aggressive form of DLBCL. It appears as a large mass in the chest . It is most common in women 30-40 years old (2.5%).
Splenic Marginal Zone B-cell Lymphoma- Begins in the spleen and can also involve the blood
Extranodal Marginal Zone B-Cell Lymphoma of mucosa-associated lymphoid tissue (MALT)- Most commonly occurs in the stomach but may also occur in the lung, skin, thyroid, salivary gland, or eye. Patients with this often have a history of auto immune disease.
Nodal Marginal Zone B-Cell Lymphoma- A rare indolent type (1%). It involves the lymph nodes
Lymphoplasmacytic Lymphoma- A rare indolent type (1%). Most often involves bone marrow, lymph nodes and spleen
Primary Effusion Lymphoma- An aggressive form. Most often occurs in people with HIV, people whose immune system doesn’t work well and the elderly. It begins in the the lung, heart or abdominal cavities. Often there is not just one tumor.
Burkitt Lymphoma/ Burkitt cell Leukemia- A very rare aggressive type. 3 forms of Burkitt Lymphoma: Endemic, Sporadic and Immuno deficiency- related lymphoma. Occurs most commonly in Africa. Appears mostly in the jawbones of children. It spreads quickly and needs immediate treatment.
Subtypes of T-cell and Natural Killer (NK) Lymphoma:
Natural Killer- Cells that fight microbes and cancer cells
Anaplastic Large Cell Lymphoma- Primary cutaneous type, it involves only skin. It is often indolent although aggressive types are possible.
Peripheral T-cell Lymphoma- Aggressive form. It is most common in people over 60 (6%) in U.S. And Europe.
Angiommunoblastic T-cell Lymphoma- Aggressive form. It has specific symptoms- swollen lymph nodes, fever, weight loss, rash and high levels of anti bodies called gamma globulin in the blood.
Anaplastic Large Cell Lymphoma- systematic type. Accounts for 2% of all lymphomas and 10% of all childhood lymphomas.
Precursor T-Lymphoblastic Lymphoma/Leukemia (Precursor T-cell Acute Lymphoblastic Leukemia- Rare type. It accounts for 2% of all NHL. Most common in young adults. It is more common in men then women. It is the same as ALL (Acute Lymphocytic (Lymphoblastic) Leukemia). When it is found in the blood or bone marrow it is called ALL. When it is in the lymph nodes it often involves the lymph nodes in the chest.
Adult T-Cell Lymphoma/Leukemia (Human T-cell Lymphotropic virus type 1 positive)- Aggressive form. Often involves the bones and skin. The lymphoma cells are found in the blood which is why it is sometimes referred to as leukemia.
Extranodal NK/T-Cell Lymphoma nasal type- Aggressive type. It is very rare in the U.S. And Europe. It is more common in Asians and Hispanics, it can occur in children or adults. It most often involves nasal area and sinuses. It can also involve the trachea, gastrointestinal tract, testicles and skin.
Enteropathy-associated T-Cell Lymphoma- Aggressive type. Rare in the U.S., it is more common in Europe. It involves the intestines of people who have caliac disease ( gluton intolerance).
Gamma/Delta Hepatosplenic T-Cell Lymphoma- Aggressive form. It involves the liver and spleen. It occurs most often in adolescents and young men.
Subcutaneous Panniculitis- Aggressive form. It is like T-cell lymphoma. Similar to Gamma/Delta Hepatosplenic T-cell. It involves the tissue under the skin.
Mycosis Fungoides- Rare idolent T-cell lymphoma. It primarily involves the skin.
Signs and Symptoms
- Enlarged lymph nodes in the abdomen, groin, neck or underarms
- Enlarged spleen or liver
- Fever that cannot be explained by an infection or other illness
- Weight loss with no known cause
- Sweating and chills
Prevention- Most people with NHL have no risk factors that can be changed. There is no way to prevent these lymphomas.
Lymphoma- Non-Hodgkin- Childhood
3 Major types- Distinguished from one another by how the cells look under the microscope.
Burkitt Lymphoma- B-Cell lymphoma that commonly affects bone marrow and central nervous system (brain and spinal cord). One of the fastest growing types of cancer. It often develops in the abdomen and may spread to other organs including the brain. Accounts for 40% of NHL in children in the U.S.
Large Cell Non-Hodgkin Lymphoma (LCL)- Accounts for 25% of childhood NHL. It may affect throat, abdomen, lymph tissue of the neck, or near the thymus ( behind the breast bone). LCL is further classified into subtypes.
Most common subtypes:
Large B-Cell Lymphoma- Accounts for 15%. Develops from B-Cells
Anaplastic Large Cell Lymphoma (ACL)- Accounts for 10%. It commonly develops from T-Cells but can arise rarely from B cells.
Lymphoblastic Lymphoma ( LBL)- Accounts for 30% of all childhood NHL. Most often develops in lymph nodes in the chest area (mediastinum) behind the breast bone (near the thymus gland). Can spread to the surface off the brain, the bone marrow, other lymph nodes and the membranes surrounding the heart and lungs.
Signs and Symptoms
- Swelling or lumps in the lymph nodes located in the abdomen, groin, neck or underarm. Swollen lymph nodes may join together to form a mass or tumor
- Fever that is not associated with an illness
- Unexplained weight loss
- Sweating and chills
- Extreme fatigue
- Symptoms related to tumor location may include:
- A swollen belly, caused by a large tumor in the abdomen
- Painful urination and bowel movements caused by fluid build up and a tumor around the kidneys and intestines
- Difficulty breathing, caused by a tumor in the chest (mediastinum) near the windpipe
Serious symptom- Super vena cava syndrome (SVCS)- A tumor in the chest behind the breastbone blocks the flow of blood in the vein that carries blood from the head and arms to the heart. This causes the head and arms to swell. SVCS is life threatening and requires emergency medical attention.
Prevention: There is no prevention.
Helpful Links: http://www.lls.org/
Thyroid Cancer- Malignant tumor or growth originating within the thyroid gland
Types of Thyroid Cancer: 4 Types
Papillary, Follicular, Medullary and Anaplastic.
Papillary and follicular thyroid cancers are referred to as differentiated thyroid cancers, which means that the cancer cells look and act like normal thyroid cells. It accounts for 90% of all thyroid cancers. They also tend to grow slower.
Papillary Thyroid Cancer- Most common type of thyroid cancer. Accounts for 80% of all thyroid cancers. Often grows slowly, but can spread to lymph nodes in the neck , also to other parts of the body.
Follicular Thyroid Cancer- Accounts for 10-15% of all thyroid cancers. Doesn’t usually spread to the lymph nodes but can spread to other parts of the body such as the lungs or bones.
Medullary Thyroid Cancer (MTC)- Accounts for 5-7% of thyroid cancers. Develops in the c cells of the thyroid gland. Easier to treat if it is found before it spreads to other parts of the body.
1. Sporadic MTC- Accounts for 80% of all MTC. Occurs in individuals without an identifiable family history.
2. Familial MTC- May be associated with hypercalcemia and adrenal tumors.
Genetic testing should be done for all people diagnosed with medullary thyroid cancer.
Undifferentiated Thyroid Cancer- Cells do not behave or look like normal thyroid cells.
Anaplastic Thyroid Cancer (ATC)- Least common type of thyroid cancer. It accounts for 1-2% of thyroid cancers. It is seen more often in people over 60. It is difficult to control, very aggressive and can spread rapidly within the neck and to other parts of the body. It is also resistant to radioactive iodine.
Signs and Symptoms of Thyroid Cancer:
- Lump in the front of the neck, near Adam’s apple
- Swollen glands in the neck
- Difficulty swallowing
- Difficulty breathing
- Pain in the neck or throat
- A cough that persists and is not caused by a cold
Prevention- Most people with thyroid cancer have no known risk factors, so it is not possible to prevent most cases of the disease.
Helpful Links: http://www.thyca.org/
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