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  4. Cancer in children and young people
  5. Types of cancer in children and young people

Childhood cancers:

There are 76 distinct types of childhood cancer. They are broadly grouped into cancers affecting the blood and those that cause solid tumours. There are clear differences between most childhood and adult tumours, reflecting different biology. Many childhood tumours are of ‘embryonal’ origin or other ‘high grade’ malignancies, whilst carcinomas are uncommon. Childhood malignancies can progress very rapidly and a delay of even a few days may be associated with substantial clinical deterioration. Conversely, some childhood tumours can present in a more indolent way, including Hodgkin Lymphoma, and some low-grade intracranial tumours - malignancy cannot therefore be excluded solely based on a long history.

The main types of childhood cancer are leukaemia, brain and spinal tumours, lymphoma, soft tissue sarcomas, neuroblastoma, renal tumours, bone tumours, germ cell tumours, retinoblastomas, other carcinomas and melanomas, and liver tumours.

 

Leukaemia:

This is the most common type of childhood cancer, accounting for approximately one third of all cancers in children87. It is a cancer of the white blood cells – white blood cell production and maturation gets out of control and the cells continue to divide.

 

Brain and central nervous system tumours:

These are the most common solid tumours in childhood. In Scotland, they account for 26% of all cancers and 51% of deaths in children aged 0 to 1487. They are often identified later than other childhood cancers due to their varied and often initially subtle symptoms.

 

Lymphoma:

This is the third most common type of childhood cancer. It accounts for around 9% of childhood cancer diagnoses in Scotland (2012-2021)87 and is split into two main groups: Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma.

 

Soft tissue sarcoma:

The most common soft tissue sarcoma is rhabdomyosarcoma. Other types include fibrosarcomas, schwannomas and primitive neuroectodermal tumours.

 

Neuroblastoma:

This is a solid cancer that develops from cells called neuroblasts. They can occur anywhere in the body but usually start in the adrenal glands or in nerve tissue that runs alongside the spinal cord. In some cases, neuroblastoma can spread to other places in the body such as the bone marrow, lymph nodes, bone, liver and skin.

 

Renal tumours:

These arise from the kidney and are more common in younger children. Wilm’s tumours may be associated with underlying genetic conditions.

 

Bone tumours:

The most common types are Osteosarcoma and Ewing’s Sarcoma. Osteosarcoma can present at any age but has a peak incidence in the second and third decade of life94. Most common sites are the femur, tibia and humerus. Ewing’s Sarcoma has a peak incidence between the ages of 10 and 15 years and rarely occurs under the age of five. Most common sites are the pelvis, femur, tibia, fibula, rib and humerus.

 

Germ cell tumours:

Germ cell tumours are growths that form from reproductive cells. They can develop at any age and usually originate in the ovaries or testes (gonadal germ cell tumours), but they can sometimes occur in other parts of the body as well (extragonadal germ cell tumours). Sites where extragonadal germ cell tumours most commonly occur are at the bottom of the spine (sacrococcygeal), the brain, chest and abdomen. There are several types of germ cell tumours including germinomas, yolk-sac tumours, embryonal carcinomas and teratomas.

 

Retinoblastoma:

This is a rare cancer of the retina. It is most common in very young children and infants, with the average age of diagnosis being around four months old. It can occur in just one eye or both. Approximately 40% of cases are inherited.

 

Liver tumours:

There are two main types of liver tumours - hepatoblastoma and hepatocellular carcinoma. Hepatoblastoma most commonly affects children under the age of five. Hepatocellular carcinoma is less common and affects older children.

 

Other:

Histiocytoses and Rhabdoid tumours are rare cancers of childhood.

 

Young people’s cancer:

Cancer is more commonly seen in young people than children, with a mixture of late presenting childhood cancers and early presenting adult cancers.

The main types of cancer in young people are:

  • Lymphoma
  • Carcinomas (cervical, melanoma, thyroid cancer)
  • Germ cell tumours (testicular or ovarian)
  • Brain tumours
  • Bone cancers
  • Soft tissue sarcoma
  • Leukaemia