About Colorectal Cancer in Children
Colorectal cancer is a common cancer in older adults but is a rare condition in children. Colorectal cancer is usually caused by polyps (growths of tissue) in the colon that become cancerous over time. Colon polyps do not always become cancerous. Risk factors for colorectal cancer in children include:
Non-modifiable risk factors (risk factors that cannot be changed):
- Genetic factors: Inherited gene mutations, such as mutations in the MLH1 and MSH2 genes, can increase the risk of colorectal cancer in children.
- Hereditary conditions: Certain hereditary conditions, such as familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC), can predispose children to colorectal cancer.
Modifiable risk factors (risk factors that can be changed):
- Diet: Consuming a diet high in processed foods, red meat, and low in fruits and vegetables may increase the risk of colorectal cancer.
- Sedentary lifestyle: Lack of physical activity and sedentary behavior have been associated with an increased risk of colorectal cancer.
- Obesity: Being overweight or obese during childhood may increase the risk of developing colorectal cancer later in life.
It's important to note that these risk factors are based on studies conducted in adults, as colorectal cancer is extremely rare in children. If you have concerns about your child's health, it's best to consult with a pediatrician or a specialist for personalized advice.
Symptoms of colorectal cancer in children include:
- Pain or cramping in the abdomen (belly)
- Changes in bowel habits that last for more than a few days (such as diarrhea and constipation)
- Nausea and vomiting
- Loss of appetite
- Feeling tired or weak
- Blood in the stool
- Anemia (tiredness, dizziness, fast or irregular heartbeat, shortness of breath, pale skin)
- Narrow, ribbon-like stool
- Unintended or unusual weight loss
It's important to note that these symptoms can also be caused by other conditions. If your child is experiencing any of these symptoms, it's best to consult with their doctor for a proper evaluation and diagnosis.
To diagnose colorectal cancer in children, the following examinations, tests, and procedures are commonly performed:
- Physical exam and health history: The doctor will examine the body for any signs of disease and gather information about the child's health habits and past illnesses.
- Analysis of a stool (poop) sample: Tests may be conducted to check for blood in the stool
- Blood tests: A sample of blood may be analyzed to look for signs of cancer or other conditions that could be causing symptoms
- Colonoscopy: This procedure involves inserting a thin, tube-like instrument called a colonoscope into the rectum and colon to look for polyps, abnormal areas, or cancer. It may also be used to remove tissue samples for further analysis.
- Barium enema: A series of x-rays of the lower gastrointestinal tract is taken after a liquid containing barium is put into the rectum. This helps visualize any abnormalities in the colon and rectum.
Additional examinations, tests, and procedures may be done to determine if other conditions are the cause of symptoms or to determine the severity of colorectal cancer. These additional tests may include:
- Chest x-ray: This imaging test provides a picture of organs and bones inside the chest to check for any signs of cancer spread.
- PET scan (positron emission tomography scan): A small amount of radioactive glucose is injected into a vein, and a scanner produces images that show areas with increased glucose uptake. This helps identify malignant tumor cells in the body.
- MRI (magnetic resonance imaging): This procedure uses a magnet, radio waves, and a computer to create detailed pictures of areas such as the chest, abdomen, and pelvis. It helps assess the extent of cancer spread.
It's important to note that these tests should be performed under medical supervision, as interpretations may vary based on individual circumstances.
The goals of treatment for colorectal cancer in children depend on the stage of the cancer.
For early-stage colorectal cancer, the goal is to cure the cancer by removing the tumor in the colon or rectum and destroying tumors in other parts of the body. The types of treatments recommended for colorectal cancer in children include:
- Surgery: The primary goal is to remove the tumor if it has not spread. Complete surgical excision is important for prognosis, but it may not always be possible.
- Radiation therapy: This may be used for tumors in the rectum or lower colon, often in conjunction with chemotherapy. Radiation therapy uses high-energy rays to kill cancer cells.
- Chemotherapy: It involves using drugs to kill cancer cells throughout the body. Combination chemotherapy has shown improved survival rates in pediatric patients with colorectal cancer.
- Immunotherapy: Immune checkpoint inhibitors such as ipilimumab and nivolumab can be used to stimulate the immune system to fight against cancer cells.
- Targeted therapy: In some cases, a clinical trial may check for specific gene changes in the tumor and use targeted therapies based on those changes.
Treatment recommendations may differ based on the stage of colorectal cancer. Therefore, it's crucial to consult with a healthcare professional who specialize in the treatment of colorectal cancer in children to determine the most appropriate individualized treatment plan.