Nice has published an updated guideline on suspected cancer, including cancer in children. It is a huge guideline, so I have done a separate blog for adult cancers.
The BMJ has published an excellent summary including a useful 'infogram' for suspected childhood cancer. One to keep handy somewhere...
The main points are:
- Abdominal mass / unexplained enlarged abdominal organ - refer in 48 hrs (Wilm's tumour or neuroblastoma).
- Visible haematuria if unexplained - refer in 48 hrs (Wilm's tumour)
- Absent red reflex - refer in 2 weeks (retinoblastoma)
- Soft tissue mass increasing in size - for USS within 48 hrs (sarcoma)
- Bone swelling or pain if unexplained - for xray within 48 hrs (sarcoma) NB need a FBC too - see below
- Lymphadenopathy or splenomegaly if unexplained - refer in 48 hrs (lymphoma)
- Hepatosplenomegaly - refer immediately (leukaemia)
- Petechiae - refer immediately (leukaemia)
- Leukaemia possible - do aFBC within 48hrs for any of the following symptoms:
- persistent fatigue
- unexplained fever
- unexplained persistent infection
- generalised lymphadenopathy
- unexplained bone pain
- unexplained bruising or bleeding