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It’s heart-breaking to see a child that’s seriously ill, particularly when they’ve got cancer and might not survive. But children do get the disease – and it’s being highlighted during September’s Childhood Cancer Awareness Month. Fortunately, it’s not common. But every day in the UK, 10 families receive a cancer diagnosis for their child, teenager or young adult, and it’s the leading cause of death in children under 14, according to the charity Children With Cancer UK (CWCUK). However, Jeanette Hawkins, chief nurse at the Children’s Cancer and Leukaemia Group (funded by Young Lives vs Cancer), stresses that childhood cancer isn’t as rare as people might think, with a similar risk as diabetes, epilepsy and bacterial meningitis. “Use of the word rare for childhood cancer is a barrier to diagnosis as both GPs and parents therefore don’t consider it’s possible,” she explains. “Families, on average, have three to five GP visits before cancer is suspected. We need to reduce that by increasing awareness. Remember that childhood cancer is often a constellation of non-specific persistent symptoms, rather than a single ‘red flag’ that would alert a GP. “If you’re worried about your child keep going back.” Christiana Ogunbote, head of research at CWCUK, says childhood cancer accounts for less than 1% of all cancers in the UK, and explains there are 12 main categories of cancers affecting children, with the most common being leukaemia (30%), brain, central nervous system (CNS), intracranial tumours (26%) and lymphomas (11%). Ogunbote says cancer symptoms in children can vary widely depending on the cancer type and where it is in the body, but points out: “Often the individual symptoms of cancer can be similar to common childhood illnesses, so it can be hard to identify. “If a symptom progresses or doesn’t get better as quickly as expected, we would suggest getting it checked out by a medical professional. It’s useful for parents who know what’s ‘normal’ for their child to be aware of the signs and symptoms of cancer, as earlier diagnosis will support better outcomes for children and young people.” Here, Ogunbote outlines the symptoms of the three most common childhood cancers… 1. Leukaemia Symptoms of leukaemia in children and babies, which may be acute myeloid or acute lymphoblastic leukaemia (ALL), can include frequent and persistent infections, unusual bleeding and/or bruising, tiredness, paleness, breathlessness and, with ALL, coughing and anaemia. “Childhood leukaemia develops quickly,” says Ogunbote. “but it’s possible for some or all of these symptoms to be apparent.” She says a leukaemia diagnosis can be made from a blood test, which may reveal low numbers of normal white blood cells and large numbers of abnormal white blood cells. Further tests will then be done on a sample of bone marrow to confirm the diagnosis. 2. Brain and spinal tumours The symptoms of brain and spinal tumours (central nervous system tumours) vary between age groups, says Ogunbote, but symptoms in babies may include persistent/recurrent vomiting, balance/co-ordination/walking problems, abnormal eye movements or suspected loss of vision, behaviour change (particularly lethargy), fits or seizures (not with a fever), abnormal head position such as head tilt or stiff neck, and increasing head circumference. Children’s brain tumour symptoms are similar to symptoms in babies, but may also include a persistent/recurrent headache, blurred or double vision, fits or seizures, reduced consciousness and abnormal growth. Ogunbote says symptoms vary depending on the type and site of the tumour, and develop much more slowly with low grade tumours. But she stresses: “It’s important to remember that many of these symptoms are extremely common, and experiencing one by itself is rarely a sign of a brain tumour.” A CT or MRI scan will be done if a brain tumour is suspected, and if the scan confirms the diagnosis, further investigations will determine the type of tumour and best treatment. 3. Lymphoma Children may get a cancer of the lymphatic system known as either Hodgkin or non-Hodgkin lymphoma, and Ogunbote says symptoms of both include a persistent (lasting a few weeks) painless swelling of a single lymph gland, usually in the neck, or possibly in the armpit or groin with non-Hodgkin, a cough or breathlessness (if glands in the chest are affected), fevers, sweats, and weight loss. There may be itching with Hodgkin lymphoma, and with non-Hodgkin there may be tiredness, feeling full after a small meal, stomach pains (if abdominal lymph glands are affected), and sleep sweats. Diagnosis is confirmed by removing part or all of an affected lymph gland, usually under general anaesthetic, and doing a biopsy on it so the cells can be examined in a laboratory. Further tests, like x-rays, CT and MRI scans and blood tests, will also be carried out to determine the size and position of the lymphoma and whether it has spread. This is known as staging. “Many of the symptoms of lymphoma can also be symptoms of other illnesses, so this can make it difficult to diagnose,” explains Ogunbote. “Symptoms your child might experience depend on where the lymphoma is in their body, and symptoms vary from child to child, even if they have the same type of lymphoma.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live 4 viral TikTok make-up trends you’ll actually want to try Daily aspirin dose could help prevent diabetes in older people – researchers Secondhand September: The best places to buy pre-loved fashion online

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Mikel Arteta praised a “phenomenal” response from Arsenal after they fought back from two goals down in the final 13 minutes to earn a 2-2 draw at Chelsea and move level on points at the top of the Premier League. Chelsea looked to be sending Arsenal to a first league defeat of the season when Mykhailo Mudryk’s cross-shot put them into a 2-0 lead minutes after half-time, the Ukrainian’s effort drifting over goalkeeper David Raya who was unable to recover from a poor starting position as the ball dropped into the goal. That added to the lead given to them by a first-half penalty from Cole Palmer, increasingly influential in Pochettino’s revitalised attack following his move from Manchester City, who slotted home after William Saliba was adjudged to have handled from Mudryk’s header. It was a commanding and deserved advantage for the hosts, who were seeking a third straight league win, but as so often during Chelsea’s turbulent last 18 months it was an individual error that turned the game and cost them points. Goalkeeper Robert Sanchez rolled the ball straight to the feet of Declan Rice who cut the arrears from 30 yards, before Leandro Trossard got a lunging right leg to Bukayo Saka’s cross six minutes from time to salvage an unlikely draw. And afterwards Arteta praised his team’s powers of recovery as they extended their unbeaten start to the league season to nine matches to go level at the top with Manchester City. “I think what went wrong was the start of the game,” said the manager. “We didn’t play with enough purpose and clarity. We were just moving the ball without the intention to threaten them. That’s a really dangerous thing to do against teams like Chelsea. “Then we didn’t win enough duels, and in tight areas when we had them, they escaped from that and they attacked open spaces, and they are really dangerous things to do. “When we changed that and we changed the level after 20, 25 minutes, especially in the second half then it’s a different game. We became a much better team, even though we conceded the second goal and it’s a disappointment. “The way the team reacted to the second goal is phenomenal from the players on the pitch and the players on the bench thinking ‘how the hell am I going to change this game?’ I loved that. “I really liked as well going into the dressing room and it’s really quiet, after drawing 2-2 with Chelsea and coming back from 2-0 down, because I know that they wanted more. That’s the positive.” Chelsea boss Mauricio Pochettino reflected on perhaps Chelsea’s best performance since he took over in the summer, and refused to lay the blame at the feet of Sanchez for allowing Arsenal back into the match. “Too many games that we’re watching every week, always mistakes,” he said. “Football is about mistakes. If you want to score, you want the opponent to make a mistake. Ninety per cent of goals are because the opponent made a mistake. Football is about mistakes. “The only thing we can criticise a little bit is to read better the situation, the tempo and the timing. After 77 minutes, we’re trying to take some risks. OK, we can because it’s our philosophy. But maybe (we need) better decisions. So we can criticise a bit, but also this is football. “It’s not to blame someone. It’s only that in this type of situation you need to read better, but that will arrive with time. Teams need to manage and drive games. You need to read the game, when to be calm, when to play, when to take risks.” Read More Gary O’Neil insists Wolves win at Bournemouth not about revenge over former club Pep Guardiola hails ‘exceptional’ Brighton after Man City return to winning ways Thomas Frank: Five-year anniversary meal will taste better after Brentford win Rob Edwards salutes Luton super-sub Elijah Adebayo after equaliser at Forest England skipper Jos Buttler questions his decision to field first in latest loss A true gentleman – David Beckham pays tribute to ‘national hero’ Bobby Charlton

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