Children’s Cancer

Treatment of paediatric cancers differs significantly from adult cases, particularly as leukaemia and solid tumours, i.e. blastomas, which often develop from abnormal embryonic cells, known as. Since most childhood cancers typically respond well to treatment, the cure rate is generally higher than for adults, with a survival rate of around 70-80%.

At the HKSH Paediatric Haematology & Oncology Centre, our patients are primarily children under 18 years of age who have been diagnosed with one of the common childhood cancers found in Hong Kong. These are acute lymphoblastic leukaemia, brain tumour, lymphoma, neuroblastoma, Wilms' tumour, soft tissue sarcoma and bone tumour.

Acute lymphoblastic leukaemia
Acute lymphoblastic leukaemia accounts for about 80% of all leukaemia cases in Hong Kong. It affects around 50 to 60 children each year.

In leukaemia, the white blood cells have turned malignant. They multiply incessantly in the bone marrow, thus affecting the function of normal bone marrow; at the same time, the cancer cells spread to other parts of the body through the bloodstream. Common symptoms of leukaemia include a persistent fever, malaise, paleness of the skin, easy bruising, gum and nose bleeding, enlargement of the lymph glands, poor appetite and weight loss. The cure rate for this form of cancer is around 80%.

Brain tumour
Brain tumours are the second most common tumour in children, with more than 30 new cases in Hong Kong every year. Similar to other tumours, brain tumours mostly result from genetic changes or mutations in cells in the central nervous system.

Brain tumours are classified as either malignant or benign.

Three types of malignant brain tumours are found in children: Glioma tumours, which originate from supportive cells in the brain called astrocytes or oligodendroglia cells; medulloblastoma tumours, which originate from embryonic tissues and usually occur in the cerebellum; and, germ cell tumours, which come from primordial germ cells and are especially prevalent among Chinese or East Asian children. Over 90% of low-grade glioma tumours, 70% to 80% of medulloblastoma tumours and around 90% of germ cell tumours can be cured successfully.

There are other types of benign tumours. The commonest one is infantile haemangioma, which is found in infants and mostly affects the head and face. Proactive treatment is recommended to avoid untoward aesthetic effect associated with this type of tumour. Other benign tumours can also be managed in our Centre such as vascular malformations and benign tumours in blood vessels.

Lymphoma
Lymphoma is a cancer of the lymphoid tissue, which is distributed widely throughout the body and helps fight infection. It accounts for about 10% of childhood cancers, affecting around 20 children each year.

There are two kinds of lymphoma: Hodgkin's lymphoma (HL), which usually affects adolescent patients, and non-Hodgkin's lymphoma (NHL), which affects children of all ages.

Symptoms of Hodgkin's lymphoma, which seldom affects children under the age of 3, include painless enlargement of lymph glands in the neck, armpits and groins; coughing, difficulty with breathing; and fever, fatigue, itchiness, night sweating and weight loss. The cure rate for this form of lymphoma is over 90%.

Non-Hodgkin's lymphoma, which is both more common and more malignant, presents symptoms such as painless enlargement of lymph glands in the neck, armpits and groin; coughing and breathlessness; abdominal swelling; and fever, skin irritation, weight loss, anaemia or bleeding. Depending on the stage and histological features of the disease, the overall cure rate is about 70% to 90 %.

We also provide advanced techniques for both leukaemia and lymphoma using CAR-T cells or bispecific antibodies.

Neuroblastoma
Neuroblastoma is a tumour of the sympathetic nerve tissue, the second most common solid tumour in children. It normally affects the suprarenal gland inside the abdomen as well as the chest, the neck and the pelvic cavity. About 50% of the cases are found in children under the age of 2 years.

Symptoms of neuroblastoma can include limb tenderness, weight loss, poor appetite, fever and anaemia, as well as diarrhoea, hypertension or profuse sweating. The cure rate for neuroblastoma patients depends on a variety of factors. If the tumour is localised and well differentiated in a child older than 2 years, the survival rate is over 90%, but much less than that if the tumour is widespread.

We also provide most of the advanced therapies for neuroblastoma, including immunotherapy, MIBG or DOTA systemic therapy, and also targeted therapy.

Wilms' tumour
Wilms' tumour originates from embryonal kidney tissue and primarily affects children aged one to three, though it can occur at any age. Typically, only one kidney is involved, but both can be affected. Some children with Wilms' tumour may also have birth defects like hemihypertrophy (when one arm or leg, or one side of the body, is larger than the other) or aniridia (when the iris, the coloured portion of the eye, is absent).

Initially, symptoms are absent but as the tumour grows, abdominal pain, blood in the urine, weight loss, and pallor may develop. For children with Wilm’s tumour, the cure rate is more than 90%, and even with kidney removal, a normal life is possible.


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