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Children's tumours - suspected - Management
General recommendations
- Children and young people who present with symptoms and signs of cancer should be referred to a paediatrician or a specialist children's cancer service, if appropriate (D).
- Childhood cancer is rare and may present initially with symptoms and signs associated with common conditions. Therefore, in the case of a child or young person presenting several times (for example, three or more times) with the same problem, but with no clear diagnosis, urgent referral should be made (D).
- The parent is usually the best observer of the child's or young person's symptoms. The primary healthcare professional should take note of parental insight and knowledge when considering urgent referral (D).
- Persistent parental anxiety should be a sufficient reason for referral of a child or young person, even when the primary healthcare professional considers that the symptoms are most likely to have a benign cause (D).
- Persistent back pain in a child or young person can be a symptom of cancer and is indication for an examination, investigation with a full blood count and blood film, and consideration of referral (C).
- There are associations between Down's syndrome and leukaemia, between neurofibromatosis and CNS tumours, and between other rare syndromes and some cancers. The primary healthcare professional should be alert to the potential significance of unexplained symptoms in children or young people with such syndromes (D).
- The primary healthcare professional should convey information to the parents and child/young person about the reason for referral and which service the child/young person is being referred to so that they know what to do and what will happen next (D).
- The primary healthcare professional should establish good communication with the parents and child/young person in order to develop the supportive relationship that will be required during the further management if the child/young person is found to have cancer (D).
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