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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

US and German weapons have shot down a “significant” total of Russian missiles, Ukraine has said. In his nightly video address on Sunday, President Volodymyr Zelenskiy said advanced air defence systems, including the US-built Patriot and Germany's IRIS-T, were proving "highly effective" and had "already yielded significant results”. Zelenskiy said Ukraine had shot down a significant part of Moscow’s attacks over the past week, which included 65 missiles of various kinds and 178 assault drones, including 87 Shaheds - despite waves of Russian air strikes that Kyiv says targeted residential buildings and civilians, leaving some dead. This comes as Kyiv struck and damaged the Chonhar road bridge linking mainland Ukraine to Crimea and a smaller bridge linking the town of Henichesk with the peninsula’s northeast coast on Sunday, Moscow-appointed officials and Ukraine’s armed forces said. Without providing evidence, acting Kherson regional governor Vladimir Saldo, a Moscow appointee, said the strike on the Chonhar bridge, one of three road links between Crimea and mainland Ukraine, involved an Anglo-French Storm Shadow missile. Read More Ukraine replaces Soviet coat of arms with trident on towering Kyiv landmark War in Ukraine: Blood transfusion centre in Kharkiv hit by Russian attack as three killed Russian opera star sues US company after dropping her for refusing to criticise Putin’s war in Ukraine

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Vladimir Putin’s missile attack on a cafe and grocery store in northeastern Ukraine that led to 51 deaths, six injuries and three people left missing was “no blind strike”, said president Volodymyr Zelensky. The strike is the deadliest in the Kharkiv region since Mr Putin’s Ukraine invasion and also among the biggest civilian death tolls in any single Russian missile attack, especially after January this year. The missile strike occurred on Thursday afternoon in Kharkiv’s Hroza village where dozens had gathered to mourn a fallen Ukraine soldier, officials said. “A deliberate missile strike on a village in Kharkiv region on an ordinary store and cafe,” Mr Zelensky said in his nightly video address on Thursday. “Russian troops could not have been unaware of where they were hitting. This was no blind strike,” he said after attending a summit of the European Political Community in Spain. Mr Zelensky said a six-year-old boy was among the dead. According to regional officials, families had remained in the village despite a war-time order to evacuate. The site of the attack showed large piles of bricks, shattered metal and building materials strewn around the cafe and shop struck by a Russian missile. The attack was likely carried out with an Iskander ballistic missile, a Ukrainian minister said, citing preliminary information. Bodies of the dead were laid out in a field next to a children’s playground as rescue workers were seen making their way and sifting through mounds of debris from the attack. Regional police investigator Serhiy Bolvinov said they will use DNA laboratories to identify the bodies as they have found only bits and pieces and remains of the bodies. Officials said the Russian missile hit a service marking a reburial in his home village of a soldier who had died in action elsewhere. The son of the soldier was also killed in the attack, along with his wife and mother, prosecutors told public broadcaster Suspilne. “There were only civilians. The boy was from this village. When he died, we were under occupation. The (family) decided to rebury him, to bring him home,” said resident Oleksandr Mukhovatyi. “Then this happened. Someone betrayed us. The attack was precise, it all landed in the coffee shop.” He said his mother, brother and sister-in-law were among the dead. Local officials were sitting down for a meal when the missile struck, interior minister Ihor Klymenko said. “From every family, from every household, there were people present at this commemoration. This is a terrible tragedy,” he told Ukrainian television. Defence minister Rustem Umerov said the strike was clearly targeted and Ukrainian security services had launched an investigation into the matter. “The terrorists deliberately carried out the attack during lunchtime, to ensure a maximum number of casualties,” he said. “There were no military targets there. This is a heinous crime intended to scare Ukrainians.” Russia has not issued a comment on the attack in Hroza. It has denied deliberately targeting civilians, but many have been killed in attacks that have hit residential areas as well as energy, defence, port, grain and other facilities. Read More Ukraine-Russia war – live: Deadly Russian attack on memorial service was no blind strike, says Zelensky White House condemns ‘horrifying’ Russian attack on grocery store in Ukraine Russian missile strike kills more than 50 Ukrainians gathered for wake – in deadliest such attack in months Nearly 50 European leaders stress support for Ukraine at a summit in Spain. Zelenskyy seeks more aid Russia has tested a nuclear-powered missile and could revoke a global atomic test ban, Putin says

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