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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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Nathan Carman’s rescue from an inflatable life raft 200 kms off the coast of Cape Cod in 2016 after spending eight days adrift in the North Atlantic Ocean was hailed as a miracle. The then 22-year-old and his mother Linda Carman had set off for an overnight fishing trip from Rhode Island on 17 September that year to try to mend their fractured relationship. She was never heard from again, and authorities quickly realised something about his extraordinary tale of survival wasn’t adding up. It would take prosecutors nearly six years to charge Nathan with her murder, and also name him as a prime suspect in the 2013 murder of his grandfather John Chakalos. The 29-year-old was arrested last May and pleaded not guilty to murder and fraud charges. He had been due to stand trial in October. Prosecutors alleged he had been plotting for more than a decade to claim his grandfather’s $40m estate, and stood to inherit millions with both elder family members dead. On Thursday morning, he was found “unresponsive” in his cell in Cheshire County Jail in Keene, New Hampshire. He was pronounced dead about 40 minutes later, an official said. Who was Nathan Carman? Nathan Carman grew up in Connecticut, the only child of Clark and Linda Carman. The family had a web of “strenuous and often combative relationships”, according to a 2018 New York article. Linda Carman had suffered from depression, and reportedly had struggled with a gambling addiction. Nathan was diagnosed with Asperger’s syndrome, and underwent years of psychiatriac analysis and pharmaceutical treatment, according to a 2022 investigation by Air Mail. He was described by those close to him as an “angry, wayward, unpredictable” child, who “matured without empathy, or recognition of the reality of anyone” other then himself, according to the article. His mother, the second of four daughters, separated from Clark Carman and struggled to maintain a harmonious relationship with Nathan. Prosecutors said they would go on fishing trips to try to mend the fractured bond. In spite of this, he had a good relationship with his grandfather, who he considered his “best friend”, Nathan’s lawyers have said. After finishing high school in 2012, Nathan Carman enrolled in community college but failed to complete most of his courses. He then began showing an interest in his grandfather’s businesses and attended several meetings with him in 2012 and 2013, according to prosecutors. During this period, his grandfather convinced Linda Carman to designate her son as a beneficiary of her trust. Chakalos also paid for his grandson’s personal expenses, funding the purchase of a truck and an apartment, and a white Irish Sport horse named Cruise. Killing of John Chakalos John Chakalos was found dead at the age of 87 from gunshot wounds in his home in Windsor, Connecticut, on 20 December 2013, one month after his wife of 59 years Rita had passed away from cancer. Chakalos had made an estimated $40m fortune in real estate, primarily from building and renting luxury nursing homes, and continued to work right up until the day he died, according to an obituary. Even after amassing enormous wealth, he and his wife continued to live in the modest home where they had raised their daughters and lived for much of their married lives. The obituary stated that Chakalos had “showered his grandchildren, nieces and nephews with paternal love”. His motto was “without family you’ve got nothing”. However, prosecutors believed his then 19-year-old grandson was secretly plotting to murder him and claim his fortune. Carman was never charged over his grandfather’s death. But authorities laid out in detail in a 2022 indictment how they believed he had carried out the killing. Authorities said that Nathan purchased a Sig Sauer rifle about a year before the shooting. They alleged that he drove from his apartment in Bloomfield, Connecticut, to his grandfather’s home at about 3am and shot him twice in the head while he slept. Carman then discarded his computer hard drive and a GPS unit in his truck, they stated, preventing them from tracing his movements and plans. He received $550,000 after his grandfather’s death. In 2014, he moved to Vernon, Vermont, and by 2016, had allegedly squandered most of his inheritance. Linda Carman’s mysterious death In 2015, Nathan Carman purchased a 31-foot fishing boat, the Chicken Pox, using his newfound wealth from his grandfather’s death. Prosecutors stated that fishing had been a way for Nathan and Linda Carman to get together, and put aside their differences. In September 2016, Nathan arranged to go on a fishing trip with his mother around Block Island, off the coast of Rhode Island. They left from Ram Point Marina in South Kingston, Rhode Island, late on the evening of 17 September, and Linda told friends they would return by noon the next day. Prosecutors say that prior to the departure, Nathan removed parts of the engine and a part of the hull that stabilises the boat. At some point soon after departing, he murdered his mother and deliberately sank the boat, prosecutors alleged. The US Coastguard was notified that the boat was missing on 18 September, and mounted an extensive search and rescue effort. On 25 September, Nathan Carman was found floating on an inflatable life raft by the Orient Lucky commercial boat 200kms off the coast of Cape Cod. The then 22-year-old would later tell investigators that he had noticed the engine making unusual noises on the day he had set off, and the Chicken Pox started taking on water. He said he saw his mother in the cockpit, and grabbed three bags containing food, flares and life jackets. But when he looked back, his mother was no longer there. The unlikely survival tale set off a media frenzy as outlets tried to secure interviews with the survivor and the ship’s captain. “I was yelling, ‘Mom! Mom!” Nathan Carman said in an interview with the Associated Press describing the sinking. “I loved my mother and my mother loved me.” The Hartford Courant reported at the time that police were investigating Nathan Carman for knowingly operating an unsafe vessel and putting his mother's life in danger. Police obtained a search warrant for his Vermont home, and found Nathan had removed his computer prior to leaving. When asked about the police search, he told the AP: “I don’t know what to make of people being suspicious. I have enough to deal with.” Arrest and death In 2019, Chakalos’ three surviving daughters filed a lawsuit in New Hampshire seeking to block Carman from receiving any more of his grandfather’s inheritance. They publicly accused him of involvement in his mother’s death. The case was dismissed after a judge ruled that Chakalos was not a New Hampshire resident. It was later refiled in Connecticut and was still pending at the time of his death. In May 2022, Carman was charged with “murder on the high seas” by US attorneys in Vermont. He was also charged with insurance fraud, relating to an attempt to claim $85,000 for the loss of the Chicken Pox. Authorities said his arrest was the culmination of a multi-year investigation conducted by the FBI, the US Coast Guard, the Bureau of Alcohol, Tobacco, Firearms, and Explosives, the Connecticut State Police, the Windsor Police Department in Connecticut, and the South Kingstown Police Department in Rhode Island. Carman denied the charges and was ordered to be held in custody pending the trial. On Thursday morning, he was found “unresponsive” in his cell at the Cheshire County Jail and was pronounced dead soon after, according to the CT Insider. A cause of death has not yet been released, and police are investigating. Carman’s attorney Martin Minnella told the Associated Press that he had been in good spirits when they spoke on Wednesday, and they had been due to meet again on Thursday. “It’s just a tragedy, a tragedy.” Carman’s three aunts issued a statement to the AP saying they were “deeply saddened” by his death. “While we process this shocking news and its impact on the tragic events surrounding the last several years we ask for your understanding and respect relative to our privacy,” they said through a lawyer. Read More Man, 28, accused of killing mother on fishing trip when he was 22 years old dies awaiting trial Youth environmentalists bring Montana climate case to trial after 12 years, seeking to set precedent Treat Williams death: Everwood and Hair star dies aged 71 following motorcycle accident

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