Colon Cancer in Children
Colorectal carcinoma is one of the most common conditions in adults over 50 years of age. However, colon cancer can also affect children, although less often. In children, the tumor, unfortunately, is more aggressive and has a worse prognosis. Find out all about colon cancer in children today.
The tumor in question appears due to the abnormal and uncontrolled growth of the cells of the intestinal epithelium. These abnormal cells have the ability to spread through the blood or lymphatic system, so they can affect other organs in the more advanced stages of the disease. In this sense, early diagnosis is of vital importance in order to improve prognosis.
Colon cancer in children
Colon cancer is the third most frequent tumor in adults, representing a significnat cause of mortality in men over 45 years of age. However, multiple studies affirm that it’s a very rare pathology in pediatric ages. In fact, its incidence is only 1 per 100,000 cases, that is, only 100 cases per year in people under 20 years of age.
The low incidence of colon cancer in children may be due to the fact that its main cause is the malignancy of an existing intestinal polyp. However, it usually takes about 10 years for this to develop. In this way, the cancer usually appears in the second decade of life, that is, after 10 years of age.
The behavior of the tumor in children is also different compared to adults. In this sense, the most frequently found tumor is mucinous. Its extension usually covers the entire colon, is more aggressive, and has a greater probability of metastasizing.
Symptoms
The clinical manifestations suffered by children aren’t very different from those reported by adults. In this sense, among the main symptoms of colon cancer in children are rectal bleeding and alternating periods of diarrhea and constipation.
A small-scale study conducted in Israel showed that the most common symptom is rectal bleeding, which can be of varying intensity. Other symptoms that are very common in children with this type of tumor are pain and abdominal distension. It’s also possible to notice the presence of any of the following clinical manifestations:
- Palpable mass in the abdomen
- Vomiting and nausea
- Unexplained weight loss
- Decreased appetite
- Signs of anemia
It’s important to note that these symptoms are very nonspecific, and can be caused by a number of different benign gastrointestinal conditions. In this sense, parents should remain calm in the presence of these symptoms, as they’re not necessarily due to colon cancer.
Causes of colon cancer in children
This type of cancer can have multiple causes in adults, most of them associated with lifestyle and bad habits. However, colon cancer in children is associated with multiple inherited diseases. They usually appear as a result of chromosomal alterations and increase the probability of developing malignant neoplasia.
One of the pathologies most related to this carcinoma is familial adenomatous polyposis. It’s produced by a mutation in chromosome 5 and generates the appearance of multiple polyps or tumors throughout the colon that tend to become malignant. Other inherited pathologies associated with the disease are the following:
- Juvenile polyposis
- Peutz-Jeghers disease
- Oligopolyposis
- Cowden syndrome
- Neurofibromatosis type 1
It’s important to note that all these alterations have a low incidence. In addition, the cancer associated with them can appear even after the age of 20. For its part, the appearance of intestinal polyps in children who don’t have these conditions doesn’t increase the risk of colon cancer.
Diagnosis
Unfortunately, the diagnosis of colon cancer in pediatric ages is difficult and is usually made when the disease is in advanced stages. This is because the tumor isn’t usually considered when establishing possible diagnoses for rectal bleeding, diarrhea, and abdominal pain, due to its low incidence.
The diagnostic methods available are the same as those used in adults. In this sense, the doctor must make a proper interrogation and a thorough physical examination. During the interrogation, the symptoms suffered will be analyzed and the personal history will be consulted. The physical examination is useful in order to look for signs that may suggest the existence of another condition.
The specialist doctor will recommend a colonoscopy when they suspect that it may be colon cancer. This imaging test will allow the entire colon and rectum to be observed, looking for any lesions that indicate malignancy. The colonoscopy will also allow a sample of the lesion to be taken for a biopsy and a definitive diagnosis.
For its part, it may also be necessary to perform some additional tests such as the presence of hidden blood in the stools and a Barium enema. Imaging studies such as X-rays and computed tomography allow the body to be analyzed in order to search for metastatic foci.
Colon cancer treatment in children
The therapeutic options available may vary depending on the stage of the disease. The National Cancer Institute establishes that there are 4 standard techniques for the treatment of colon cancer in children, which are surgery, chemotherapy, radiotherapy, and immunotherapy.
Surgical procedures are the preferred option for treating colon cancer in its early stages. They seek to totally remove the lesion and are the definitive cure for the disease in most cases.
On the other hand, radiation therapy and chemotherapy can be used to shrink a tumor before an operation. They can also be useful to kill cancer cells after surgery or, in more advanced cases of the disease, to treat metastasis.
Both radiotherapy and chemotherapy are effective techniques that allow cancer cells to be eliminated from the body; however, they use different mechanisms. Radiation therapy employs the use of local or systemic X-rays, while chemotherapy uses certain drugs with specific properties.
Lastly, immunotherapy uses the immune system itself to kill malignant cells in the body. It uses substances synthesized in the body or in a laboratory to target specialized cells and attack cancer. All these treatments carry their own risks; even radiotherapy increases the probability of suffering from other types of cancer at some point.
A rare condition with a poor prognosis
Colon cancer in children is a rare condition, which usually manifests after 10 years of age. It generates symptoms such as abdominal pain, rectal bleeding, and diarrhea, so it can be confused with multiple conditions. Unfortunately, these tumors tend to behave more aggressively than in adults, so they metastasize in a short time.
The diagnosis of this disease tends to be delayed, since there are many more frequent pathologies in children with similar symptoms. This fact causes cancer to be diagnosed in the most advanced stages, which worsens the life expectancy of affected children.
Fortunately, there are multiple treatments available to combat this malignant tumor, which are effective and can give a total cure. In this sense, it’s important to consult with the doctor about any questions you may have, as they will offer you the best solutions.
- Arteaga R, Boscán A, Quero R, Rojas N et al. Cáncer de colon y recto en pediatría presentación de casos. Rev Venez Oncol. 2013;25(2):104-108.
- Kravarusic D, Feigin E, Dlugy E, Steinberg R et al. Colorectal Carcinoma in Childhood: A Retrospective Multicenter Study, Journal of Pediatric Gastroenterology and Nutrition. 2007; 44(2): 209-211.
- Vásquez L, Oscanoa M, Maza I, Gerónimo J et al . Colorectal cancer in children: report of three cases. Rev. gastroenterol. Perú. 2014; 34(3): 243-246.
- Pais A, Candarle P, Ferrer M, Costaguta A, Tabacco O. Adenocarcinoma colorrectal en una niña de 5 años de edad. Arch Argent Pediatr. 2015;113(6):e333-e335.
- Teepen JC, Ronckers CM, Kremer LCM. Colorectal Cancer Screening in Childhood Cancer Survivors. J Natl Cancer Inst. 2019;111(11):1114-1115.
- Karim A. Cáncer colorrectal en la edad pediátrica: reporte de un caso. Pediatría (Asunción). 2017; 44(2): 148-152.
