It’s normal for children to get sleepy; however, if your child feels tired and exhausted all of the time, no matter how much they sleep or rest, this may be indicative of cancer.

Fatigue or tiredness is a key symptom of cancer in children — particularly leukaemia (which is the most common cancer type in children, accounting for around a third of paediatric cancer).

The over-production of abnormal white blood cells in cases of leukaemia means that the body lacks the normal, healthy blood cells that it needs. The resulting low count of healthy red blood cells can make the patient feel tired and weak because the body has to work overtime to get enough oxygen (which red blood cells carry) to cells.

Your child might not tell you if they are feeling tired and exhausted, but you may notice these signs yourself. They may struggle to keep up with their peers or rest frequently while playing or during activities. Your child may also look noticeably pale.

Children generally recover from illnesses quite quickly; persistent, recurring infections may be a sign of cancer.

Your child may suffer from lots of lingering infections (such as colds, coughs, chest infections, ear infections, or sore throat) that they struggle to shake off, or keep coming back.

Cancer weakens the immune system; in cancer types like leukaemia, this is because of low levels of white blood cells that normally fight infections in the body.

As well as the presence of infections, you may also notice flu-like symptoms: lethargy, fevers, chills, or episodes of night sweats (to the point where their pyjamas and bedding becomes drenched).

Fever is the body’s natural response to fighting infections, and high temperature is very common in young children, with their temperature usually returning to normal within a few days. However, if your child has a fever (high temperature of 38°c or more) that lasts for several days and doesn’t seem to have any identifiable cause, then you should check it out with your GP.

One of the more obvious physical symptoms of cancer that you may notice in your child is an unexplained lump or mass on any part of the body (especially in the tummy, neck, chest, pelvis or armpits).

Lymphoma can cause swollen lymph nodes in the neck, armpit, or groin. These will appear as one or several lumps, which you might be able to feel on your child. Depending on the type of lymphoma, these lumps can present in different ways on different parts of the body; for example, children with Hodgkin lymphoma most often have swollen lymph nodes down one side of the neck.

Swollen lymph nodes can also be as a result of an infection (like a cold or sore throat) and can be painful, but the swelling will generally go down in a few weeks. In lymphoma, the swelling will remain, though is usually painless.

With other cancer types, you may also notice increased swelling in your child’s joints, back, or legs; they may complain of persistent pain (this could be sharp or dull) too but might not know how to describe it if it is in their joints or bones.

After leukaemia, brain tumours are the second most common cancer type in children. Signs and symptoms can vary greatly depending on the type, size and location of the tumour — as well as the rate of growth.

However, persistent, regular headaches that grow in severity are one indicator. These may be accompanied by a feeling of pressure in the head, particularly behind the eyes — so your child may complain of their eyes and head hurting, as well as possible eyesight problems like double vision.

Feelings of dizziness and persistent nausea can accompany these headaches, and children may be physically sick, often when waking up in the morning. If your child has unexplained nausea or vomiting, you should consult your GP.

Children fall over and bump into things all the time, so bruises aren’t unusual. However, frequent and unexplained bruising, as well as bruising very easily (with minimal contact) can be a sign of cancer in children. You might notice lots of little bruises appearing on your child’s body — these are typically purple, red and brown.

Alternatively, you may also see rash-like, small red or purple spots on the skin. This is called ‘petechiae’, and isn’t actually a rash; it’s caused by bleeding under the skin, which happens when tiny blood vessels break open.

Unexplained, frequent bruising and rash-like marks on the skin are both signs of leukaemia caused by the over-production of white blood cells.

This over-production means that the body cannot produce enough of the other blood cells it needs, such as blood-clotting platelets; the resulting low platelet count is what causes the body to bruise more easily.

Similar to bruising, another sign of cancer in children is unexplained bleeding (again, caused by a low platelet count).

You may find blood in your child’s wee or poo (and they may have problems, discomfort or pain while going to the toilet). If they are vomiting too, you might also find blood here too; they may also bleed from their gums and have severe nosebleeds.

If you’re noticing blood or that your child keeps bleeding from unusual places, then you should visit your doctor immediately.

For many parents, unexplained weight loss is one of the first visible signs of cancer in their child.

Illness is one of the most common reasons for weight loss in children; this is both because the fever burns up extra calories and because children eat less and lose their appetite when they feel sick.

However, any illness that is serious enough to cause any noticeable weight loss in your child is worth getting checked out by your GP. They may suggest further tests or treatments are needed.

The anaemia (low red blood cell count) which is caused by some types of cancer can also cause shortness of breath and difficulty breathing.

In cases of leukaemia and Hodgkin lymphoma, a lack of oxygen-rich red blood cells means that the lungs have to work much harder to get oxygen around the body, resulting in breathless, a persistent cough and struggling to breathe normally.

Lymphoblastic lymphoma often causes swelling of the lymph nodes inside the chest. This can put pressure on the windpipe, resulting in respiratory problems such as coughing, wheezing and shortness of breath.

These symptoms are sometimes mistaken for asthma, so it’s worth taking your child to the doctor for further testing if you notice any of these symptoms or problems.

Ask them how they are feeling as well; these breathing problems can also cause dizziness, lightheaded and feelings of fatigue and weakness.