When expecting parents dream of their baby’s arrival, cancer is the last thing on their minds. Yet, while rare, some children are born with cancer. This reality affects families across India and worldwide. Knowing how and why this happens can help parents recognise early warning signs and seek timely treatment.
In India, approximately 50,000 to 75,000 children are diagnosed with cancer each year. Most childhood cancers develop after birth, but a small number of children are born with the disease or develop it within the first month of life. These cases, called congenital or neonatal cancers, make up about 2-5% of all paediatric cancer cases.
What Is Congenital Cancer?
Congenital cancer means cancer that’s present at birth or diagnosed within the first 28 days of life. Unlike adult cancers, which often result from lifestyle factors and environmental exposures over many years, congenital cancers develop during foetal development in the womb.
The term “congenital” simply means “present from birth.” When cancer cells begin forming before a baby is born, the tumour may be detected during prenatal ultrasounds, immediately after delivery, or within the first few weeks of life.
How Can Cancer Develop Before Birth?
Cancer in newborns happens when DNA changes, or mutations, occur during foetal development. Here’s what happens:
Rapid Cell Growth During Pregnancy
During pregnancy, a baby’s cells multiply at an extraordinary rate. The foetus grows from a single cell to billions of cells in just nine months. This rapid cell division is necessary for normal development, but it also creates opportunities for errors in the DNA copying process.
When these errors happen in genes that control cell growth and division, abnormal cells may begin to multiply out of control, leading to cancer.
Genetic Mutations and Chromosomal Abnormalities
Most congenital cancers result from random genetic mutations that occur spontaneously during foetal development. In 5-10% of cases, inherited genetic conditions increase the risk. These include:
🗹 Down syndrome (increases leukaemia risk)
🗹 Neurofibromatosis
🗹 Li-Fraumeni syndrome
🗹 Beckwith-Wiedemann syndrome
🗹 Von Hippel-Lindau disease
🗹v Fanconi anaemia
Children born with these conditions have genetic changes that make their cells more likely to become cancerous.
Environmental Factors During Pregnancy
While most congenital cancers occur randomly, certain prenatal exposures may increase risk:
🗹 Radiation exposure: Medical imaging or radiation therapy during pregnancy
🗹 Chemical exposure: Certain drugs, pesticides, or industrial chemicals
🗹 Infections: Viruses like Epstein-Barr virus (EBV)
🗹 Parental lifestyle factors: Tobacco or alcohol use
Research in India has raised concerns about pesticide residues in food and environmental pollution as potential contributing factors to rising childhood cancer rates.
Most Common Types of Cancer in Newborns
Not all cancers affect newborns equally. Certain types are more likely to be present at birth:
🗹 Neuroblastoma
Neuroblastoma is the most common congenital cancer, accounting for roughly 30-50% of neonatal cancer cases. It develops from immature nerve cells and typically forms in the adrenal glands above the kidneys. Some neuroblastomas detected in infants may spontaneously disappear without treatment.
🗹 Leukaemia
Leukaemia, particularly acute myeloid leukaemia (AML), is another cancer that can be present at birth. Congenital leukaemia is rare but serious, often requiring immediate treatment.
🗹 Brain and Central Nervous System Tumours
Brain tumours, including teratomas and gliomas, can develop during foetal development. These may be detected on prenatal ultrasounds or shortly after birth.
🗹 Retinoblastoma
This rare eye cancer can be present at birth or develop in early infancy. It often has a hereditary component and may affect one or both eyes.
Other Congenital Cancers
Less common congenital cancers include:
🗹 Wilms’ tumour (kidney cancer)
🗹 Hepatoblastoma (liver cancer)
🗹 Soft tissue sarcomas
🗹 Germ cell tumours
Recognising Early Warning Signs
Early detection dramatically improves outcomes for children born with cancer. Parents should watch for these warning signs in newborns and young infants:
🗹 Unusual lumps or swelling: Particularly in the abdomen, neck, or near the spine
🗹 Abdominal distension: Visible swelling of the belly
🗹 Pale skin or excessive bruising: May indicate blood disorders
🗹 Persistent fever without obvious infection
🗹 Difficulty breathing or feeding
🗹 Unusual eye appearance: White pupil (leukocoria) or bulging eyes
🗹 Lethargy or poor responsiveness
🗹 Jaundice that persists beyond the normal newborn period
If your newborn shows any of these symptoms, consult a paediatric oncologist immediately. Early treatment can be lifesaving.
Diagnosis of Congenital Cancer
Diagnosing cancer in newborns requires specialised expertise and advanced diagnostic tools:
Prenatal Detection
Some congenital cancers are detected during routine prenatal ultrasounds. Unusual masses or abnormalities in the foetus may prompt further investigation with foetal MRI or amniocentesis.
Postnatal Evaluation
After birth, diagnosis typically involves:
🗹 Physical examination: Checking for visible lumps or abnormalities
🗹 Blood tests: Detecting abnormal blood cells or tumour markers
🗹 Imaging studies: Ultrasound, CT scans, or MRI to visualise tumours
🗹 Biopsy: Removing a small tissue sample for laboratory analysis
🗹 Genetic testing: Identifying inherited cancer predisposition syndromes
Dr Kriti Hegde is a pediatric oncologist in mumbai uses advanced diagnostic technologies to accurately identify and stage congenital cancers, ensuring personalised treatment planning.
Treatment Options for Newborns With Cancer
Treating cancer in newborns presents unique challenges. Their tiny bodies are still developing, making them more vulnerable to treatment side effects. Advances in paediatric oncology have significantly improved outcomes.
Treatment approaches may include:
🗹 Surgery
When possible, surgical removal of tumours is often the first-line treatment, especially for solid tumours like neuroblastoma or teratomas.
🗹 Chemotherapy
Chemotherapy drugs are carefully selected and dosed to minimise toxicity while effectively targeting cancer cells. Newborns often respond well to chemotherapy, recovering faster than older children or adults.
🗹 Watchful Waiting
For certain congenital cancers, particularly some neuroblastomas, doctors may recommend careful monitoring without immediate treatment. Some tumours spontaneously regress on their own.
🗹 Supportive Care
Comprehensive supportive care addresses nutritional needs, infection prevention, and pain management, ensuring the baby’s wellbeing throughout treatment.
The Role of Genetic Counselling
If your child is diagnosed with congenital cancer or has a family history of childhood cancers, genetic counselling can be helpful. Genetic counsellors help families understand:
🗹 The likelihood of inherited cancer syndromes
🗹 Implications for future pregnancies
🗹 Screening recommendations for siblings
🗹 Long-term health monitoring strategies
🗹 Early genetic testing can identify at-risk children before symptoms appear, allowing for proactive monitoring and early treatment.
Why Choose Dr Kriti Hegde for Paediatric Cancer Care
Dr Kriti Hegde is Mumbai’s leading paediatric oncologist, specialising in comprehensive, compassionate care for children with blood disorders and cancer. With advanced training in bone marrow transplantation and cellular therapies from renowned centres in India and the UK, she brings world-class expertise to every case.
Her approach combines:
🗹 Specialist Expertise: Focused training in paediatric brain tumours and complex haematological disorders
🗹 Holistic Multidisciplinary Care: Collaborating with a team of specialists to address medical, emotional, and psychological needs
🗹 Personalised Treatment Plans: Tailoring care to each child’s unique condition and family circumstances
🗹 Advanced Therapies: Access to the latest treatment protocols
🗹 Compassionate Support: Guiding families through every step of the diagnosis and treatment journey
Taking the Next Step
If you’re concerned about congenital cancer, experiencing a high-risk pregnancy, or need a second opinion for your child’s diagnosis, don’t wait. Early consultation with a specialist can make all the difference.
Dr Kriti Hegde and her team at Mumbai’s leading paediatric oncology practice are here to help. Whether you need diagnostic evaluation, treatment planning, or ongoing cancer care, you’ll find a partner committed to achieving the best possible outcomes for your child.
Contact Dr Kriti Hegde today at +91 8450909323 to schedule a consultation. Your child’s health and future are too important to delay.