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Children with cancer are among the most intensively monitored patients in healthcare. Paradoxically, even with close medical supervision, the medical situation may create conditions in which child maltreatment becomes more difficult to detect. In paediatric oncology, several physical and behavioural signs commonly associated with abuse or neglect—such as bruising, fractures, weight loss, fatigue or emotional withdrawal—may also arise from cancer itself or from treatment-related toxicities. As a result, warning signals that might trigger safeguarding concerns in other paediatric contexts may be interpreted as expected consequences of disease or therapy.