New Study Calls for Greater Awareness of Bone Cancer Symptoms in Children and Young Adults
Nottingham, UK – A new research paper led by experts at the University of Nottingham is highlighting the importance of early detection and intervention for bone cancers in children and young adults. The study, published in Archives of Disease in Childhood, reveals that over 150 cases of bone cancer are diagnosed annually in the UK, with many young people facing significant delays in diagnosis, which can impact their chances of survival.
Long-term survival rates for bone cancers have remained unchanged for over 15 years, with fewer than seven in 10 patients surviving beyond five years. This has prompted experts to emphasize the urgent need for earlier diagnosis and intervention.
The paper identifies the most common early symptoms of Ewing sarcoma and osteosarcoma based on data from over 1,400 patients. These symptoms include pain, swelling, fever, unexplained fractures, and limping, providing crucial insights into symptom presentation.
Professor David Walker, Emeritus Professor of Paediatric Oncology at the University of Nottingham and senior author of the paper, said: “This paper is part of our Child Cancer Smart project, funded by Children’s Cancer and Leukaemia Group (CCLG), which focuses on identifying childhood cancers earlier in their development so that interventions can be streamlined and improved.”
He added: “Efforts to improve outcomes for children with bone tumours have not led to improvements in cure rates or disability rates for nearly two decades. It is time to look at whether accelerating diagnosis could change this static state of affairs.”
The research also highlighted differences in symptoms between bone cancer patients, with young people with Ewing sarcoma more likely to experience fevers or impaired limb use, while those with osteosarcoma often reported unexplained fractures, pain, and weight loss. Understanding these differences could help accelerate diagnosis and improve outcomes.
Dr. Anita Chithiramohan, a GP, emphasized the importance of this research in providing “valuable insights into the warning signs of bone tumours” in children. She added that childhood bone tumours can be challenging to diagnose because the symptoms are often non-specific and may overlap with those of more common conditions, such as injuries or infections.
Despite being one of the ten most common types of childhood cancer, bone cancer is often not considered a risk by young people and their families. Shockingly, around one in 10 patients wait over three months after noticing symptoms before talking to a healthcare professional, and then often face further delays before a diagnosis is reached. GPs play an important role in the speed of diagnosis but may only see a case of childhood cancer once in 20 years.
Kieran Maxwell, a schoolboy from Darlington, was diagnosed with Ewing sarcoma in 2010, and it took 14 months from the start of his leg pain to being referred for an X-ray. He died in 2017 at the age of 18 after an amputation and multiple relapses. His mother, Nicola, said, “Kieran’s diagnosis should have been quicker. We thought we were lucky as it hadn’t spread at initial diagnosis, but Kieran’s tumour kept coming back.”
She added: “It is very difficult to treat relapsed bone cancers, and survival is very poor. Early diagnosis has a positive impact on survival, and the chance of recurrence drops quite significantly. I often wonder, if Kieran had been diagnosed earlier, would we have had the chance to save his leg and his life?”
Another mother, Karen, also experienced the devastating consequences of a late diagnosis when her 16-year-old son, Ben, was diagnosed with osteosarcoma. Initially, Karen assumed that Ben’s leg pain was due to a cycling injury, but the GP immediately referred him for an X-ray, and he started treatment just six weeks later. Sadly, Ben passed away in 2020, five years after finishing treatment.
Karen said: “The speed of Ben’s diagnosis in 2014 was down to our GP. She took the pain seriously, and within six weeks of the GP appointment, his chemotherapy treatment had started. I worry that young people’s pain is not always taken as seriously as Ben’s was.”
She added: “People need to be very aware of the signs and symptoms of bone cancer, but that needs to be joined up with medics also being aware that, although rare, the child before them could be the one bone cancer case they see in perhaps their whole GP career, and to miss it would be devastating for everyone.”
Dr. Paul Nathan, a GP, explained that there is a lack of education about childhood cancers among GPs, whereas there is education regarding many adult conditions. He added that childhood cancers are seen as rare by primary care, so they are not uppermost in GPs’ minds.
The findings from this work will be used to develop referral guidelines to help healthcare professionals recognize bone cancers sooner, potentially saving families from the heart
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