The 5 hidden signs of aggressive cancer with shockingly low survival rates that targets kids and teens
SCIENTISTS have called for more people to be aware of symptoms caused by an aggressive form of cancer striking children and teens.
Over 150 cases of the disease are spotted in the UK every year – but young people often face significant delays in being diagnosed, fuelling shockingly low survival rates.
Long-term survival rates for bone cancers – such as osteosarcoma and Ewing sarcoma – haven’t changes in over 15 years, new research by the University of Nottingham shows.
Fewer than seven in 10 people struck by the cancers survive more than five years, researchers said, calling for diagnoses to be sped up so that patients can get treatment earlier.
Senior author David Walker, an emeritus professor of paediatric oncology at the University of Nottingham, said: “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.”
Read more on childhood cancer
Bone cancer such as osteosarcoma can cause symptoms like bone pain – often in the knee or upper arm – as well as tenderness and swelling and fractures following minor injuries.
But researchers said different types of bone cancer can lead to different symptoms.
For example, children and teens with Ewing sarcoma were more likely to experience fevers or difficulty using their limbs, while those with osteosarcoma often suffered from unexplained fractures, pain, and weight loss.
Understanding these differences could help accelerate diagnosis and improve outcomes, the study authors noted.
GP Dr Anita Chithiramohan said: “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.
“These challenges highlight the need to raise awareness of childhood bone tumours among healthcare professionals to facilitate earlier recognition and diagnosis.”
Bone cancer is one of the 10 most common types of childhood cancer.
But it often won’t occur to young people and their families that symptoms such as bone pain and tenderness could be caused by cancer – sports injuries, growing pains or infections can sometimes seem like more plausible explanations.
Around one in 10 patients wait over three months to speak to a healthcare professional after noticing worrying symptoms, researchers said – and they often face further delays in getting a diagnosis after raising their concerns.
GPs may only see a case of childhood cancer once every 20 years, which can further hamper diagnosis.
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GP Dr Paul Nathan explained: “There is a lack of education for GPs about children’s cancers and how they may present in primary care, whereas there is education regarding lots of adult conditions.
“In addition, childhood cancers are still seen as rare by primary care, so are not uppermost in GP’s minds.”
The paper’s findings will be used to develop referral guidelines to help healthcare professionals recognise bone cancers sooner, researchers said – potentially saving families from the heart-breaking consequences of a late diagnosis.
They may also be used for awareness campaigns to help educate families and primary healthcare professionals about the signs of bone cancer.
Co-author Ashley Ball-Gamble, CEO of Children’s Cancer and Leukaemia Group (CCLG), which funded the study, said: “This research underscores the need for earlier diagnosis of bone cancers in children and young people.
“By identifying common symptoms, and showing differences between Ewing sarcoma and osteosarcoma, we are taking an important step toward improving awareness and reducing delays in diagnosis.
“Raising bone cancer awareness in healthcare professionals is essential to ensuring that no child or young person’s symptoms are overlooked, and that treatment can begin as early as possible.
“By acting on these findings, we can give every patient the best chance of survival.”
Red flag symptoms of bone cancers
Osteosarcoma is the most common type of bone cancer in children.
Tumours can appear in any bone in the body, but they mostly occur in the bones on either side of the knee and in the upper arm.
It mainly affects children and young adults under the age of 25 and has a survival rate of 65 per cent, according to Children with Cancer UK.
Ewing sarcoma is the second most common type of bone cancer in children that mainly affects legs, pelvis, arms and ribs.
Children suffering from osteosarcoma or Ewing’s sarcoma may experience:
- Bone pain – this may come and go initially but then become more persistent
- Tenderness
- Redness
- Swelling
- Fracture may occur after a minor injury at the site of the weakened bone
According to CCLG, pain tends to be the most common symptom of bone cancer and this will often be worse at night.
There may also be some swelling in the affected area if the tumour is close to the surface of the body and it may become tender to touch.
Bone can cancers can cause a limp if the tumour is in the leg or pelvis, while people with Ewing sarcoma may also experience as well as fever or weight loss.
Schoolboy Kieran Maxwell was diagnosed with Ewing sarcoma in 2010.
Who’s most at risk of bone cancer?
There has been a lot of research into the causes of bone cancers but, like most childhood cancers, a definite cause is unknown.
But it is important to remember that nothing you have done has caused your child’s cancer.
Children who have hereditary retinoblastoma – a rare tumour of the eye – may have an increased risk of developing osteosarcoma.
Children who have previously had radiotherapy and chemotherapy also have an increased risk of developing osteosarcoma.
It’s not caused by injuries or damage to the bone, although an injury may draw attention to a bone tumour.
The development of Ewing sarcoma may be related in some way to times of rapid bone growth, which may explain why more cases are seen in teenagers.
Source: CCLG
It took 14 months for him to referred for an X-ray after suffering leg pain.
He died in 2017 at age 18, after an amputation and multiple relapses.
His mum 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. His first relapse was to his lungs, and the second relapse was to his heart.
“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 mum, Karen, initially assumed that her 16-year-old son Ben’s leg pain was due to a cycling injury.
However, the GP immediately referred him for an X-ray, and he started osteosarcoma treatment just six weeks later.
Sadly, Ben died 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.
“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.”