Early detection of bone cancer in children key

Cancer is often a terrible burden to bear, particularly for children and adolescents, with sarcomas and bone cancers among the most dangerous types. Though relatively rare, these two stand out because of the complexities associated with their diagnosis and treatment.

Sarcomas develop in the bones or soft connective tissues such as muscle, fat, blood vessels, nerves, tendons and joint linings. The most common forms of bone cancer in children are osteosarcomas and Ewing’s sarcoma. Osteosarcomas develop in the long bones, specifically the arms and legs, while Ewing’s sarcoma are found in the flat bones of the pelvis, scapula and rib cage.

Not only are these cancers aggressive, but they also go undetected until at the advanced stages, complicating treatment and giving them a poorer prognosis. And as with the other cancers, early detection is critical for improving survival rates and treatment outcomes.

One of the most effective interventions for dealing with childhood sarcomas and bone cancers is raising awareness to empower children’s caregivers on the symptoms that may indicate the need to have the child reviewed by a healthcare provider. Some of these symptoms—such as bone pain, swelling and fatigue—are easily misinterpreted as “growing pains” or injuries. Caregivers must be aware and vigilant, keeping an eye out for pain that lasts longer than usual or is worse in the night or even associated with swelling, so as to seek professional medical advice.

Sarcomas and bone cancers can also cause bone fractures close to the tumour which can be triggered by minor trauma. Other symptoms to watch for include unexplained weight loss or persistent fatigue.

Physicians must maintain a high level of suspicion and may perform tests to confirm the diagnosis—including plain X-rays, MRIs and CT scans, and thereafter take a biopsy of the tumour.

After a diagnosis is confirmed, treatment usually commences immediately and consists of chemotherapy, surgery with or without radiotherapy. The treatment plan is based on the type of cancer, the stage of the disease, the location of the disease and the patient’s overall health.

Children, adolescents and young adults who have been diagnosed with sarcomas and bone cancers must seek treatment at specialised facilities with the necessary expertise and resources.

Paediatric oncologists are trained to support children with cancer, and they work with multidisciplinary teams of nurses, surgeons, radiologists, pathologists and other clinicians who provide supportive care like infectious disease experts, rehabilitation experts who understand children's needs and provide comprehensive care.

Paediatric bone cancers and sarcomas have a 50-60 per cent survival rate in developed countries. But children in developing countries have very low survival rates due to late diagnosis and a lack of resources to adequately diagnose and treat them. In Kenya, for example, children with cancer have a 20 per cent overall survival rate.

Despite their rarity, sarcomas and bone cancers can have a devastating impact on children and place a significant burden on families. Early diagnosis can give a patient the best chance at a cancer-free life.

Dr Karimi is a paediatric haematology oncologist at Gertrude's Children's Hospital. [email protected].