Bone cancer in children and young adults: Early warning signs every parent should know

While bone cancer is uncommon, it ranks as one of the most commonly occurring types of cancer among children, adolescents, and young adults. The primary types of bone cancer among children are osteosarcoma and Ewing sarcoma, which are both known to manifest during periods of rapid bone growth that mostly happen in the knees, upper arms, and pelvis. Since the symptoms closely resemble sports injuries, diagnosis may be missed.

Chronic pain in the bones is the earliest symptom: The earliest and most common symptom of cancer is persistent bone pain. Unlike pain associated with growing pains, cancerous pain does not get better with rest; instead, it usually worsens with time. Initially, it may occur only during the day; however, after some time, the pain may become constant and disrupt sleep. Parents should contact a doctor if their children have bone pain that lasts for two or three weeks and there is no significant injury.

Swelling or lump: As the tumour increases in size, swelling may occur near the area of the bone where the tumour is located. At times, the lump may be apparent when touching or palpating. The swelling may or may not be painful and, depending on its location, may limit the ability to move. If there is any abnormal swelling that has not gone away or continues to grow, then a doctor should check it out.

Difficulty walking or mobility issues: Bone tumours affecting the legs or pelvis may prevent a person from walking normally or moving around the way he or she would normally do. An active child may stop playing sports and anything else that requires activity because of pain.

Frequent fractures: Bone cancer can weaken the structure of the affected bone, leading to bone fractures even with minor injuries.

These fractures are termed pathological fractures. Any fracture from a minor injury should alert a physician to check for any underlying bone problem.

Symptoms:

Though rarer, a few children may also have:

• Persistent tiredness
• Unexplained weight loss
• Fever
• Loss of appetite

None of these symptoms is unique to bone cancer, but if combined with ongoing bone pain, they merit further investigation.

How is bone cancer diagnosed?

It all starts with the initial step of collecting the necessary medical history as well as physical examination. First-level examination is normally done with the help of imaging. X-rays are among the first techniques that are carried out in imaging, while MRI is used to see the extent of the discovered problem using the same imaging. Blood tests may give additional insight into the diagnosis of bone cancer, although they cannot confirm the diagnosis themselves.

Reasons for early diagnosis:

While cancer is rarely the reason for chronic bone pain in children, neglecting signs that last for a few weeks can delay diagnosis. Early detection makes treatment start sooner and increases the chances of success.

Parents have to be aware that chronic pain, sporadic swelling, or problems with using a limb should never be dismissed as normal growing pains if the symptoms stay or become worse.

The author is a lead consultant - Pediatric Oncology, Haematology, and Bone Marrow Transplant at Madhukar Rainbow Children's Hospital. 

 

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.