– Young people do not suffer from osteoarthritis, so if they have pain in their limbs, it must be carefully diagnosed. A simple X-ray can save a life, says the oncologist prof. Piotr Rutkowski
Bone sarcomas are very rare neoplasms. They most often attack children and adolescents. The main symptoms are pain and swelling, most often associated with accidental trauma patients. Then there is weakness, increased temperature and anemia. The problem, however, is that doctors are not always able to associate these symptoms with the cancer.
Bone sarcoma diagnosis
The charges of the SARCOMA Association for Aid Patients with Sarcomas tell how they were diagnosed with the disease. Kamil’s first symptoms appeared when he was 17 years old. After falling from a bicycle, he suffered an injury to his right leg. The correct diagnosis was made only a few months later. Until then, he was treated with various types of ointments. – If the disease had been diagnosed earlier, perhaps the treatment would not have been so aggressive. I survived 18 cycles of chemotherapy, 3 months of radiotherapy and managed to avoid amputation to this day – he recalls.
Also in Asia’s case, it took a long time to correctly diagnose the disease. During a physical education lesson while running, the girl felt her leg refuse to obey her and she fell over. She went to the doctor and was referred for a blood test. It turned out to be anemia. – I was given a drug that raises iron levels to swallow, and that’s it … The pain started again, so I went to the orthopedist. My hip was found to be pushing out from scoliosis – I was advised to go to the pool and partially exempted from physical education. Unfortunately, the pain was bothering me more and more, I couldn’t lie down or sit, it was most comfortable for me to walk. At night, I wandered through the house like a ghost in pain. And then I went to another orthopedist. He admitted me to the ward, did a pelvic tomography quickly and it turned out that I had tumors – he recalls. She underwent 15 cycles of chemotherapy. – I appeal to others: do not underestimate the pains that are getting worse. Maybe if I had gone to the orthopedist who did my tomography earlier, I wouldn’t have had to take chemotherapy – he warns.
Find out which symptoms should make you alert
X-ray in the diagnosis of bone neoplasms
One of the most common types of bone sarcoma is osteosarcoma. It is most often diagnosed in children and adolescents under 30 years of age. It is characterized by high malignancy and a tendency to metastases to the lungs. It is usually located in the long bones, mainly in the femur, tibia or humerus. Its symptoms are swelling, for example, in the leg and pain that intensifies at night. In some patients, the limb fractures due to the destruction of the bone by the tumor. The basic examination in the case of bone neoplasms is x-ray. This examination is primarily used to locate the tumor. Bone biopsy plays a key role in making an accurate diagnosis.
– The family doctor, if they see any swelling of the tissues, should send the child for an X-ray. You have to show oncological vigilance. Meanwhile, even orthopedists sometimes put the leg in a plaster cast instead of taking an x-ray. We can cure almost 60% of children, but they must first be diagnosed with the disease. In small patients, the development time of the disease is twice as fast as in adults. In the case of sarcoma, lung metastases may appear two or three months after the first symptoms appear. However, it happens that patients come to us two weeks after the onset of symptoms and already have metastases – says prof. Jerzy Kowalczyk, national consultant in the field of pediatric oncology and hematology, head of the Department of Hematology, Oncology and Transplantology at the Children’s Clinical Hospital. Prof. Antoni Gębala in Lublin. – After all, adolescents do not suffer from joint degeneration, so they need to be X-rayed, because such a photo can save their lives – adds prof. Piotr Rutkowski, head of the Department of Tumors of Soft Tissues, Bones and Melanomas at the Oncology Center, Instytut im. Maria Skłodowskiej-Curie in Warsaw.
Treatment of bone sarcoma
In the treatment of sarcomas, surgical surgery to excise the tumor is of the greatest importance. It is often complemented by radiotherapy and chemotherapy. Such combined treatment requires the cooperation of an oncology surgeon, a radiotherapist, a clinical oncologist, a pathologist, and a physiotherapist. Therefore, it should be conducted in a specialized oncology center that employs experienced staff and has the appropriate equipment. – Immediate excision of the tumor in a non-specialized center is a mistake, and this is the case in 40% of cases in Poland. This is called surgery on the paw without proper diagnostics – says prof. Rutkowski. Meanwhile, the difference in the prognosis for treatment in a general pediatric center and the reference center is even 40%. Accurate diagnosis is important. – Contrary to appearances, although these are very rare neoplasms, we have carefully decoded them at the level of molecular biology. However, full diagnostics of the sarcoma neoplastic cell is possible only in Warsaw. It allows you to choose individual therapy and thus save up to 80% of patients with sarcomas – explains Prof. Rutkowski. Also prof. Kowalczyk emphasizes that there is really only one pathologist in Poland who can diagnose bone sarcoma in children well. – It’s not abnormal. In France, all sarcomas are also diagnosed in one histopathological center – he adds. There are 17 reference centers for children in Poland. Patients up to 18 years of age receive treatment there immediately. Things are worse when they turn 18. Then they have to start treatment in adult facilities and it turns out that they wait two or even three months for an appointment and not every treatment is available to them. Therefore, oncologists postulate that young adults up to 24 or 26 years of age should be treated in children’s centers.
Text: Halina Pilonis