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BE AWARE  -  Look for the  S.I.G.N.S

Because Primary Bone Cancers (PBC) are rare, it is far from uncommon for healthcare professionals to misdiagnose the S.I.G.N.S as a Sports Injury or Growing Pains, which means that there is a delay receiving the correct diagnosis.

Any delay can affect a positive outcome for the patient – delay can give the cancer the opportunity to spread including the onset of secondary bone cancer (metastasis), which can invade other organs such as the lungs.  The presence of metastasis can have a very significant impact on the percentage rate of the patient’s survival beyond 5 years.

The rarity of PBC means that it is quite possible for a General Practitioner (GP) to go through the whole of his or her career without seeing a single case.

So it is important that the patient tells the Doctor how they are feeling and what changes to their body have taken place.  You know your body better than anyone else.  It is really important that you tell your Doctor how you are feeling and what changes have taken place.

S.I.G.N.Sis a simple way to check for change.

S.= Swelling. 

Is there a swelling on one side of your body compared with the other side?

Look for a lump or swelling around the tumour area, mostly commonly in the end of the long bones in the arm or leg.  There may be limited movement if this is near to the joint. 

I.= Increasing pain. 

Is there a pain that is getting worse?

This is a common problem, particularly at night – when the pain is so severe that it wakes you up - and is more intense around the painful area which may be tender and look reddened.  The pain may cause a limp if the leg is affected, because weight-bearing is uncomfortable or if the cancer is interfering with the way the joint works.  If in the arm, lifting may be painful.

G.= Gradual weight loss. 

Have you noticed that are you losing weight?

If you are a teenager, you may still growing so are more likely to be adding to your weight, not losing it.

N.= No energy / tiredness. 

                     Feeling tired for no apparent reason?

                     Lethargy or tiredness are common signs, and may be accompanied by sweats or fever.

S= Seek advice. 

Why are these things going on associated with your body?

Teenagers particularly, are often reluctant to visit their GP.  On average, a teenager will visit 3 times before their Doctor refers them to the local hospital because Growing Pains or a Sports Injury are so often thought to be the source of the problem.

For the reasons referred to above, misdiagnosis and delayed diagnosis are not uncommon.

Using our S.I.G.N.S Patient’s Checklist, draw your Doctor’s attention to what you feel is happening to your body.  Don’t be shy – ask for an X-ray if the signs continue.

Be persistent – keep going back to your Doctor ........

.....and get the support of your parents or a close friend to go with you.

NICE - Advice for General Practitioners – “Improving Outcomes for People with Sarcoma”.

The National Institute for Health and Clinical Excellence (NICE) has issued guidelines for General Practitioners (GPs) to follow if they suspect that the patient is showing the symptoms of primary bone cancer.  Bone sarcomas are rare but if the patient in front of them is a teenager who has experienced pain whilst participating in a sporting or leisure activity, then having this checked out is a sensible option.

To read the NICE guidelines to GP’s, click here.

Remember  - 

                 it probably isn’t, but it might be Bone Cancer