Detect Childhood Cancer Early, Take Knee, Shoulder Pain Seriously - Sunway Medical Centre

KUALA LUMPUR, Nov 18 (Bernama) -- Bone cancer in children, particularly osteosarcoma and Ewing's sarcoma, presents unique challenges in diagnosis and treatment, so early detection should be prioritised by parents.

Sunway Medical Centre Paediatric Haematology & Oncology consultant, Dr Yap Tsiao Yi said primary malignant bone tumours accounted for three to five per cent of cancers in children and adolescents.

“Osteosarcoma (OS) is the most diagnosed bone tumour, accounting for 20 to 40 per cent of all bone cancers while Ewing tumours (Ewing sarcomas) consists of one per cent of all childhood cancers,” she said in a statement today.

Osteosarcoma, which usually appears around the knee, shoulder, ankle, or pelvic bone, is the most common bone tumour in childhood, typically occurring during puberty, she said, while Ewing's sarcoma, which can affect both bones and soft tissues, commonly occurring in the extremities, pelvic bone, and sometimes the spine, is broader than that of osteosarcoma. It can affect teenagers and sometimes younger children.

Dr Yap said both osteosarcoma and Ewing's sarcoma are notably aggressive and progress rapidly. In Malaysia, over 55 per cent of bone cancer cases were in Stage Four, which requires intensive chemotherapy, surgery, and sometimes radiotherapy.

Therefore, early detection would significantly improve survival rates as localised disease has a much better survival rate compared to metastatic disease, where the survival rate can drop to 25 per cent compared to 75 per cent for localised disease, she added.

“The most common symptoms of osteosarcoma and Ewing’s disease is pain in the knees, shoulders, and extremities that is persistent, does not go away and may wake children up from sleep as well as swelling or a lump and could be indicative of something more serious,” she noted as she stressed how early detection and a multidisciplinary approach to treatment would offer hope for better outcomes.

“Parents are urged to take persistent pain in the knees, shoulders, and extremities seriously and seek medical advice promptly,” she said, adding that imaging tests were the main diagnostic tool for suspected cancer.

“For osteosarcoma, which often spreads to the lungs, a CT scan of the lungs is performed. Ewing's sarcoma, being more unpredictable, may require a PET scan and bone marrow aspiration to assess the disease extent,” she explained, stressing that treatment would usually be a combination of surgery, chemotherapy, and radiotherapy.

Dr Yap cautioned that treatment could be physically and emotionally taxing, lasting six months to a year, and impacting children and their families.

“Children are often out of school and isolated due to the side effects of chemotherapy, surgeries, and prolonged hospital stays.

“They may also experience depression, especially if they face rejection from peers upon returning to school or from the sense of loss of their childhood, while many families can face challenges adjusting to the new normal,” she said, explaining that visible changes, such as hair loss from chemotherapy or walking with a limp due to prostheses, were issues that made reintegration into normal life difficult.

Despite these challenges, Dr Yap highlighted children’s resilience, as they have yet to face lifestyle health damage and would be more capable of enduring treatment.

“This is why our approach to treatment for childhood cancers to ensure the child has the best possible chance of a long life,” she added.

Sunway Cancer Centre at Sunway Medical Centre, Sunway City, the largest private quaternary hospital in Malaysia, offers comprehensive care for all types of cancer, from common to rare.

With a robust cancer team and advanced technologies, including surgical robotics, the centre has earned multiple awards, ranking 26th in Newsweek's Best Specialised Hospitals Asia Pacific for Paediatrics and top 75 for Oncology in 2023 and 2024.

-- BERNAMA