Bone Cancer Misdiagnosis: Why is it so Common?

Bone Cancer Misdiagnosed as Growing Pains

Osteosarcoma, a dangerous but common form of bone cancer which mostly affects children and young adults, is often being misdiagnosed by GPs as growing pains or muscle strains, according to the Bone Cancer Research Trust (BCRT). The frequency with which bone cancer misdiagnosis occurs is a genuine cause for concern, as only 42% of those who develop osteosarcoma survive for five years after the disease is first diagnosed, according to the charity. This places even greater importance on diagnosing the disease as soon as possible, as a late diagnosis of cancer is likely to have an adverse effect on the patient’s chances of survival.

No Improvement in Survival Rates for Osteosarcoma

Unfortunately, instances of bone cancer misdiagnosis are still common, which is the most likely reason for survival rates remaining unchanged for the past 25 years. If osteosarcoma is localised (i.e. has not spread to other areas of the body), the chances of long-term survival are reasonably good (70-75%). However, in approximately 15-20% of patients, the disease has spread to other areas of the body by the time it is diagnosed. In cases where osteosarcoma has spread to the lungs or other bones, the long-term survival rate falls dramatically to just 30%. It is therefore crucial that this form of bone cancer is diagnosed as quickly as possible.

BRCT has called for faster X-ray referrals by GPs after a report by the National Cancer Intelligence Network found that, while five-year survival rates for almost all forms of cancer have improved in England between 1985 and 2009, there has been no improvement in the survival rate for primary bone cancer. Furthermore, although only 380 people were diagnosed with bone sarcomas annually between 1979 and 2007, the total number of cases annually is rising as the population ages.

Causes of Primary Bone Cancer

Primary bone cancer is one of the most misunderstood forms of cancer, with no definitive answer as to why the disease develops in the first place. Factors that are widely believed to encourage cancerous cells to form and grow in the bone include rapid bone growth (which would explain why the disease is most prevalent in children and young adults), genetic predisposition (damaged genes inherited from a parent which make it more likely that a person will develop cancer) and radiation exposure, among others.

Signs and Symptoms of Osteosarcoma

Pain and Swelling

Excruciating pain in the affected bone (usually around the knee or in the upper arm, and often occurring at night) is the most common symptom of osteosarcoma. Initially, the pain might not be constant, but it generally increases in intensity and frequency with activity. If the malignant tumour is located in a leg bone, the victim may develop a limp as a result.

Swelling in the afflicted area is another common symptom of osteosarcoma, although it may not be noticeable until several weeks after the initial pain starts. Depending on where the tumour is situated, it may be possible to feel a lump or mass.

Bone Fractures / Breaks

Although osteosarcoma can sometimes weaken the bone it develops in, the bones rarely break or fracture. However, telangiectatic osteosarcomas, a rare form of bone cancer, tends to weaken bones more severely than other forms of osteosarcoma and can cause a fracture at the site of the tumour.

Limb pain, swelling and/or fractures are very common in normal, active children and young adults, which can make the disease more difficult to diagnose in its early stages. The classic symptoms of osteosarcoma are far more likely to be caused by normal activities than they are by bone cancer, which often leads to a cancer misdiagnosis.

Dr Harriet Unsworth, information and research officer at the BCRT, said: “Primary bone cancer symptoms can include painful bones or swollen joints, and this can easily be misdiagnosed by GPs as a sporting injury or growing pains.

“Many children and young adults have had to make several visits to their GP over many months before they are finally sent for an X-ray, or referred to a specialist. That can have a huge impact on their chances of survival.

“There is clearly a need to improve GPs’ awareness of primary bone cancer so that a quicker diagnosis can be made.

“Faster diagnosis and new treatment options have boosted the survival chances of people with many of the more common forms of cancer. We need to urgently address the imbalance here and find ways to improve primary bone cancer patients’ chances of survival.”

Alarming Levels of Bone Cancer Misdiagnosis in Patients

Bone cancer can be misdiagnosed for a number of reasons: sometimes it is down to the vague and misleading symptoms of the disease itself; sometimes it is because initial radiographs appear normal or the findings are so subtle they escape detection. Occasionally, however, osteosarcoma is misdiagnosed as a result of simple human error.

Lack of suspicion on the part of the GP or consultant is a common reason for a medical misdiagnosis occurring, as are a lack of access to adequate imaging equipment, a general disregard for symptoms that should be a cause for concern and inadequate physical examinations . At the heart of the problem, many medical professionals and caregivers lack the necessary experience and training in these situations and therefore fail to even consider a sarcoma as the possible cause of the symptoms.

Jason Brady, clinical negligence solicitor at Blackwater Law in Suffolk, said: “It is concerning that there has been no progress in survival rates in relation to bone cancer when there have been improvements for almost all other forms of cancer. The BCRT has indicated that doctors need more experience and training to assist them in recognising patients presenting themselves with symptoms of bone cancer. This is crucial to ensure patients have the best chance of getting an early diagnosis of cancer, facilitating effective treatment.”

Claiming cancer misdiagnosis compensation

If you believe you are the victim of cancer misdiagnosis or any other form of clinical negligence, the personal injury solicitors at Blackwater Law will be happy to assess your case for clinical negligence compensation and more specifically, cancer misdiagnosis compensation. Simply call us on 0800 083 5500 or send us an email for more information.