Monday 7 October 2013

Campaign For Earlier Bone Cancer Diagnosis

I have written before about the poor record we have in the UK regarding osteosarcoma, the disease that ultimately killed my son George. It  is a scandal that survival rates have not improved for more than 25 years in this country, and that the figures are lower than for comparable countries in Europe and North America, (see for example my article on dismal bone cancer statistics). Figures from Cancer Research UK suggest that survival for many common cancers has doubled in the last 40 years, but there has been no change in the 54% overall survival rates for bone cancers (osteosarcoma and Ewings sarcoma) in 25 years. I don't know about you, but I find that shocking.

In a bid to address this the Bone Cancer Research Trust, in alliance with the Royal College of GPs, has launched a new e-learning module to help doctors recognise and diagnose bone cancers earlier. The idea being that earlier disgnosis will lead to better outcomes as there is less disease and lower risk of metastates at diagnosis. I know from our own experience with George that it took many weeks of visits to a number of oncology departments before even the experts were able to diagnose osteosarcoma of the jaw. Admittedly this is a rare cancer, but too many doctors were not alerted to the possibility that a numbness of the lips is a warning of cancer in the jaw. Bone cancers are more common in the long bones of the arms and legs, but we know from other parents that we met that even in the more common cases there were long delays in their children being diagnosed.

While we should welcome the campaign to get earlier diagnosis and improve the recognition of the key symptoms, we also need to make sure we do more to research on new treatments. As with many cancers, it is often metastatic disease that kills, not the primary tumour. So it's with some interest that we note that one of the cancers that has a bimodal pattern of recurrence is osteosarcoma. As with breast cancer, there is a spike of metastases/recurrence in the first couple of years after surgical treatment. This is the trigger for the work of Dr Patrice Forget, who has found that treatment with the anti-inflammatory pain-killer ketorolac at the time of surgery massively reduces the rate of recurrence in breast cancer patients. Perhaps it's time we looked at osteosarcoma in the same way. Can the pattern of metastases/recurrence be massively reduced by the use of ketorolac (or other similar drugs) before and during surgery?

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