It worsens at night. The first symptom of a rare cancer is easy to ignore.
In a press release sent to PAP , oncologists noted that symptoms such as limb pain, swelling, and limited movement are most often related to physical overload or minor trauma . In children, bone pain can also be caused by rapid growth. However, if attempts to alleviate the symptoms are ineffective and symptoms persist for weeks, the cause may be more serious. In both children and adults, these can be symptoms of a rare bone and soft tissue cancer called sarcoma .
Staying vigilant is especially important in the case of young children, whose symptoms of malignant tumors can be non-specific and easy to miss.
"In Poland, approximately 1,100-1,200 malignant tumors are diagnosed in children each year, of which approximately 7% are bone or soft tissue sarcomas," said Prof. Anna Raciborska, head of the Department of Oncology and Oncological Surgery for Children and Adolescents at the Institute of Mother and Child.
As she explained, the most commonly diagnosed soft tissue sarcoma in children and adolescents is rhabdomyosarcoma, and when it comes to bone sarcomas – osteosarcoma and Ewing's sarcoma.
According to the specialist, the most obvious and common symptom of a sarcoma is a lump or bulge in the soft tissue. Often, it may not be painful at first, but it persists and may even enlarge. It is sometimes confused with a hematoma, hemangioma, or swelling.
"At the same time, or even earlier, especially in the case of bone sarcomas, pain appears, which may be the only symptom and resembles typical ailments of developmental age: growing pains, overload pain, or post-traumatic pain. However, if it persists for more than two to three weeks, worsens at night, and does not subside despite rest or symptomatic treatment, it is worth performing a more detailed diagnostic procedure," emphasized Professor Raciborska.
The nature of the pain may be an important clue in the diagnosis - unlike growth pain, which is bilateral, intermittent and subsides after massage, cancer pain can be unilateral, constant, worsens at night and is resistant to pain relief.
Additionally, sarcomas may be accompanied by:
- fever with no apparent cause,
- weight loss,
- general weakness.
In children, the symptoms can be difficult to interpret, but in adults, sarcoma can also remain unnoticed for a long time - although for different reasons.
- In the case of soft tissue sarcomas, the problem is that the tumor can grow asymptomatically for many weeks or months - said Prof. Piotr Rutkowski, president of the Polish Oncology Society.
He added that patients often seek medical attention only when the lesion reaches several centimeters in diameter and begins to cause problems—enlargement, pressure on nerves, pain, or restriction of mobility. Often, the lesion remains painless for a long time and resembles benign subcutaneous lesions such as lipomas or cysts.
"The larger the tumor, the more difficult the treatment—extensive surgery, tissue reconstruction, and often radiotherapy or systemic treatment are often necessary. Therefore, prompt referral to a specialist center even when cancer is suspected is crucial," noted Professor Rutkowski.
He emphasized that sarcomas should be diagnosed and treated in specialized centers experienced in treating these cancers. Treatment is often combined, including surgery, chemotherapy, and in some cases, radiotherapy. In children, due to their young age, rehabilitation plays a particularly important role, as does the use of modern endoprostheses where possible, which help avoid amputation.
"Today, we treat not only effectively but also with the patient's future in mind. In young patients, we strive for limb-sparing treatment, often using advanced reconstructive solutions. Psychological support, rehabilitation, and return to social life are equally important," noted Professor Raciborska.
As the experts concluded, sarcomas are rare, but early diagnosis, regardless of age, is of great importance in their case - for the effectiveness of treatment, the scope of therapy and the quality of life after its completion.
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