With over 20 years’ experience as a GP, Dr Green explains more about why it is so essential for GPs to be aware of the symptoms of primary bone cancer and the difference he thinks the Bone Cancer Awareness Initiative will make to early diagnosis.
Why do you think it is important for GPs to be aware of primary bone cancer symptoms?
PBCs are rare and most GPs will see no more than 1 during their career. However, they are no rarer than bacterial meningitis and despite medical professionals being well versed in the presenting signs and symptoms of this condition, the same cannot be said for PBCs.
Most cases are diagnosed following multiple encounters with primary care professionals and often following the development of progressive disease.
Many PBCs are initially labeled as ‘growing pains’, a non-diagnosis which is not a single entity and could be viewed as an inadequate explanation for symptoms that must have a specific underlying cause.
The consequences of missing a PBC are enormous both for the patient and consulting medical professionals. Late diagnoses equate to the requirement for more aggressive treatment regimes, including life-changing and often catastrophic surgery. Many patients have metastases at the point of diagnosis, significantly impacting their survival potential. As most PBCs occur in children, teenagers and young adults, the number of life-years lost in a palliative scenario is collectively vast and the impact on the family and friends from the death of a PBC sufferer is devastating.
30% of all GP consultations are for musculoskeletal disorders and it is therefore very difficult for GPs to sieve through them and spot the serious presenting pathologies. A heightened awareness and a good knowledge of the presenting features is critical for a GP to make an early diagnosis and thereafter, to follow the correct rapid-referral pathways.
Are GPs trained in primary bone cancer signs and symptoms?
GPs are not specifically trained in primary bone cancer as it is not a specified component of the GP trainee curriculum. It may be that their knowledge comes from seeing a case in practice or via background reading but no mandatory training in this area of medicine is required to become a qualified GP.
What difference do you think the Bone Cancer Awareness Initiative (BCAI) will make to early diagnosis?
The consequences of missing a PBC are enormous both for the patient and consulting medical professionals. Late diagnoses equate to the requirement for more aggressive treatment regimes, including life-changing and often catastrophic surgery. Many patients have metastases at the point of diagnosis, significantly impacting their survival potential. As most PBCs occur in children, teenagers and young adults, the number of life-years lost in a palliative scenario is collectively vast and the impact on the family and friends from the death of a PBC sufferer is devastating.
The implications of delayed diagnoses for medical professional can be equally cataclysmic. The harbinger of litigation is ever present and living with the knowledge of being a contributing factor to the poor prognosis of a young patient, is without comparison. Primum non nocere (first, do no harm) is always the rule to which we all must abide. Avoidable delayed diagnoses due to inadequate knowledge or poor clinical reasoning skills is at odds with this concept.
The Bone Cancer Awareness Initiative educational resources are designed to inform and up-skill primary healthcare professionals about PBCs. This collective drive is towards reducing the frequency of delayed or late diagnoses and thus, improving the outcomes for PBC sufferers.
To find out more about the Bone Cancer Awareness Initiative click below.