Diagnosis intervals for sarcoma appear to vary based on the aggressiveness of the tumour, with more aggressive tumours having shorter intervals on average. determined that the mean interval amongst high-grade bone sarcoma patients ranged from 160 delays for patients with Ewing sarcoma, to 688 days for patients with chondrosarcoma. Another study assessing 545 patients with a suspected sarcoma found that the median interval for diagnosis was 176 days from when the patient noticed their symptoms. reviewed patients recently diagnosed with soft tissue sarcoma and found that 47% of patients waited longer than a month before consulting a health professional, and 27% of patients took longer than a month to receive a diagnosis after consulting a health professional. Sarcoma can be challenging to diagnose compared to other cancers due to its heterogeneous nature and rarity.
An Australian study ( n = 91) found that patients with a delayed diagnosis for extremity sarcoma experienced distress relating to their diagnosis a year after treatment. Delayed diagnosis in sarcoma may have an impact on the patient’s opportunity for fertility preservation, psychological distress, patient dissatisfaction, and poor adherence to treatment. Delays in diagnosis are associated with larger tumours, increased risk of metastases, and increased risk of amputation rather than limb salvage surgery. For sarcoma patients, early diagnosis is essential to reduce the magnitude of surgery and increase survival chances. Importance of a timely diagnosisĪ systematic review concluded that, for commonly occurring cancers, expedited diagnosis improves cancer outcomes. Ideally, sarcoma patients are managed by a multidisciplinary sarcoma specialist team, which may include receiving clinical management and support from a sarcoma nurse specialist (Weaver et al. Patients experience a variety of unmet needs, including access to information, health services, psychosocial support, and financial support.
The 5-year post-diagnosis sarcoma survival rate is estimated to be approximately 60% in Western countries (such as the UK, US and Australia), ranging from about 90% survivorship for low grade lesions, to less than 50% survivorship for high grade tumours. Currently, two in five patients diagnosed with sarcoma will die from their disease. In Australia approximately 1200 new cases are diagnosed each year, accounting for approximately 1% of all adult malignancies and 15% of paediatric malignancies. Sarcomas arise in connective tissues such as fat, cartilage and bone, and may occur in almost any anatomical location. Sarcomas can occur at any age, including in childhood and adolescents. Sarcoma is a group of very rare primary bone and soft tissue tumours accounting for less than 3% of all cancers. A public health approach should be taken to improve sarcoma knowledge and health seeking behaviours in the community.
#In a timely manner meaning professional
Sarcoma education must be embedded in medical courses and professional development curricula. Patients with a potential sarcoma need to be promptly referred to a sarcoma specialist centre and additional diagnosis pathways need to be developed to reduce the rate of patients being referred to wrong specialists. Intervals also occurred when patients underestimated the severity of their symptoms and did not seek prompt medical consultation.
Diagnosis was prolonged by the limited availability of health services, lack of prompt referrals to a sarcoma specialist centre, and diagnostic challenges. Resultsįour overarching themes were identified: patient perception of symptoms, difficulties of diagnosis, lack of experience, and availability of health services. Interview transcripts were analysed using thematic analysis. Semi-structured interviews were conducted with: health professionals working with sarcoma ( n = 21) patients who have been diagnosed with sarcoma ( n = 22) and carers of patients diagnosed with sarcoma ( n = 17). The aim of this study was to explore patients’, carers’, and health professionals’ perceived barriers to timely diagnosis and referral for treatment for sarcoma. Previous research has focused on quantifying the time taken to achieve a diagnosis without exploring the reasons for potential delays. Patients with a delayed diagnosis may require more radical surgery and have a reduced chance of survival. Prolonged diagnosis intervals occur more often in rare cancers, such as sarcoma.
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