As kids grow, their muscles, tendons and ligaments grow as well. So when they complain about aches and pains, it's often due to the rapid pace of their developing bodies.
Two out of every five kids get growing pains, and it happens right around the time of their growth spurts – during the toddler and pre-teen years. It can cause achy thighs, calves and knees.
However, if your child complains about persistent pain or the pain is coupled with other ailments, it might be something more serious.
Joining the show to offer tips on the best ways for parents to tell the difference between normal aches and pains, and something more serious, is Denise Rokitka, MD, MPH. This is an important segment that all parents should hear.
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Is It Growing Pains or Cancer?
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Learn more about Denise Rokitka, MD
Denise Rokitka, MD, MPH
Denise Rokitka, MD., joined the Medical Oncology Department at Roswell Park Comprehensive Cancer Center in 2008 as an Assistant Professor in Pediatric Hematology and Oncology and Director of the Pediatric Long-Term Follow-up (LTFU) Program.Learn more about Denise Rokitka, MD
Transcription:
Is It Growing Pains or Cancer?
Bill Klaproth (Host): As kids grow, their muscles, tendons and ligaments grow as well. So, when they complain about aches and pains, it’s often due to the rapid pace of their developing bodies. However, sometimes these growing pains may be signs and symptoms of pediatric bone cancer. And here to talk with us about recognizing the signs of when something may be more than just growing pains, is Dr. Denise Rokitka, Director Long-term Follow-up Clinic Department of Pediatric Oncology at Roswell Park Comprehensive Cancer Center. Dr. Rokitka, thank you for your time today. So, first off, do all kids get growing pains?
Dr. Denise Rokitka, MD, MPH (Guest): Most kids get growing pains at some point, typically when they are having growth spurts and they are growing at a faster rate. Often this can happen in their toddler and their sort of preteen years when you tend to have more of that growth spurt activity.
Bill: And generally, in what body parts do these aches and pains, or these growing pains as we say, happen in?
Dr. Rokitka: More commonly, kids will complain of pains in their thighs, knees, sometimes their calves as well.
Bill: And what’s the best way for parents to tell the difference between normal aches and pains and something more serious?
Dr. Rokitka: So, often, what I tell parents is that you should always be concerned if the pain is waking them up from sleep, if the pain is persistent and interfering with them being able to do daily activities and if it is something that is continually happening and not really getting better or getting worse.
Bill: So, when you say persistent pain, how persistent should the pain be to take it seriously and what other kinds of ailments would occur alongside the pain? Are there any at all?
Dr. Rokitka: If it is just growing pains, then you wouldn’t typically have anything other than some pains that tend to go away relatively quickly. When I say persistent, I mean in the sense that the pain is always there. It’s waking you up at night. It’s something that affects you being able to participate in gym or walk around the house. It’s something that it is always there.
Bill: So, if a parent is noticing that or a child is complaining of those symptoms, best case then is to get to the doctor just to make sure.
Dr. Rokitka: Right, absolutely.
Bill: And how prevalent are these growing pains? Is it half the population, a third? Do we even know how prevalent it appears?
Dr. Rokitka: Probably two out of every five kids can get growing pains.
Bill: Okay, and what types of pediatric cancer typically share symptoms with growing pains?
Dr. Rokitka: So, any of our bone cancers that we see in pediatrics can often have bony pain as well. So, osteosarcoma or Ewing’s sarcoma would be the more common cancers that we see in kids. But often those go along with other symptoms as well, not just pain.
Bill: And what are some of those other symptoms?
Dr. Rokitka: So, often you can see some swelling of the joint or inability to move the leg or the joint as you normally would. Sometimes you can have limping or fevers associated as well. And then as I mentioned before, that persistence of the pain and the pain that lasts all day, wakes you up at night because it hurts so much.
Bill: Right. So, if you notice any of those things, make sure to contact your physician.
Dr. Rokitka: Correct.
Bill: And when it comes to growing pains then, as far as you said toddlers and preteens, is that right?
Dr. Rokitka: Correct.
Bill: So, if you have someone that is outside of those areas and notice these types of symptoms, is that generally a warning sign then?
Dr. Rokitka: It can be. It also again, can be normal. Every child is a little bit different in terms of what their growing pains may look like. So, what I usually tell parents is if you feel that there is cause for concern; then you should just get checked out. Because otherwise, you are continuing to think about it and be scared and it makes the most sense to see somebody – to see a doctor.
Bill: And when you see a child that comes in with growing pains or potential symptoms that may be more serious; how do you diagnose then if it is more than just growing pains? What’s the process for that?
Dr. Rokitka: So, the first step would really just be an x-ray of the limb or the joint just to see if there is anything abnormal on the x-ray. Oftentimes with these kinds of bone cancers, you will see something on just a plain x-ray that looks abnormal.
Bill: And then what about general treatment? Can you tell us about that?
Dr. Rokitka: For growing pains or for cancer?
Bill: For both actually yes, for growing pains and then the pediatric bone cancer.
Dr. Rokitka: Okay, yeah. So, for growing pains, there is really not much you can do. Sometimes Motrin or Tylenol can help to reduce some of the pain. But generally, it goes away on its own. If you move on to the next step of having x-rays and those x-rays are abnormal; then diagnosing the specific kind of bone cancer would involve a biopsy and then determining what kind of chemotherapy and if there is any other surgery that needs to happen or radiation.
Bill: And then how common is it for growing pains to actually be pediatric bone cancer?
Dr. Rokitka: So, osteosarcoma and Ewing’s sarcoma are the bone cancers that I mentioned that we see most often, but those are still extremely rare. We only see about 12,000 cases of cancer per year in the United States and of those cancers, are osteosarcoma and Ewing’s sarcoma is somewhere around maybe 5 or 10 percent of that. So, it’s not a lot. But obviously, is concerning if it does turn out to be a cancer.
Bill: Absolutely. And what is the general treatment plan then?
Dr. Rokitka: So, both of those cancers get chemotherapy that usually lasts several months and they often both have some sort of a surgery to remove the tumor. And if you can’t remove it all, then radiation is the next step.
Bill: And what is the prognosis for a child that’s diagnosed with pediatric bone cancer?
Dr. Rokitka: It depends on where the disease is and if it’s localized or if you have disease anywhere else. The most common place that it goes to is the lungs. So, if you have localized cancer the prognosis is actually quite good. It is somewhere around 70% event free survival at five years. If you have more disseminated disease, then it’s not good. It is like somewhere around 20% survival.
Bill: And how often does it spread to other organs in the body?
Dr. Rokitka: All depending again on how quickly it is picked up. Typically, more cases are localized than are spread, which is good. Ewing’s sarcoma tends to be more widespread than osteosarcoma. So, often with Ewing’s sarcoma, you will have more than just one joint, more than just one bone that hurts. And it often, like I said, can go to kind of all of the bones. Both cancers tend to be in the longer bones, so the humerus of the arm or the femur of the leg are the most common places.
Bill: If cancer is found then, does the child have a higher risk for cancer throughout their entire life?
Dr. Rokitka: Not specifically related to the type of cancer, but because they get chemotherapy, that can put you at a higher risk for other kinds of cancers later in life, there is long-term screening that we continue to do to make sure that we try to keep all these kids healthy.
Bill: And is this hereditary at all with these types of cancers in children?
Dr. Rokitka: Osteosarcoma can be hereditary, so if you have a family history of osteosarcoma or a family history of an eye tumor called retinoblastoma, those can be more hereditary related. And so that is something that usually when we are doing a history, we try to get that information as well because it makes long-term surveillance more important in terms of making sure that they have any cancer screening earlier in life if needs to be, than the typical child.
Bill: And Dr. Rokitka, if you could wrap it up for us,is there anything else we should know about the sings and symptoms of pediatric bone cancer?
Dr. Rokitka: Again, the most important take home point would be prolonged pain, pain that is persistent and any unusual kind of bone swelling, or difficulty being able to move the joint or limping would be the most important symptoms to really get yourself to see a doctor and get checked out.
Bill: Well, that’s terrific information and thank you so much for sharing that with us today Dr. Rokitka. And for more information, you can visit www.roswellpark.org , that’s www.roswellpark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth. Thanks for listening.
Is It Growing Pains or Cancer?
Bill Klaproth (Host): As kids grow, their muscles, tendons and ligaments grow as well. So, when they complain about aches and pains, it’s often due to the rapid pace of their developing bodies. However, sometimes these growing pains may be signs and symptoms of pediatric bone cancer. And here to talk with us about recognizing the signs of when something may be more than just growing pains, is Dr. Denise Rokitka, Director Long-term Follow-up Clinic Department of Pediatric Oncology at Roswell Park Comprehensive Cancer Center. Dr. Rokitka, thank you for your time today. So, first off, do all kids get growing pains?
Dr. Denise Rokitka, MD, MPH (Guest): Most kids get growing pains at some point, typically when they are having growth spurts and they are growing at a faster rate. Often this can happen in their toddler and their sort of preteen years when you tend to have more of that growth spurt activity.
Bill: And generally, in what body parts do these aches and pains, or these growing pains as we say, happen in?
Dr. Rokitka: More commonly, kids will complain of pains in their thighs, knees, sometimes their calves as well.
Bill: And what’s the best way for parents to tell the difference between normal aches and pains and something more serious?
Dr. Rokitka: So, often, what I tell parents is that you should always be concerned if the pain is waking them up from sleep, if the pain is persistent and interfering with them being able to do daily activities and if it is something that is continually happening and not really getting better or getting worse.
Bill: So, when you say persistent pain, how persistent should the pain be to take it seriously and what other kinds of ailments would occur alongside the pain? Are there any at all?
Dr. Rokitka: If it is just growing pains, then you wouldn’t typically have anything other than some pains that tend to go away relatively quickly. When I say persistent, I mean in the sense that the pain is always there. It’s waking you up at night. It’s something that affects you being able to participate in gym or walk around the house. It’s something that it is always there.
Bill: So, if a parent is noticing that or a child is complaining of those symptoms, best case then is to get to the doctor just to make sure.
Dr. Rokitka: Right, absolutely.
Bill: And how prevalent are these growing pains? Is it half the population, a third? Do we even know how prevalent it appears?
Dr. Rokitka: Probably two out of every five kids can get growing pains.
Bill: Okay, and what types of pediatric cancer typically share symptoms with growing pains?
Dr. Rokitka: So, any of our bone cancers that we see in pediatrics can often have bony pain as well. So, osteosarcoma or Ewing’s sarcoma would be the more common cancers that we see in kids. But often those go along with other symptoms as well, not just pain.
Bill: And what are some of those other symptoms?
Dr. Rokitka: So, often you can see some swelling of the joint or inability to move the leg or the joint as you normally would. Sometimes you can have limping or fevers associated as well. And then as I mentioned before, that persistence of the pain and the pain that lasts all day, wakes you up at night because it hurts so much.
Bill: Right. So, if you notice any of those things, make sure to contact your physician.
Dr. Rokitka: Correct.
Bill: And when it comes to growing pains then, as far as you said toddlers and preteens, is that right?
Dr. Rokitka: Correct.
Bill: So, if you have someone that is outside of those areas and notice these types of symptoms, is that generally a warning sign then?
Dr. Rokitka: It can be. It also again, can be normal. Every child is a little bit different in terms of what their growing pains may look like. So, what I usually tell parents is if you feel that there is cause for concern; then you should just get checked out. Because otherwise, you are continuing to think about it and be scared and it makes the most sense to see somebody – to see a doctor.
Bill: And when you see a child that comes in with growing pains or potential symptoms that may be more serious; how do you diagnose then if it is more than just growing pains? What’s the process for that?
Dr. Rokitka: So, the first step would really just be an x-ray of the limb or the joint just to see if there is anything abnormal on the x-ray. Oftentimes with these kinds of bone cancers, you will see something on just a plain x-ray that looks abnormal.
Bill: And then what about general treatment? Can you tell us about that?
Dr. Rokitka: For growing pains or for cancer?
Bill: For both actually yes, for growing pains and then the pediatric bone cancer.
Dr. Rokitka: Okay, yeah. So, for growing pains, there is really not much you can do. Sometimes Motrin or Tylenol can help to reduce some of the pain. But generally, it goes away on its own. If you move on to the next step of having x-rays and those x-rays are abnormal; then diagnosing the specific kind of bone cancer would involve a biopsy and then determining what kind of chemotherapy and if there is any other surgery that needs to happen or radiation.
Bill: And then how common is it for growing pains to actually be pediatric bone cancer?
Dr. Rokitka: So, osteosarcoma and Ewing’s sarcoma are the bone cancers that I mentioned that we see most often, but those are still extremely rare. We only see about 12,000 cases of cancer per year in the United States and of those cancers, are osteosarcoma and Ewing’s sarcoma is somewhere around maybe 5 or 10 percent of that. So, it’s not a lot. But obviously, is concerning if it does turn out to be a cancer.
Bill: Absolutely. And what is the general treatment plan then?
Dr. Rokitka: So, both of those cancers get chemotherapy that usually lasts several months and they often both have some sort of a surgery to remove the tumor. And if you can’t remove it all, then radiation is the next step.
Bill: And what is the prognosis for a child that’s diagnosed with pediatric bone cancer?
Dr. Rokitka: It depends on where the disease is and if it’s localized or if you have disease anywhere else. The most common place that it goes to is the lungs. So, if you have localized cancer the prognosis is actually quite good. It is somewhere around 70% event free survival at five years. If you have more disseminated disease, then it’s not good. It is like somewhere around 20% survival.
Bill: And how often does it spread to other organs in the body?
Dr. Rokitka: All depending again on how quickly it is picked up. Typically, more cases are localized than are spread, which is good. Ewing’s sarcoma tends to be more widespread than osteosarcoma. So, often with Ewing’s sarcoma, you will have more than just one joint, more than just one bone that hurts. And it often, like I said, can go to kind of all of the bones. Both cancers tend to be in the longer bones, so the humerus of the arm or the femur of the leg are the most common places.
Bill: If cancer is found then, does the child have a higher risk for cancer throughout their entire life?
Dr. Rokitka: Not specifically related to the type of cancer, but because they get chemotherapy, that can put you at a higher risk for other kinds of cancers later in life, there is long-term screening that we continue to do to make sure that we try to keep all these kids healthy.
Bill: And is this hereditary at all with these types of cancers in children?
Dr. Rokitka: Osteosarcoma can be hereditary, so if you have a family history of osteosarcoma or a family history of an eye tumor called retinoblastoma, those can be more hereditary related. And so that is something that usually when we are doing a history, we try to get that information as well because it makes long-term surveillance more important in terms of making sure that they have any cancer screening earlier in life if needs to be, than the typical child.
Bill: And Dr. Rokitka, if you could wrap it up for us,is there anything else we should know about the sings and symptoms of pediatric bone cancer?
Dr. Rokitka: Again, the most important take home point would be prolonged pain, pain that is persistent and any unusual kind of bone swelling, or difficulty being able to move the joint or limping would be the most important symptoms to really get yourself to see a doctor and get checked out.
Bill: Well, that’s terrific information and thank you so much for sharing that with us today Dr. Rokitka. And for more information, you can visit www.roswellpark.org , that’s www.roswellpark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth. Thanks for listening.