Signs and symptoms: The following should be investigated.

For bone sarcoma:

• persistent non-mechanical pain in any bone lasting more than a few weeks/referred pain/unremitting pain not responsive to analgesics/nocturnal bone pain
• a mass, swelling, a limp
• limited mobility or loss of limb function
• fractures with minimal trauma.

For soft tissue sarcoma:

• any deep mass or superficial mass with a diameter larger than 5 cm
• a small but growing mass
• a rapidly growing change in a mass (over months)
• a mass where there is no associated history of trauma.

General/primary practitioner investigations should include:

• medical history and baseline blood tests
• physical examination including assessing the physical characteristics of the mass and of the regional lymph nodes
• if there is bone pain, a plain x-ray
• if there is a soft tissue lump, refer to a specialist.

Referral: All patients with suspected sarcoma should be referred to a specialist sarcoma multidisciplinary team within two weeks and before biopsy.

Communication

The lead clinician’s (1) responsibilities include:

• explain to the patient/carer who they are being referred to and why
• support the patient and carer while waiting for specialist appointments.