Scottish referral guidelines for suspected cancer: quick reference guide

Sarcomas

Soft tissue mass with one or more of the following:

• Size >5 cms.
• Increasing in size.
• Deep to fascia, fixed or immobile, regardless of size.
• Painful (soft tissue sarcomas often painless).
• Recurrence after previous excision.

Bone Cancer

X-ray if unexplained bone pain of:

• Increasing severity or
• persistent or
• tender or
• non-mechanical bone pain particularly disturbing rest or sleep.
• If symptoms persist but x-ray is normal, repeat x-rays and consider referral.
• Spontaneous or minor trauma fracture should raise suspicion of bone cancer.

Further causes of bone pain in older adults include metastases, myeloma and lymphoma.