Last updated date: 23-Sep-2022
Originally Written in English
The term "bone cancer" refers to a variety of malignancies that grow within the bones. Normal bone tissue can be harmed when cancer cells develop in a bone. The type of bone cancer depends on the type of cell and tissue in which the disease starts.
Generally, bone cancer is a rare disease, accounting for about 1 percent of all malignancies. They can affect anyone at any age, but they are more frequent in children, teenagers, and young adults, unlike in older persons.
Primary bone cancers are tumors that start within the bone itself. Most cancers that form in the organs or other body parts can metastasize to the bones and other body parts. Secondary or metastatic bone cancers are the term for these growths. Examples of cancers that mostly spread to the bones are breast, prostate, and lung cancers.
Types of Bone Cancer
The three common bone cancer types include;
Ewing sarcoma: This encompasses a wide range of tumors with comparable characteristics and originates in the same cell types. These tumors can develop in the bones as well as the soft tissue surrounding them. Ewing sarcoma usually develops in the ribs, hips, shoulder blades, as well as long bones like the legs.
Osteosarcoma: This is the most frequent type of bone cancer. Osteosarcoma arises in the cells that generate new bone tissue. It can also start in any bone, although it most commonly occurs at the ends of long major bones like the legs and arms. Osteosarcoma is usually diagnosed in children and teenagers.
Chondrosarcoma: This form of cancer starts in the cartilage tissue. Cartilage refers to the soft connective tissue that permits bones and joints to move freely. When the body incorporates calcium into cartilage, some of it becomes bone. This malignancy usually develops in the bones of the arm, leg, or pelvis. Chondrosarcoma is also more common in adults than in children.
Signs and Symptoms of Bone Cancer
The following are the common signs and symptoms of bone cancer:
- Swelling and discomfort in the afflicted bones
- A hard mass in the limbs' long bones
- Feeling exhausted or worn out
Symptoms that are less prevalent include:
- Bones that are easily broken
- Unexpected weight loss
Causes of Bone Cancer
Doctors aren't sure the bone cancer causes. However, they have discovered connections between it and other variables. Exposure to radiation or medicines while undergoing treatment for other malignancies is the most critical cause. Although this is not always the case, certain bone tumors are caused by diseases passed down through families (hereditary).
Risk Factors of Bone Cancer
Some of the risk factors that can contribute to bone cancer include;
- Genetic syndromes that are inherited: Li-Fraumeni syndrome and hereditary retinoblastoma are two rare genetic diseases that enhance the risk of bone cancer in families.
- Paget's disease (bone disease): Paget's disease of the bone, which is most frequent in elderly persons, can raise the risk of developing bone cancer later in life.
- Radiation therapy (cancer treatment): Large doses of radiation, like those used in cancer radiation therapy, can increase the chance of developing bone cancer with time.
Diagnosing Bone Cancer
During bone cancer diagnosis, doctors or oncologists normally use imaging tests to determine the size and location of the bone tumors. Imaging tests also help identify if the tumors have metastasized to other body parts.
The types of imaging tests to use usually depend on the signs and symptoms of the patient. They can thus include;
- Computerized tomography (CT) scan to show if cancer has metastasized to other body parts and the extent.
- Bone scan to determine if cancer has spread to other bones.
- Magnetic resonance imaging (MRI) gives an outline of bone cancer.
- X-ray to check for bone cancer and determine whether cancer has spread towards the lungs.
- Positron emission tomography (PET) scan to scan the entire body for malignancy.
Biopsy (needle or surgical):
Sometimes, the oncologist can suggest a procedure to take out a small tissue sample (biopsy) from the tumor for lab testing. This test enables them to determine if the tissue is malignant and the form of cancer you have. It may also tell if tumor cells are rapidly or gradually developing.
The following are examples of biopsy methods to diagnose bone cancer:
- A needle is inserted into a tumor through your skin. Your doctor will introduce a small needle into the skin and direct it into cancer during a needle biopsy. The needle makes it easy for the doctor to remove small fragments of tissue from the tumor.
- Surgical removal of a tissue sample testing. The doctor can create an incision or cut in the skin to remove the entire tumor or a section of it during a surgical biopsy.
Bone Cancer Staging
If the physician verifies a diagnosis of bone cancer, he or she will try to establish the cancer's extent or stage. This will be helpful in choosing the best treatment options. They will consider the following factors;
- The tumor's size
- How quickly the cancer is developing
- The affected bones, including the nearby spine vertebrae.
- If the cancer is spreading to other areas of the body
Bone cancer stages include;
Stage 1: The tumor is smaller than or equal to 8 centimeters (cm) in diameter and has not spread beyond its original location. It's a low grade, or the doctor cannot figure out the grade through tests. This is, however, the most curable stage of bone cancer.
Stage 2: The size of a phase 2 tumor is similar to that of a stage 1 tumor, but the malignancy is of a higher grade. It is more aggressive as a result of this.
Stage 3: Tumors in at least two locations on the same bone have not yet metastasized to the lungs or lymph nodes. A bone tumor in stage 3 has a high grade.
Stage 4: Bone cancer has progressed to this stage. A bone cancer stage 4 will have spread to the lungs, lymph nodes, or other organs and is present in multiple locations.
Bone Cancer Treatment
The type of cancer you have, the stage, your overall health, and your preferences all influence your treatment choices for bone cancer. Some types of bone cancer react to different treatments. Hence, the oncologist can advise you on the best option for you.
In general, bone cancer treatment can include one or a combination of the following;
Chemotherapy kills the tumor cells by administering powerful anti-cancer medications intravenously into a vein. However, certain types of bone cancer respond better to this treatment, unlike others. Chemotherapy, for instance, isn't very successful for chondrosarcoma. Nonetheless, it's a crucial part of the treatment for Ewing sarcoma and osteosarcoma.
- Radiation therapy
To destroy cancer cells, radiation therapy uses high-powered energy beams, like x-rays. Your doctor will ask you to lie on a table during radiation therapy. Meanwhile, special equipment rotates around you, aiming energy beams at specific areas of your body.
Before surgery, radiation therapy is frequently utilized to shrink the tumor, making it easy to eliminate. As a result, there's a better chance that amputation won't be necessary. Patients who have bone cancer that cannot be treated through surgery may benefit from radiation therapy.
Radiation therapy may be performed following surgery to destroy any cancerous cells that remain. Radiation therapy can also assist people with advanced bone cancer manage their signs and symptoms, including pain.
The purpose of surgery is to fully take out the malignant tumor. In most situations, this entails using specialized approaches to remove the tumor in one piece, together with a small part of surrounding healthy tissue. The surgeon then replaces the missing bone with bone obtained from a different part of the body. It could be a substance from a bone bank or metal and hard plastic replacement.
Bone tumors that are exceedingly big or at a difficult location on the bone might need amputation of all or sections of a leg. Amputation is, however, becoming less prevalent as new treatments are being developed.
Outlook for Bone Cancer Patients
Most people with bone cancer can effectively recover following treatment. Cancer does not return in these circumstances. In other cases, many procedures are necessary to achieve this result.
Others with bone cancer may have to continue with the treatment, such as radiation therapy and chemotherapy, to prevent the disease from spreading. Also, to manage cancer, the patient may have to continue with these treatments permanently.
It's critical to see your doctor regularly to assess signs that the cancer is returning (recurrent) or spreading. The earlier the oncologist discovers a recurrence, the sooner they can begin treatment.
Bone cancer can start in any bone in the body, but the pelvis and long bones in the arms and legs are the most affected. Bone cancer is extremely rare, while those that aren't cancerous are far more common than the cancerous.
Some forms of bone cancer are more common in children, whereas others are more common in adults. The most usual treatment is surgery, but chemotherapy and radiation therapy may also be helpful. Usually, the type of bone cancer determines whether surgery, chemotherapy, or radiation therapy will be effective.