Bone cancer can be primary bone cancer or secondary bone cancer.
Primary bone cancer starts in the bone; the cancer initially forms in the cells of the bone, while secondary cancer starts elsewhere in the body and spreads to the bone. Examples of primary bone cancer include steosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma.
According to the National Cancer Institute, USA, it is estimated that by the end of 2015 there will have been 2,970 new cases and 1,490 deaths from cancer of the bones and joints. They suggest that approximately 0.1 percent of men and women will be diagnosed with bone and joint cancer at some point during their lifetime1.
Primary bone cancer (tumor) - these can be divided into benign tumors - which can have a neoplastic (abnormal tissue growth), developmental, traumatic, infectious, or inflammatory cause - and cancers.
Examples of benign bone tumors include: osteoma, osteoid osteoma, osteochondroma, osteoblastoma, enchondroma, giant cell tumor of bone, aneurysmal bone cyst, and fibrous dysplasia of bone.
Examples of malignant primary bone tumors include: osteosarcoma, chondrosarcoma, Ewing's sarcoma, malignant fibrous histiocytoma, fibrosarcoma, and other sarcomas. Multiple myeloma is a blood cancer which may include one or more bone tumors. Teratomas and germ cell tumors are frequently located in the tailbone.
Osteosarcoma is the most common type of bone cancer. It usually develops in children and young adults. After leukemia and brian tumors, osteosarcoma is the third most common cancer among for children in the UK and the USA.
Ewing sarcoma usually develops in the pelvis, shin bone or thigh bone. 90% of patients develop this type of cancer when they are less than 20 years of age.
Chrondrosacroma usually develops in adults. It starts in the cartilage cells and moves on to the bone.
The outlook for a patient with malignant bone cancer depends mainly on whether it has metastasized (spread to other parts of the body). If the cancer is localized (has not spread), prognosis is usually good.
Symptoms of bone cancer
A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor notice. For example, pain may be a symptom while a rash may be a sign.
The patient initially experiences pain in the affected area. Over time the pain gets worse and continuous. In some cases the pain is subtle and the patient may not see a doctor for several months. The progression of pain with Ewing sarcoma tends to be faster than in most other bone cancers. Typically, bone cancer pain is deep, nagging and has a permanent character.
- There may also be swelling in the affected area.
- Often the bone will weaken, resulting in a significantly higher risk of fracture.
- The patient may find he/she loses weight unintentionally.
- A mass (lump) may be felt in the affected area.
- Although much less common, the patient may also experience fever, chills and/or night sweats.
Causes of bone cancer
Nobody knows in general what the causes of bone cancer are. Patients with chronic (long-term) inflammatory diseases, such as Paget's disease are at a significantly higher risk of developing bone cancer later on in life. However, nobody can explain why one person gets bone cancer while another one doesn't. It is not contagious - you cannot catch it from someone else.
The following groups of people may be at a higher risk of developing bone cancer (risk factors):
- Being a child or very young adult - most cases of bone cancer occur in children or young adults aged up to 20.
- Patients who have received radiation therapy (radiotherapy).
- People with a history of Paget's disease.
- People with a close relative (parent or sibling) who has/had bone cancer.
- Individuals with hereditary renoblastoma - a type of eye cancer that most commonly affects very young children.
- People with Li-Fraumeni syndrome - a rare genetic condition.
- Babies born with an umbilical hernia.
On the next page we look at the diagnosis of bone cancer and the available treatments for bone cancer.