What's to know about bone cancer?
Bone cancer is divided into primary and secondary bone cancer: primary bone cancer forms in the cells of the bone and secondary bone cancer starts elsewhere, eventually spreading to bones.
In this article, we will discuss the survival rates, types, causes, symptoms, and treatments for bone cancer.
- Benign bone tumors are more common than malignant bone tumors.
- There are a number of different bone cancer types.
- Early symptoms might include pain in the affected area.
- A range of diagnostic tests can help diagnose bone cancer.
- Radiotherapy, chemotherapy, and surgery can all be used to treat bone cancer.
Treatment
The type of treatment for bone cancer depends on several factors, including:
- the type of bone cancer
- where it is located
- how aggressive it is
- whether it is localized or has spread
There are three approaches to treating bone cancer. These are surgery, radiation therapy, and chemotherapy.
Surgery
Surgery aims to remove the tumor and some of the bone tissue that surrounds it. If some of the cancer is left behind, it may continue to grow and eventually spread.
Limb-sparing surgery, also known as limb salvage surgery, means that surgical intervention occurs without having to amputate the limb. The surgeon may take some bone from another part of the body to replace lost bone, or an artificial bone may be fitted.
In some cases, however, amputation of a limb may be necessary.
Radiation therapy
Radiotherapy, machine pictured here, is commonly used for treating bone cancer and other forms of cancer.
Radiotherapy is commonly used in the treatment of many cancer types. It involves the use of high-energy X-rays or particles to destroy cancer cells. Radiotherapy works by damaging the DNA inside the tumor cells, preventing them from reproducing.
Radiotherapy can be used to:
- cure the patient by completely destroying the tumor.
- relieve pain in more advanced cancers.
- shrink the tumor, making it easier to then surgically remove it.
- eliminate the cancer cells that remained behind after surgery.
Combination therapy is radiotherapy combined with another type of therapy. This may be more effective in some cases.
Chemoradiation, or radiotherapy combined with chemotherapy, may also be used.
Chemotherapy
Chemotherapy involves the use of chemicals to treat disease. More specifically, it refers to the destruction of cancer cells. Chemotherapy has five possible goals:
- Total remission: Chemotherapy aims to cure the patient. In some cases, chemotherapy alone can get rid of the cancer completely.
- Combination therapy: Chemotherapy can help other therapies, such as radiotherapy or surgery, produce better results.
- Delay or prevent recurrence: Chemotherapy, when used to prevent the return of cancer, is most often used after a tumor has been removed surgically.
- Slow down cancer progression: Chemotherapy can slow down the advancement of the cancer.
Chemotherapy may also help to relieve symptoms; this is more frequently used for patients with advanced cancer.
Stages
Bone cancer is staged dependent on how advanced it is:
- Stage 1: The cancer has not spread from the bone. The cancer is not aggressive.
- Stage 2: This is the same as stage 1 but more aggressive.
- Stage 3: Tumors exist in at least two places in the same bone.
- Stage 4: The cancer has spread to other parts of the body.
The stage of the cancer will dictate how it is treated and the likelihood of survival.
Causes
While doctors are unsure or precise causes, patients with long-term inflammatory diseases, such as Paget's disease are at a significantly higher risk of developing bone cancer later in life. However, nobody can explain why one person gets bone cancer while another one does not. It is not contagious.
The following groups of people may be at a higher risk of developing bone cancer:
- children or young adults aged up to 20 years
- people who have received radiation therapy
- individuals with a history of Paget's disease
- people with a close relative who has bone cancer
- individuals with hereditary retinoblastoma, a type of eye cancer that most commonly affects very young children
- people with Li-Fraumeni syndrome, a rare genetic condition
Symptoms
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. Other symptoms include:
- swelling in the affected area
- weakened bones that resulting in a significantly higher risk of fracture
- unintentional weight loss
- a lump in the affected area
Although much less common, the patient might also experience fever, chills, and night sweats.
Types
There are many types of bone cancer, pictured here is myeloma of the bone marrow.
There are several types of bone cancer, including:
Primary bone cancers
Primary bone cancers are either benign tumors or cancers. Benign tumors can be due to developmental changes, trauma, infections, inflammation, or abnormal tissue growth; they are more common in people under the age of 30.
Examples of benign bone tumors include:
- osteoma
- osteoid osteoma
- osteochondroma
- osteoblastoma
- enchondroma
- giant cell tumor of the bone
- aneurysmal bone cyst
- fibrous dysplasia of the bone
Examples of malignant primary bone tumors include:
- osteosarcoma
- chondrosarcoma
- Ewing's sarcoma
- malignant fibrous histiocytoma
- fibrosarcoma
- other sarcomas
Multiple myeloma is a blood cancer that may include one or more bone tumors. Certain bone cancers are found in specific bones; for instance, teratomas and germ cell tumors are frequently located in the tailbone.
Osteosarcoma
Osteosarcoma is the most common type of bone cancer. It usually develops in children and young adults. After leukemia and brain tumors, osteosarcoma is the third most common cancer among teens in the United States.
Ewing sarcoma
Ewing sarcoma usually develops in the pelvis, shinbone, or thighbone. It most commonly affects teenagers and young adults.
Chondrosarcoma
Chondrosarcoma usually develops in adults. It starts in the cartilage cells and moves on to the bone.
Diagnosis
A doctor may order a blood test to rule out other possible causes. The patient will then be referred to a bone specialist. The following diagnostic tests may be ordered:
Outlook
The outlook for a patient with malignant bone cancer depends mainly on whether it has spread to other parts of the body. If the cancer is localized (has not spread), the prognosis is usually good.
According to the University of Rochester Medical Centre, United Kingdom, for all bone cancers combined, the 5-year survival rate is around 70 percent.
The survival rate varies depending on the staging of the disease. The National Cancer Institute, U.S. estimates that by the end of 2016, there will have been 3,300 new cases and 1,490 deaths from cancer of the bones and joints.
