Bone cancer that originates in the bone, primary bone cancer is rare. Fewer than 2,500 Americans are diagnosed with this type of cancer each year. The condition affects more children than adults. Bone cancer is a malignant (cancerous) tumor of the bone that destroys normal bone tissue. Not all bone tumors are malignant. In fact, benign (noncancerous) bone tumors are more common than malignant ones. Both malignant and benign bone tumors may grow and compress healthy bone tissue, but benign tumors do not spread, do not destroy bone tissue, and are rarely a threat to life.
Most of the time when someone with cancer is told they have bone cancer, the doctor is talking about a cancer that spread there from somewhere else. This is called metastatic cancer and can be seen in people with advanced breast cancer, prostate cancer, lung cancer as well as many others. When these cancers in the bone are examined under a microscope they resemble the tissue they came from. If someone has lung cancer spread to bone, the cells of the cancer look and act like lung cancer cells, not bone cancer cells, even after they have spread from the lungs to the bones. They are treated with the same kind of treatment (chemotherapy drugs, for example) that is used for lung cancer.
Malignant tumors that begin in bone tissue are called primary bone cancer. Cancer that metastasizes (spreads) to the bones from other parts of the body, such as the breast, lung, or prostate, is called metastatic cancer, and is named for the organ or tissue in which it began. Primary bone cancer is far less common than cancer that spreads to the bones.
What is Bone Cancer?
Bone cancer: Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing's sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung). The most common types of primary bone tumour are osteosarcoma and Ewing's sarcoma, both of which are most frequently diagnosed in children and young adults.
The first symptom of bone cancer is usually pain or tenderness near the cancer. Bone pain is caused by stretching of the periosteum (thick membrane that covers bone) by the cancer, or by stimulation of nerves within the bone. Bone pain may be hard to differentiate from ordinary low back pain or arthritis. Usually the pain due to bone metastasis is fairly constant, even at night. It can be worse in different positions, such as standing up, which may compress the cancer in a weight bearing bone.
If pain lasts for more than a week or two, doesn't seem to be going away, and is unlike other pain that may have been experienced, it should be evaluated by a physician.
Bone cancer is caused by a problem with the cells that make bone. More than 2,000 people are diagnosed in the United States each year with a bone tumor. Bone tumors occur most commonly in children and adolescents and are less common in older adults. Cancer involving the bone in older adults is most commonly the result of metastatic spread from another tumor.
The most common symptom of bone cancer is pain. Other symptoms may vary depending on the location and size of the cancer. Surgery is often the main treatment for bone cancer. Other treatments may include amputation, chemotherapy and radiation.
Bone Cancer: Symptoms and Signs
People with bone cancer may experience the following symptoms or signs. Sometimes, people with bone cancer do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer.
When a bone tumor grows, it presses on healthy bone tissue and can destroy it, which causes the following symptoms:
- Pain. The earliest symptoms of bone cancer are pain and swelling where the tumor is located. The pain may come and go at first. Then it can become more severe and steady later. The pain may get worse with movement, and there may be swelling in nearby soft tissue. Learn more about cancer and pain.
- Joint swelling and stiffness. A tumor that occurs near or in a joint may cause the joint to swell and become tender or stiff. This means a person may have a limited and painful range of movement.
- Limping. If a bone with a tumor breaks, or fractures, in a leg, it can lead to a pronounced limp. Limping is usually a symptom of later-stage bone cancer.
- Other less common symptoms. Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low red blood cell level.
If you are concerned about any changes you experience, please talk with your doctor.
What tests are used to diagnose bone cancer?
A variety of imaging tests may be used to detect bone tumors, including bone cancers. Very early bone cancers may or may not be apparent on plain X-rays. CT scans and MRI scans are more precise in defining the location of bone cancers.
A bone scan is a test that uses radioactive material to produce images of the entire skeleton. This may allow the localization of bone cancer anywhere in the body. This test is not specific for bone cancers and can also reveal areas of inflammation as found with arthritis, fractures, and infections.
While many bone cancers have a characteristic appearance on imaging studies, a biopsy (tissue sample) must be taken in order to precisely determine what kind of cancer is present and confirm the diagnosis. The biopsy is a procedure to acquire a sample of a piece of the tumor that is examined under a microscope. The tissue sample may be obtained with a needle inserted through the skin into the tumor or with a surgical operation.
At present, there are no screening tests available to detect early bone cancers.
What is the treatment for bone cancer?
An operation to remove the cancer is the mainstay of treatment for bone cancers. Surgical techniques can remove most bone cancers without requiring amputation of the affected limb. In some cases, amputation may be avoided with limb-sparing surgery. Sometimes, muscles and other tissues that surround the cancer also have to be removed. Reconstructive surgery may be needed, in addition to cancer resection, to help maximize function of the limb.
Ewing sarcoma, osteosarcoma, and other bone cancers may require chemotherapy in addition to surgery.
Radiation therapy is the typical treatment for chondrosarcoma.
Ewing sarcomas that do not respond well to high-dose chemotherapy may require radiation therapy and even a stem-cell transplant. In this procedure, the patient's stem cells (blood cells that have the potential to develop into all the different kinds of blood cells) are harvested from the bloodstream. After high doses of chemotherapy medications to destroy the bone marrow, the harvested stem cells are next returned to the body, as with a blood transfusion. Over the next three to four weeks, the stem cells produce new blood cells from the bone marrow.
Targeted therapies are specially designed treatments that aim treatment specifically at the cancer cells. For example, denosumab (Xgeva) is a monoclonal antibody that acts to block the activity of specialized bone cells called osteoclasts. This medication has been used in the treatment of giant cell tumors of bone that have recurred after surgery or cannot be removed by surgery. Imatinib (Gleevec) is a targeted therapy drug that can block the signals from certain mutated genes that cause tumor cells to grow. Imatinib has been used to treat some chordomas that have spread or recurred after treatment.
Clinical trials are another type of treatment for bone cancers. In clinical trials, doctors test promising new medications, combinations of medications, or procedures. Clinical trials are carefully controlled research studies. Talk to your doctor if you think you may be interested in participating in a clinical trial.
Cancers are a bit different to each other's but the fears and worries patients have is similar. The best option to reduce stress and focus on proper treatment of cancer is to know more about it.
Find below cancer guides so that you are made aware of important aspects of it.