Description

Bone cancer is a growth of cells that starts in a bone. Bone cancer can begin in any bone. But most often it affects the bone of the thigh.

The term "bone cancer" does not include a cancer that starts in another part of the body and spreads to the bones. In contrast, the cancer that spreads to the bones, is named for the place in which it started. For example, cancer that begins in the lungs and spreads to the bones is still lung cancer. Health professionals might call the lung cancer that has metastasized to the bones.

The cancer that begins in the bone is rare. Different types of bone cancers exist. Some types of bone cancers occur in children. Other types of happen especially in adults.

Common bone cancer treatments include surgery, radiation and chemotherapy. The best treatment for bone cancer depends on the type of cancer of the bone, the bone is affected, and other factors.

Symptoms

The signs and symptoms of bone cancer are:

  • Pain in the bones.
  • Swelling and tenderness near the affected area.
  • Weakens the bone, which can lead to a broken bone.
  • Feeling very tired.
  • Losing weight without trying.

When to see a doctor

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

Causes

The cause of most bone cancers are not known. Bone cancer starts when cells in or near a bone to develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time. In cancer cells, changes in DNA to give different instructions. The changes, to tell the cancer cells to make many more cells quickly. Cancer cells can continue living when healthy cells would die. This makes too many cells.

The cancer cells may form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. At the time, cancer cells can break off and spread to other parts of the body. When cancer spreads, it is called metastatic cancer.

Types of bone cancer

The bones contain a variety of different types of cells. Cancer of the bones are divided into different types, often based on the type of cell where the cancer began. The most common types of bone cancer are:

  • The Osteosarcoma. Osteosarcoma is a type of bone cancer that begins in the cells that form bones. It is the most common type of bone cancer. Osteosarcoma tends to occur more frequently in teens and young adults. But it can also occur in young children and older adults. Osteosarcoma occurs more frequently in the long bones of the legs and sometimes the arms. Very rarely, it occurs in soft tissue outside the bone.
  • Chondrosarcoma. Chondrosarcoma is a type of bone cancer that usually starts in the bones, but can sometimes occur in the soft tissues. Chondrosarcoma occurs most often in the pelvis, the hip and the shoulder. Occurs most often in middle-aged and older adults.
  • Ewing's sarcoma. Ewing's sarcoma is a type of bone cancer that begins in the bones and the soft tissues around the bones. Ewing's sarcoma occurs primarily in children and young adults, although it can occur at any age. Most often starts in the bones of the legs and pelvis, but it can occur in any bone.

Risk factors

Things that increase the risk of bone cancer are:

  • Inherited genetic syndromes. Certain rare genetic syndromes passed through families increase the risk of bone cancer. Examples include Li-Fraumeni syndrome and hereditary retinoblastoma.
  • Other diseases of the bones. Some other diseases of the bones can increase the risk of bone cancer. The other bone conditions include Paget's disease of bone and fibrous dysplasia.
  • The treatment of cancer. Radiation therapy for cancer, and some types of chemotherapy drugs used to treat cancer can increase the risk of bone cancer.

Health professionals have not found ways to prevent cancer of the bone.

Diagnosis

Bone for the diagnosis of cancer often involves imaging tests to look for in the affected bone. To be sure if the bone growth is cancer, a piece of tissue can be removed and tested for cancer cells.

Imaging tests

Imaging tests create pictures of the body. You can show the location and size of bone cancer. Tests may include:

  • X-ray.
  • Magnetic resonance imaging, also called magnetic resonance imaging.
  • Computerized axial tomography scan, also called a CT or cat scan.
  • The positron emission tomography scan, also called a PET.
  • Bone scan.

Biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. For cancer of the bone, the tissue sample may be collected by:

  • The insertion of a needle through the skin. During a needle biopsy, a health care provider inserts a thin needle through the skin and guides in cancer. The health care provider uses a needle to collect small samples of tissue.
  • Extraction of the sample during the surgery. During a surgical biopsy, the surgeon makes an incision in the skin to access the cancer. The surgeon removes a portion of the cancer to the tests.

Determine the type of biopsy you need and the details of how to do the biopsy requires careful planning on the part of your medical team. Health professionals need to perform the biopsy in a way that does not interfere with the future of surgery to remove the bone cancer. For this reason, ask for a referral to a health care team which caters to a large number of bone cancers before the biopsy.

Stages of bone cancer

If you detect that you have cancer in the bones, often, the next step is to find out the extent of the cancer. This is called the stage of the cancer. Your healthcare team uses the stage of the cancer to help create your treatment plan. To determine the stage of the cancer, the healthcare team considers:

  • The cancer of the location.
  • The size of the cancer.
  • How fast the cancer is growing.
  • The number of affected bones, such as the number of affected vertebrae of the spinal column.
  • If the cancer has spread to the lymph nodes or to other parts of the body.

Stages of bone cancer in the range of 1 to 4. Stage 1 cancer of the bone, in general, is a small cancer that is growing little by little. As the cancer grows or grows faster, the stages get more. A stage 4 bone cancer has spread to the lymph nodes or to other parts of the body.

Treatment

Bone cancer treatments include surgery, radiation and chemotherapy. What treatments are best for your bone cancer depend on several factors. These factors include the type, location and stage of bone cancer. Your health care team also considers your overall health and your preferences.

Surgery

The goal of surgery for cancer of the bones is to remove all of the cancer. The surgeon can remove the cancer in the bones, and part of the healthy tissue around it. The surgeon then repairs the bone. This may involve the use of a piece of bone from another part of your body. Sometimes the bone is repaired with metal or plastic material.

Sometimes, surgeons need to remove an arm or a leg in order to get all of the cancer, although this is not common. This may be necessary if the cancer grows very large, or if the cancer is in a place that makes surgery difficult. After an arm or leg, you can choose to use an artificial limb. With the training and the time with the new member, you can learn how to do everyday tasks.

Chemotherapy

Chemotherapy treats the cancer with strong medications. Many chemotherapy drugs exist. The majority of chemotherapy drugs are given through a vein. Some come in the form of a pill.

Chemotherapy is often used after surgery for some types of bone cancers. You can kill any cancer cells that remain and decrease the risk that the cancer will come back. Sometimes chemotherapy is given before surgery to reduce the size of a bone cancer and make it easier to remove.

Not all types of bone cancer respond to chemotherapy treatments. Chemotherapy is often used for the treatment of osteosarcoma and Ewing's sarcoma. It is not often used for chondrosarcoma.

Radiation therapy

Radiation therapy treats cancer with powerful rays of energy. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.

Radiation therapy may be used after surgery to destroy any bone cancer cells that might remain. It can also help control the cancer of the bone when the surgery is not an option.

Some types of bone cancers are more likely to be helped by the therapy of radiation than others. Radiation therapy may be an option for the treatment of Ewing's sarcoma. Not often used to treat chondrosarcoma or osteosarcoma.

Coping and support

A cancer diagnosis can be overwhelming. With the time you're going to find ways to cope with the distress and uncertainty of cancer. Until then, you can find help for:

  • Learn enough about the bone cancer to make decisions about your care. Ask your health care team about your bone cancer, including treatment options and, if you like, your prognosis. As you learn more about the bone cancer, you may feel more confident in making treatment decisions.
  • Keep friends and family close. Keep your close relationships strong can help you to deal with the cancer of the bone. Friends and family can provide the practical support you need, such as help to take care of your house if you're in the hospital. And that you can serve as emotional support when you feel overwhelmed by the cancer.
  • Find someone to talk to. Find a good listener who is willing to listen to you talk about your hopes and fears. This can be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group may also be useful. Ask your health care team about support groups in your area.

Preparing for your appointment

If you have any symptoms that worry you, start by making an appointment with a doctor or other health care professional. If your doctor suspects you may have cancer of the bone, you may be referred to a specialist. The bone cancer is often treated by a team of specialists that may include:

  • The surgeons operating on the bones and joints, called orthopedic surgeons.
  • The orthopedic surgeons who specialize in the operation of the cancers that affect the bones, called orthopedic oncologists.
  • Doctors who specialize in the treatment of cancer with drugs, so-called medical oncologists.
  • The medical uses of radiation to treat the cancer, called radiation oncologists.
  • The doctors who analyze tissue to diagnose the specific type of cancer, called pathologists.
  • Rehabilitation specialists that can help you recover after surgery.

How to prepare

Because appointments can be brief, it is a good idea to be prepared. Try:

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking.
  • Consider the possibility of a family member or friend. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Bring your previous scans or X-rays, the related reports and other medical records are important to this situation to the appointment.

Questions to ask

Prepare a list of questions can help you make the most of your time. A list of questions from most important to least important in case time runs out. For bone cancer, some basic questions to ask include:

  • What type of bone cancer do I have?
  • What is the stage of my cancer of the bone?
  • How fast is my cancer of bone in-growth?
  • Will I need additional tests?
  • What are the treatment options for my bone cancer?
  • What are the odds that the treatment is going to cure my cancer of the bone?
  • What are the side effects and risks of each treatment option?
  • We tried to make it impossible for me to have children?
  • I have other health conditions. How will cancer treatment affect my other conditions?
  • There is a treatment you think is best for me?
  • What would you recommend to a friend or family member in my situation?
  • You should see a specialist? What will that cost, and will my insurance cover it?
  • If you would like a second opinion, you can recommend a specialist?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

In addition to the questions you have prepared, do not hesitate to ask questions during your appointment.

What to expect from your doctor

Be prepared to answer some questions about your symptoms and your medical history. The questions may include:

  • When did you first begin experiencing symptoms?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Bone cancer