Bone cancer can begin in any bone in the body, but it most commonly affects the pelvis or the long bones in the arms and legs. Bone cancer is rare. Noncancerous bone tumors are much more common than cancerous ones.
The term “bone cancer” doesn’t include cancers that begin elsewhere in the body and spread (metastasize) to the bone. Instead, those cancers are called for where they began, such as breast cancer that has metastasized to the bone.
Symptoms of Bone cancer
Signs and symptoms of bone cancer include:
- Pain in the bone
- Unexplained weight loss
- Swelling and tenderness near the affected area
- Weakened bone, leading to fracture
Causes of Bone cancer
The cause of most bone cancers is unknown. Though hereditary factors and radiation exposure have been linked to small number of bone cancers.
Types of bone cancer
Bone cancers are broken down into different types based on the type of cell where the cancer began. The most common types of bone cancer include:
- Osteosarcoma is the most common form of bone cancer. In this tumor, the cancerous cells produce bone. This variety of bone cancer occurs most often in children and young adults, in the bones of the leg or arm. In rare circumstances, osteosarcomas can arise outside of bones (extraskeletal osteosarcomas).
- Chondrosarcoma is the second most common form of bone cancer. The cancerous cells produce cartilage. Chondrosarcoma usually occurs in the legs, arms, or pelvis in middle-aged and older adults.
- Ewing sarcoma.This tumor is common in the pelvis, legs or arms of children and young adults.
It’s not clear what causes bone cancer, but doctors have found certain factors are linked with an increased risk, including:
- Inherited genetic syndromes.Certain rare genetic syndromes passed through families increase the risk of bone cancer, including Li-Fraumeni syndrome and hereditary retinoblastoma.
- Paget’s disease of bone.Most commonly occurring in older adults, Paget’s disease of bone can increase the risk of bone cancer developing later.
- Radiation therapy for cancer.Exposure to large doses of radiation, such as those given during radiation therapy for cancer, increases the risk of bone cancer in the future.
When to see a doctor
See your doctor immediately if:
- Pain doesn’t stop with OTC pain relievers
- Pain is recurrent
- Pain Becomes worse at night
Imaging tests can help determine the location and size of bone tumors, and whether the tumors have spread to other parts of the body. The types of imaging tests recommended depend on your individual signs and symptoms. Tests may include:
- Bone scan
- Computerized tomography (CT)
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
Needle or surgical biopsies
Your doctor may recommend a procedure to remove a sample of tissue (biopsy) from the tumor for testing in a lab. Testing can tell your doctor whether the tissue is cancerous and, if so, what type of cancer you have. It can also reveal whether the tumor cells are growing quickly or slowly.
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Types of biopsy procedures used to diagnose bone cancer include:
- Inserting a needle through your skin and into a tumor.During a needle biopsy, your doctor inserts a thin needle through your skin and guides it into the tumor. Your doctor uses the needle to remove small pieces of tissue from the tumor.
- Surgery to remove a tissue sample for testing.In this case, your doctor makes a small cut through your skin and removes either the entire tumor or a portion of it.
Stages of bone cancer
If your doctor confirms a diagnosis of bone cancer, he or she tries to determine the extent (stage) of the cancer because that will guide your treatment options. Factors to be considered include:
- The size of the tumor
- How fast the cancer is growing
- The number of bones affected, such as adjacent vertebrae in the spine
- Whether the cancer has spread to other parts of the body
The stages of bone cancer are indicated by Roman numerals, ranging from 0 to IV. The lowest stages indicate that the tumor is smaller and less aggressive. By stage IV, the cancer has spread to other parts of the body.
Bone cancer treatment
The treatment options for your bone cancer are based on the type of cancer you have, the stage of the cancer, your overall health and your preferences.
Surgery is performed to remove the whole cancerous tumor. In most cases, this involves special methods to remove the tumor in one single piece, along with a small portion of healthy tissue that surrounds it. The surgeon replaces the lost bone with some bone from another area of your body, with material from a bone bank or with a replacement made of metal and hard plastic.
Chemotherapy uses strong anti-cancer drugs, usually delivered intravenously, to kill cancer cells. However, this type of treatment works better for some forms of bone cancer than for others. For example, chemotherapy is generally not good for chondrosarcoma, but it’s an important part of treatment for osteosarcoma and Ewing sarcoma.
Radiation therapy uses high-powered beams of energy, such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table while a special machine moves around you and targets the energy beams at precise points on your body. Radiation therapy is often used before an operation because it can shrink the tumor and make it easier to remove.