Cancer that starts in a bone is rare.Bone cancer can begin in any bone in the body, but it most commonly affects the long bones that make up the arms and legs.
Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing 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).
Some types of bone cancer occur primarily in children, while others affect mostly adults.
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Bone cancer also doesn’t include blood cell cancers, such as multiple myeloma and leukemia, that begin in the bone marrow — the jelly-like material inside the bone where blood cells are made.
The symptoms of bone cancer depend where the tumour grows (about half occur in or near the knee). By the time a lump or swelling is detectable, the cancer may have been present for some time. (Swelling and tenderness near the affected area)
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Pain, especially at night, is a common problem and may cause a limp if the leg is affected, because weight-bearing is uncomfortable or the cancer interferes with the way the joints work.
There may also be generalised symptoms such as weight loss, sweats, fever and lethargy , tiredness or fatigue. Sometimes, bone cancer is discovered incidentally – when an x-ray is taken after an accident, for example – or occasionally when the bone breaks due to weakness caused by the cancer.
Weakened bones, sometimes leading to fractures.
It’s not clear what causes most bone cancers. Doctors know bone cancer begins as an error in a cell’s DNA. The error tells the cell to grow and divide in an uncontrolled way. These cells go on living, rather than dying at a set time. The accumulating mutated cells form a mass (tumor) that can invade nearby structures or spread to other areas of the body.
Unlike most cancers, bone cancer tends to affect the young. Osteosarcoma usually appears in children and young adults, while Ewing’s sarcoma is most common between the ages of 10 and 20.
Other risk factors include:
•Previous radiotherapy treatment, especially at a young age. Some chemotherapy drugs also increase the risk of osteosarcoma
•As many as one in eight people who develop a tumour of the eye will go on to develop an osteosarcoma, possibly because of a genetic susceptibility to both conditions and the additional effect of anti-cancer treatments
•Genetic conditions linked to bone tumours including Li-Fraumeni syndrome, HME, inherited breast cancer and congenital umbilical hernia (Ewing’s sarcoma is three times more common in children with this condition)
•Paget’s disease, a bone disease that generally occurs in older people and increases the risk of osteosarcoma, as does another bone condition called chondroma
•Bone cancer has often been linked to injuries to a limb, but it’s questionable and may simply be that the injury draws attention to a tumour that was already growing
Imaging tests :-
What imaging tests you undergo depends on your situation. Your doctor may recommend one or more imaging tests to evaluate the area of concern, including:
*Computerized tomography (CT)
*Magnetic resonance imaging (MRI)
*Positron emission tomography (PET)
Removing a sample of tissue for laboratory testing
Your doctor may recommend a procedure to remove (biopsy) a sample of tissue from the tumor for laboratory testing. Testing can tell your doctor whether the tissue is cancerous and, if so, what type of cancer you have. Testing may also reveal the cancer’s grade, which helps doctors understand how aggressive the cancer may be.
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. The needle is used to remove small pieces of tissue from the tumor.
*Surgery to remove a tissue sample for testing. During a surgical biopsy, your doctor makes an incision through your skin and removes either the entire tumor (excisional biopsy) or a portion of the tumor (incisional biopsy).
Determining the type of biopsy you need and the particulars of how it should be performed requires careful planning by your medical team. Doctors need to perform the biopsy in a way that won’t interfere with future surgery to remove bone cancer. For this reason, ask your doctor for a referral to an appropriate surgeon before your biopsy.
Tests to determine the extent (stage) of the bone cancer
Once your doctor diagnoses your bone cancer, he or she works to determine the extent (stage) of your cancer. The cancer’s stage guides your treatment options.
Stages of bone cancer include:
*Stage I. At this stage, bone cancer is limited to the bone and hasn’t spread to other areas of the body. After biopsy testing, cancer at this stage is considered low grade and is not considered aggressive.
*Stage II. This stage of bone cancer is limited to the bone and hasn’t spread to other areas of the body. But biopsy testing reveals the bone cancer is high grade and is considered aggressive.
*Stage III. At this stage, bone cancer occurs in two or more places on the same bone.
*Stage IV. This stage of bone cancer indicates that cancer has spread beyond the bone to other areas of the body, such as the brain, liver or lungs.
The treatment options for your bone cancer are based on the type of cancer you have, the stage of the cancer, how far it has spread, your overall health and your preferences. Bone cancer treatment typically involves surgery, chemotherapy, radiation or a combination of treatments.
Bone cancer that hasn’t spread outside the bone may be treated with surgery and may not require chemotherapy. More abnormal bone cancer that has spread will be more difficult to treat, and chemotherapy as well as surgery is usually recommended.
In general, treatment of bone cancer has a good outlook, especially if it’s in the early stages and can be completed during surgery. About two-thirds of people with primary bone cancer can be cured. But if the cancer is more advanced or has spread, the prognosis may not be so good, with five-year survival rates of only 10-20 per cent. It’s vital that you talk to your specialist to get a picture of how successful treatment is likely to be in your individual case.
Treatment usually consists of surgery often combined with chemotherapy to shrink the tumour and make it less likely to recur. Because surgery involves removing bone, it can be quite drastic. Where possible, the surgeon will try to replace the diseased bone with a graft of bone from elsewhere in the body or an implant, but sometimes amputation is necessary.
Some bone cancers, such as Ewing’s sarcoma, respond well to chemotherapy and other treatments such as radiotherapy.
Newer biological therapies based on natural body chemicals such as interferon are also being used. These may work, for example, by encouraging the body’s immune system to attack the cancer cells. A number of different research trials are looking at different combinations of these treatments in an effort to improve results.
After initial treatment, regular follow-ups are essential to check for recurrences and to manage the consequences of treatment, such as the use of an artificial limb.
You may click to see:-
*Bone and Tissue Transplantation
*Bone Sarcoma in the Upper Extremity
*Ewing’s Family of Tumors (PDQ)…(Also available in Spanish)
*Osteosarcoma/Malignant Fibrous Histiocytoma of Bone (PDQ) …..(Also available in Spanish)
*Surgical Management of Cancer that Spreads to the Bone
*Vertebroplasty and Kyphoplasty
Prevention, Genetics, Causes:-
Information related to prevention, genetics, and risk factors:
Understanding Gene Testing
Search: Cancer Genetics Services Directory
Cancer Genetics Overview
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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.