Bone cancer - Causes, Symptoms, and Treatment

What Is Bone Cancer?

The word cancer refers to the growth of abnormal cells in the body. Bone cancer refers to the uncontrolled growth of these cells in the bone. When cancer occurs in the skeletal system, it starts destroying the tissue. It can instantly spread to different organs such as the lungs. The treatment required for bone cancer is surgery.

What Are the Types?

There are two main types of cancer. They are primary and secondary bone cancer. In primary bone cancer type, cancer begins to develop directly in the cells of the bone. Secondary bone cancer type occurs when cancers begin to develop in other organs due to metastasis. Metastasis is the spread from the initial site to another site.

What Is Primary Bone Cancer?

Bone cancers can be either benign or malignant. Benign tumors are non-cancerous conditions, and malignant tumors are serious cancerous conditions. Benign tumors do not spread beyond their initial site. Malignant tumors are very aggressive. They have a very high risk of growing and spreading.

The examples of benign tumors are:

• Osteoma.

• Osteochondroma.

• Osteoid osteoma.

• Aneurysmal bone cyst.

• Enchondroma.

• Fibrous dysplasia of the bone.

Osteoblastoma and giant cell tumors may start as a benign tumor and develop into a malignant one. Once they become aggressive, they begin to cause damage to the adjacent cells.

Examples of malignant primary bone tumors include:

• Osteosarcoma.

• Malignant fibrous histiocytoma.

• Ewing’s sarcoma.

• Chondrosarcoma.

• Fibrosarcoma.

• Chordoma.

Only the malignant ones are considered as cancerous.

• Osteosarcoma:

This is the type of cancer that develops in the bone-forming cells called osteoblasts. Patients with Paget’s disease have a high risk of osteosarcoma.

• Ewing’s Sarcoma:

Ewing’s sarcoma occurs in the bones of the pelvis, chest wall, or thighbone. It is known to occur in muscles, soft tissues, and blood vessels. It is a fast-growing one.

• Chondrosarcoma:

Chondrosarcoma is seen in adults. It occurs in the shoulders and pelvis.

• Chondroma:

Chondroma is a rare cancer of the spine. It is seen in adults.

What Is Secondary Bone Cancer?

The most common bone cancer type in adults is secondary bone cancer. They develop when cancer metastasis to the bone from other sites in the body. Most of the cancers can spread to the bone cells. People who are suffering from breast and prostate cancer have a high risk of developing secondary bone cancer. These types of cancers can cause fractures, pain, and hypercalcemia.

What Are the Symptoms and Signs?

The symptoms or signs experienced by patients with bone cancer are:

• Pain. When a bone tumor grows, it might hit the healthy bone tissue and causes pain. The initial symptom of bone cancer is pain. This may be accompanied by swelling in the location of the tumor. The pain may get severe with movements.

• Joint Swelling. A tumor that is occurring near a joint may cause the swelling. This might cause tenderness over the affected joints. There may be stiffness in the joints also.

• Difficulty in Walking. If a bone involving the tumor fractures, the function of the particular bone may be lost. If the fracture occurs in the leg, there will be difficulty in walking. This is known as limping.

The other symptoms are:

• Fever.

• Anemia.

• Weight loss.

• General weakness.

What Are the Causes?

The causes of bone cancer are not known. However, there are certain factors contributing to the aggressive growth of tumors.

• Radiation Therapy:

The high dosage of radiation may be a contributing factor.

• Abnormal Cellular Growth:

Healthy cells begin to divide rapidly and replace older cells. After the completion of the dividing process, the abnormal cells start living.

What Are the Risk Factors?

• Cancer Treatment. Patients who have received radiation and chemotherapy drugs are at high risk.

• Health Conditions. Certain cancers such as retinoblastoma (eye cancer) can make a person more susceptible to bone cancer.

• Paget’s Disease.

• Family History. If your family member is known to have cancer, you might probably have a risk of getting bone cancer.

How Is It Diagnosed?

The diagnosis and treatment always require a multidisciplinary approach. The oncologists take the help of various tests and tools to diagnose bone cancer. The major laboratory tests are:

• Biopsy:

There are two biopsy techniques to identify bone cancer. They are:

• Needle Biopsy: The doctor will anesthetize the involved area with local anesthetic agents before injecting a needle. Then samples are collected from the site.

• Surgical Biopsy: This is performed by a doctor under general anesthesia. The doctor will remove a sample of the tissue or the whole tumor by incision. The process of removing the particular tissue is called an incisional biopsy. The process of removing the whole tumor is called an excisional biopsy.

• X-ray:

Cancer gives a different appearance to the bone. The affected bone looks ragged, and it might have a hole in it. A chest X-ray might help you determine whether cancer has spread to the lungs.

• Bone Scan:

Bone cancer can identify whether the tumor has spread to other organs. This test is highly sensitive. It can detect metastases even before they could appear on a regular X-ray.

• MRI:

Magnetic resonance imaging may help to find the outline of a tumor. It might also identify the spread to the spinal cord and brain.

• CT scan:

Computed tomography scans are used to identify cancer in areas which are difficult to be found out by other procedures. It can also be used to guide the biopsy needle during a biopsy procedure.

• PET scan:

Positron emission tomography scans do not show many details. But when they often are performed in combination with computed tomography scans, the diagnosis results are more accurate.

What Is Staging?

After the test results are obtained, doctors will describe the severity of bone cancer. Staging helps a person to understand the severity and degree of spread of the tumor.

What Is the Grading of Cancer?

• Low Grade. In low grade, the cancer cells might seem like normal cells. They are slow-growing and do not spread much.

• High Grade. In high grade,the cancer cells are abnormal. They grow rapidly.

What Are the Stages of Bone Cancer?

There are different stages of bone cancer. They are:

• Stage 1: Cancer contains low-grade cells. It is totally localized, and there is no spreading of the cells beyond the bone.

• Stage 2: Cancer contains high-grade cells. It is totally localized, and there is no spread beyond the bone.

• Stage 3: These are several high-grade tumors occurring in the same bone.

• Stage 4: Cancer in this stage, can spread to other parts. It is an advanced stage.

What Are the Treatment Options?

Depending on the stage and location of the disease, there are various treatment options. The bone cancer experts will suggest a treatment plan that might work for you.

The treatment options are:

• Chemotherapy: Chemotherapy may be recommended for a specific type of bone cancer. Anti-cancer drugs are prescribed by doctors, as they are good at identifying and attacking the cancer cells.

• Surgery: Many surgeries might be necessary depending on the location and also the extent of the tumor.

• Radiation Therapy: Radiation therapy might require highly skilled healthcare professionals to succeed in cancer treatment.

• Targeted Therapy: In targeted therapy, drugs are prescribed. It might be used alone or in combination with chemotherapy.