Introduction
Cancer is a disease that results in the uncontrollable growth of cells and often spreads to other parts of the body. Bone is a human body structure that helps support and protect internal organs. There are various types of bone cancers, and primary bone cancer refers to cancer that generally originates from bone and bone tissues. They are usually aggressive. This article will discuss primary bone cancer, its types, prevalence, diagnosis, and treatment in detail.
What Is Primary Bone Cancer?
Primary bone cancer (PBC) is a rare cancerous tumor originating from the bone and from the first embryonic mesenchymal tissues. They account for about 0.2 percent of all cancerous tumors worldwide. Primary bone cancer is developed from the outer layer, the surface, or the central portion of the bone. They are often aggressive and multiply rapidly, destroying the adjacent bone. In severe cases, they bear and spread to other parts of the body. There are various subtypes of primary bone cancer.
How Common Is Primary Bone Cancer?
Primary bone cancer is a rare condition that affects people of all ages. But they generally occur more commonly in childhood and between the ages of 10 to 25. They account for five percent of all childhood cancers. Studies have shown its prevalence more commonly in males than females in the ratio of 1.43 to 1.
What Are the Types of Primary Bone Cancers?
There are various types of primary bone cancer, and the common types of PBC are mentioned below.
1. Osteosarcoma: This type of primary bone cancer is called osteogenic sarcoma. This type of cancer originates from the osteoblasts (bone-forming cells) in immature bone tissues. They commonly occur in the arms near the shoulder and the knees but can occur in any part of the body. This tumor accounts for about 35 percent of all bone cancers.
2. Chondrosarcoma: This type of PBC occurs mainly in adults and arises from cartilage tissues. Cartilage is a flexible connective tissue that lines and protects the joints of the bone. Chondrosarcoma is a slow-growing tumor that rarely spreads to other body parts. They often develop in the hipbone, legs, and shoulder. They are usually seen between the ages of 30 to 60 years.
3. Ewing Sarcoma: This type of bone cancer accounts for about 15 percent of all bone cancers. They commonly affect the hipbone, legs, upper arm, and backbone. They are more aggressive and tend to metastasize to other regions of the body, especially the lungs.
What Are the Causes of Primary Bone Cancers?
The possible causes of primary bone cancer include:
1. Genetic factors: Some inherited syndromes, such as Li Fraumeni syndrome and retinoblastoma, tend to have genetic abnormalities predisposing patients to develop primary bone cancers.
2. Radiotherapy: Patients with a previous history of cancer and who underwent radiotherapy, especially when exposed to ionizing radiation during early childhood, are at high risk of developing primary bone cancers.
3. Benign Bone Conditions: Certain bone disorders are likely to progress to malignant bone cancers. Patients with conditions such as Paget's disease (a chronic bone disorder that disrupts the turnover rate of the bone) are at an increased risk of developing primary bone cancers such as osteosarcoma. Benign conditions like enchondromas and osteochondromas (cartilaginous tumors) may progress to malignant primary bone cancer.
How Is Primary Bone Cancer Diagnosed?
-
When determining the patient's primary bone cancer diagnosis, the doctor takes a thorough medical history as well as information on the patient's family history.
-
The doctor also performs a thorough physical examination of the patient.
-
The radiographic investigation is an effective method of inquiry in diagnosing primary bone cancer.
-
The radiographic investigation includes X-rays that help visualize the tumor's size, shape, and location.
-
The doctor may perform a bone scan (a diagnostic test also called bone scintigraphy, a specialized radiographic procedure used to diagnose various bone diseases).
-
Other radiographic investigations such as MRI (magnetic resonance imaging) and CT (computed tomography) scans may also be performed to diagnose any abnormalities of the bone.
-
The doctor may perform a bone biopsy, a diagnostic technique, to remove a sample of bone tissue from the tumor to assess the tissue under the microscope.
-
A blood test may also be required to assess the patient's overall health.
How Is Primary Bone Cancer Treated?
The treatment for primary bone cancer primarily depends on the location, type, size of the tumor, general health of the patient, patient's age, and whether the tumor is metastasized or not. The treatment of primary bone cancer is based on the staging of the tumor. The available treatment options for primary bone cancer include surgical interventions, chemical therapy, radiotherapy, targeted therapy, and cryosurgery.
1. Surgery: Surgical intervention is the most commonly performed treatment option. The surgical procedure involves the removal of the entire tumor with negative margins. Multiple procedures may be required based on the size and extent of the cancer.
2. Radiation Therapy: This treatment option generally involves using targeted high-energy radiation to kill cancer cells. They are often performed in combination with surgical interventions. They may be used when local surgical tumor excision might not be possible.
3. Chemotherapy: This treatment involves using anti-cancer drugs to slow down the condition's progression and destroy cancer cells. Certain high-grade tumors, such as osteosarcomas and Ewing sarcoma, may require chemotherapy. There may be specific side effects such as nausea, vomiting, hair loss, weight loss, constipation, diarrhea, and hearing defects with chemotherapy.
4. Targeted Therapy: This therapy involves using specially designed drugs to alter cancer cell growth and spread.
Conclusion
Primary bone cancer is a rare type of cancerous tumor that originates from the bone tissues. The patient generally develops unusual pain and swelling along the bone affected by the condition. The risk of developing primary bone cancer may be increased in patients with a history of radiation therapy and certain benign bone diseases. This condition is generally diagnosed through a physical examination, bone scan, X-ray, and bone biopsy. The treatment for primary bone cancer depends on the severity of the disorder, the tumor's location, the type of cancer, and the possibility of spreading to other areas of the body.
