Bone Cancer
Its types, causes, symptoms, diagnosis and treatment

What is bone cancer?

Bone cancer refers to cancer that originates in the bone itself and has not invaded it from any other region. Though it can affect any bone in the body, long bones like that of arms and legs are most commonly involved.

What is Bone Cancer

What are the types of bone cancer?

Based on the cells of origin and age group affected there are several types of bone cancers. Common types of bone cancer are:

• Osteosarcoma – Originates in bone cells
• Chondrosarcoma – Originates in cartilage cells
• Ewing’s sarcoma – Its origin is not clearly understood yet

What are the signs and symptoms of bone cancer?

Some of the common symptoms of bone cancer include:

• Pain in the affected bone: Pain in the affected bone is the most common sign of the bone cancer. Initially, pain may be intermittent and appear only with activity, but in advanced stages, pain lingers constantly with exacerbation during active periods.
• Swelling: Pain may be followed by swelling in the region.
• Bone weakness: Fracture, though uncommon, may occur due to weakening of bone as a result of tumor.
• Other symptoms include unintended weight loss, fatigue, tingling and numbness if the spine is involved.

What are the causes of bone cancer?

Certain changes in a person’s DNA, called mutations, can cause normal cells to grow and multiply in an uncontrolled fashion, without getting destroyed like the normal cells would, thus resulting in the development of a tumor. These mutations can either be inherited or acquired during a person’s lifetime.

What are the risk factors for bone cancer?

Most people with bone cancer do not have any apparent risk factors, but doctors have stated certain factors that predispose to cancer:

• Inherited genetic syndromes like Le-Fraumeni syndrome and hereditary retinoblastoma
• Paget’s disease of bone
• Radiation: Exposure of bones to ionizing radiations may develop cancer as in case of radiotherapy or exposure to radioactive materials like radium or strontium

How bone cancer is diagnosed?

Your oncologist can diagnose bone cancer by:

• Medical history
• Physical examination
• Tests:
• Imaging tests
  • – Bone Scan
  • – Computerised tomography (CT) scan
  • – Magnetic resonance imaging (MRI)
  • – Positron emission tomography (PET)
  • – X-ray
• Biopsy – A sample of the tumor tissue is removed for its microscopic examination to study the presence of cancerous changes in the cells. A sample can be derived either by inserting a needle through the skin and into a tumor or by a surgery. Biopsy also helps in determining the stage of cancer.

Diagnosis of Bone Cancer

What are the stages of bone cancer?

Once diagnosed, staging of cancer is necessary to make the treatment plan.

Cancer staging is done in two ways: TNM (Tumour, Node, Metastasis) staging and Number staging from I to IV. It was developed by the International Union against Cancer and the American Joint Committee on Cancer (AJCC).

• ‘T’ refers to the size of the primary tumor
• ‘N’ refers to whether the lymph nodes in the neck area have become cancerous
• ‘M’ refers to whether cancer has spread to distant organs in the body (metastasized), such as your lungs, bones, or liver

Stages progress from stage I to stage IV depending upon the aggressiveness of the cancer cells and the extent of spread.

Stage 1: In stage 1A, cancer is smaller than 8 centimeters across and has not spread to nearby lymph nodes or to distant sites. In stage 1B, cancer grows larger than 8 centimeters across and may occur at more than one place on the same bone. Stage 1 bone cancers are low grade (G0) or cannot be determined (GX).

Stage 2: In stage 2A, cancer is smaller than 8 centimeters across and has not spread to nearby lymph nodes or to distant sites. In stage 2B, cancer grows larger than 8 centimeters across and may occur at more than one place on the same bone. Stage 2 bone cancers are high grade (G2 or G3).

Stage 3: Stage 3 bone cancer is in more than one place on the same bone and has not spread to nearby lymph nodes or to distant sites. Stage 3 bone cancers are high grade (G2 or G3).

Stage 4: Stage 4 bone cancer can be of any size and may occur in more than one place on the same bone. Stage 4A cancer has not spread to lymph nodes but it has spread only to lungs (M1a). Stage 4B cancer may or may not have spread to lymph nodes, lungs or other bones. Stage 4 bone cancers can be of any grade.

What is the treatment for bone cancer?

Treatment for bone cancer depends on the type, site, size, and stage of cancer and on the individual’s age and overall health. Available options are:

• Surgery: It is commonly used for bone cancer and involves the removal of the entire tumor with negative margins (no cancer cells are found at the border of the resected tissue). Recent advances in surgical techniques and pre-operative treatments have made it feasible to avoid extensive surgical procedures like removal of the entire limb.
• Chemotherapy: It involves the use of anticancer drugs to kill cancer cells.
• Radiation therapy: It involves targeting of cancer cells by high energy X-rays.
• Cryosurgery: This technique kills cancer cells by freezing them using liquid nitrogen.

Treatment for Bone Cancer

What is the survival rate for bone cancer?

Survival rates are based on outcomes of a large number of people who had the disease. Survival rates are often used by doctors to determine the patient’s prognosis. The 5-year survival rate implies the percentage of people surviving 5 years after the diagnosis of their disease. It depends on many factors like the overall health of the patient, stage, and site of the tumor.

The 5-year survival rates for various circumstances are as mentioned below:

• For all cases of bone cancer: about 70%
• For chondrosarcomas: about 80%
• For localized osteosarcomas and Ewing’s sarcoma: 60-80%
• For cancers that spread to distant parts: 15-30%

How can bone cancer be prevented?

Preventive measures are not yet established for bone cancer. Although, knowledge of risk factors and timely medical assistance can help diagnose bone cancer in its initial stages and thus can be treated effectively.

To know more about bone cancer, you can request a callback and our Bone Cancer Specialties will call you and answer all your queries.

Related blogs you may like to read:

• Bone Cancer Usually affects the long bones that make up arms and legs

References:

• Mayo Clinic. Bone cancer. Available at: https://www.mayoclinic.org/diseases-conditions/bone-cancer. Accessed on April 7, 2018.
• American Cancer Society. Bone cancer. Available at: https://www.cancer.org/cancer/bone-cancer/detection-diagnosis-staging/signs-symptoms.html. Accessed on April 7, 2018.
• National Cancer Institute. Bone cancer. Available at: https://www.cancer.gov/types/bone/.Accessed on April 7, 2018.

Disclaimer:

“The content of this publication has been developed by a third party content provider who is clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”