Treatment

How is bone cancer treated?

There are many different methods available for your doctor to treat bone cancer. The best treatment is based on the type of bone cancer, the location of the cancer, how aggressive the cancer is, and whether or not the cancer has invaded surrounding or distant tissues (metastasized). There are three main types of treatment for bone cancer: surgery, chemotherapy, and radiation therapy. These can be used either individually or combined with each other

Surgery is often used to treat bone cancer. The goal of surgery is usually to remove the entire tumor and a surrounding area of normal bone. After the tumor has been removed, a pathologist examines it to determine if there is normal bone completely surrounding the tumor. If a portion of the cancer is left behind, it can continue to grow and spread, requiring further treatment. Historically, amputations were frequently used to remove bone cancer. Newer techniques have decreased the need for amputation. In many cases, the tumor can be removed with a rim of normal bone without the need for an amputation. Depending on the amount of bone removed, the surgeon will replace something in its location. For smaller areas, this may be either bone cement or a bone graft from another place in your body or from the bone bank. For larger areas, the surgeon may place larger grafts from the bone bank or metal implants. Some of these metal implants have the ability to lengthen when used in growing children.

You may be referred to a medical oncologist for chemotherapy. This is the use of various medications used to try to stop the growth of the cancer cells. Chemotherapy can be used prior to surgery to try to shrink the bone tumor to make surgery easier. It can also be used after surgery to try to kill any remaining cancer cells left following surgery.

You could also be referred to a radiation oncologist for radiation therapy. The radiation therapy uses high-energy x-ray aimed at the site of the cancer to try to kill the cancer cells. This treatment is given in small doses daily over a period of days to months.

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risk of bone cancer

Bone marrow transplantation

Osteosarcoma has been reported in a few patients who have undergone bone marrow (stem cell) transplantation.

Injuries

People have wondered whether injury to a bone can cause cancer, but this has never been proven. Many people with bone cancer remember having hurt that part of their bone. Most doctors believe that this did not cause the cancer, but that the cancer caused them to remember the incident, or that the injury drew their attention to that bone and caused them to notice a problem that had already been present for some time.

Radiation

Bone exposure to radiation may also increase the risk of developing bone cancer. A typical x-ray of a bone is not dangerous, but exposure to large doses of radiation does pose a risk. For example, radiation therapy to treat cancer can cause a new cancer to develop in one of the bones in the treatment area. Being treated at a younger age and/or being treated with higher doses of radiation (usually over 60 Gy) increases the risk of developing bone cancer. Exposure to radioactive materials such as radium and strontium can also cause bone cancer because these minerals build up in bones. Non-ionizing radiation, such as microwaves, electromagnetic fields from power lines, cellular phones, and household appliances, does not increase bone cancer risk.

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Risk

Risk of bone cancer
A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for cancers of the lung, mouth, larynx, bladder, kidney, and several other organs. But having a risk factor, or even several, does not mean that you will get the disease. Most people with bone cancers do not have any apparent risk factors.

Genetic disorders

A very small number of bone cancers (especially osteosarcomas) appear to be hereditary.

Osteosarcoma

Children with certain rare inherited syndromes have an increased risk of developing osteosarcoma.

1. The Li-Fraumeni syndrome makes people much more likely to develop several types of cancer, including breast cancer, brain cancer, osteosarcoma, and other types of sarcoma. Most of those cases are caused by a mutation of the p53 tumor suppressor gene, but some are caused by mutations in the gene CHEK2.
2. Another syndrome that includes bone cancer is the Rothmund-Thompson syndrome. Children with this syndrome are short, have skeletal problems, and rashes. They also are more likely to develop osteosarcoma. This syndrome is caused by abnormal changes in the gene REQL4.
3. Retinoblastoma is a rare eye cancer of children that can be hereditary. The inherited form of retinoblastoma is caused by a mutation (abnormal copy) of the RB1 gene. Those with this mutation also have an increased risk of developing bone or soft tissue sarcomas. Also, if radiation therapy is used to treat the retinoblastoma, the risk of osteosarcoma in the bones around the eye is even higher.

Finally, there are families with several members that have developed osteosarcoma without inherited changes in any of the known genes. The gene defects that may cause cancers in these families haven't been discovered yet.

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Types

Types of Bone Cancer
Bones serve various purposes in the body. They protect and support the organs in the body. For instance, the brain is protected by the skull and the lungs are protected by the ribs. Blood cells are made and stored in the bone marrow, the spongy and soft tissue that many bone have in their center.

Primary bone cancer occurs most commonly in the legs and arms, although it can also affect other bones of the body. Primary bone cancers are usually referred to as sarcomas, of which there are several types. Each type of sarcoma affects a different type of bone tissue, with the most common being: chondrosarcoma; Ewing’s sarcoma; and osteosarcoma.
Chondrosarcoma: This type of bone cancer occurs mostly in adults. It affects the cartilage, which is the rubber-like tissue that is around the joints.

Ewing's sarcoma: This bone cancer occurs most often amongst people between the ages of 10-25, with teenagers being most affected. It affects the shaft, or middle part of large bones. It usually occurs in the long bones of the upper arm and thigh and also the hipbones. It can also affect the ribs.

Osteosarcoma: This is the most common kind of bone cancer and it affects young people in the age group of 10-25 years. Males are more susceptible to it compared to females. Osteosarcoma usually begins where new bone tissue forms, at the ends of bones, as young people grow. The long bones of the legs and arms are usually affected by it.

Cancers like the above, which start in the bone, occur rarely. However, it is quite common for cancers to spread from the other parts of the body to the bone. This type of cancer is known as metastatic cancer. Around 80% of the metastatic cancers that affect the bone are due to primary carcinomas that affect other organs such as the prostate, breast, kidney, lung, stomach, pancreas, and thyroid. Each of these types of metastatic cancers, which affect the bone, is named according to the tissue or organ where the primary cancer occurs.

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Symptoms

Symptoms of bone cancer
The symptoms of bone cancer vary from one person to another according to the location and size of the bone cancer. Pain is one of the most common bone cancer symptoms. Generally, there is a gradual increase in the severity of the symptoms with time. At first, the pain may only be felt with activity or at night. According to the growth of the cancerous tumor, people may experience the symptoms for weeks, perhaps even months, sometimes even years until they seek medical help. Sometimes a lump or mass may occur either in the tissues that surround the bone or on the bone itself. This commonly occurs with fibrosarcoma or MFH, but can also occur with other types of bone tumors as well. Some of the less common bone cancer symptoms are weight loss, night sweats, chills, and fever. These symptoms usually occur when the cancerous tumor spreads to the other parts of the body.

Various factors affect the successful treatment of bone cancer, one of the most important being the early detection of the symptoms of bone cancer. Moreover, the recovery from this disease is largely dependent on the recognition and understanding of bone cancer symptoms. These symptoms are actually signs warning that something could be wrong. Hence, these symptoms of bone cancer should not be ignored. And, even though the symptoms may ultimately prove to be the root causes of some other ailment, it is better to make certain and not ignore these bone cancer symptoms.

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