Bone cancer is a malignancy in bone. Cancer that originates in the bone is termed as primary bone cancer. This type of cancer is very rare.
Children are effected mostly by this type rather than adults. More often, cancer cells spread metastasize to the bones from other parts of the body such as the breasts, lungs, and prostate.
The most common forms of Primary bone cancer are Osteosarcoma, which occurs primarily in growing bone tissue, Ewing’s sarcoma, which arises primarily in immature tissue in bone marrow and Chondrosarcoma, which occurs in cartilage.
The first two forms occur most often in children, adolescents and young adults, ages 10 to 25 and the last Chondrosarcoma is more common in adults.
Bone Tumors in majority is classified into Primary tumors and Secondary tumors.
Primary bone tumors are rare (less than 1% of all malignant tumors) and are most common in young men. The four most common types of primary bone tumors are:
- Ewing’s sarcoma
- Multiple Myeloma
Secondary or Metastatic Tumors
Secondary or Metastatic tumors can be further subdivided into:
Tumors resulting from contiguous spread of adjacent soft tissue neoplasm’s and
Tumors representing malignant transformation of the pre-existing benign lesions
The most common tumors which account for bone metastases are breast cancer, lung cancer, and prostate cancer. Secondary or Metastatic tumors more frequently involve the axial skeleton than the appendicular skeleton.
Cause of Bone Cancer
Majority of the time, rather than starting in bones, cancer cells spread or metastasize to the bones from other areas effected by other types of cancer in the body.
This type is most common and occurs mostly in adults and is termed as secondary or metastatic bone cancer. This means that the cancer originated in a different place but has now migrated to the bones. For example, lung cancer commonly spreads from the lungs to the bones.
Though, no one knows for exactly what causes primary bone cancer, it is uncommon or rare type occurring in children.
Adults with Paget’s disease of bone, which involves abnormal development of new bone cells, may be at increased risk of osteosarcoma. Bone cancers may have a hereditary component; this is predicted in certain cases.
Secondary Bone Cancer
As discussed above Secondary bone cancer is a cancer that has spread, or metastasized, from a primary cancer in another part of the body to the bones. This type is more common than primary bone cancer, which is cancer that originates in the bones themselves.
The most common primary cancers that metastasize to the bones are breast, lung, and prostate, and the bones most commonly affected are the spine, ribs, pelvis, skull, and the upper bones of the arms and legs.
Some secondary bone cancers, such as those that metastasize from the kidneys, appear years after the primary cancer has been treated, and are diagnosed as secondary bone cancer because the cells resemble the cells of the primary cancer, rather than bone cancer cells.
Bone Cancer Symptoms or Sign of Bone Cancer
Bone cancer symptoms tend to develop slowly. They depend on the type, location, and size of the tumor.
- Pain is the most frequent symptom of bone cancer.
- Sometimes a firm, slightly tender lump on the bone can be felt through the skin.
- In some cases, bone cancer interferes with normal movements.
- Bone cancer can also cause bones to break.
These symptoms are not sure signs of cancer. They may also be caused by other, less serious problems. Individuals who are experiencing any such kind of symptoms should consult a doctor.
Although bone cancer can arise in any of the body’s 206 bones, it most frequently occurs in the long bones of the arms and legs.
Other possible signs and symptoms of bone cancer include:
- Weakening of bones which may sometimes lead to fractures
- Swelling of joints and tenderness for tumors in or near joints
- Unintentional weight loss
Managing Bone Cancer pain: If you suffer from pain, your might want to ask your doctor to write you a prescription for an opioid, such as hydrocodone medication, which is considered one of the best pain pills.
Secondary Bone Cancer Symptoms
Secondary bone cancer symptoms are as follows:
- Chronic pain in the afflicted area
- Weakened bones, often leading to pathological fractures
- Bone fractures that occur as a result of the bone’s fragility, not from an external force
- Pressure on the spinal cord that can cause weakness or even paralysis
- Nausea, constipation, drowsiness, and confusion often caused by a raised level of calcium in the blood .This condition is referred to as hypercalcemia.
- Unexplained fatigue
- Anemia and increased susceptibility to infection as cancer cells invade further into the bone and hamper the bone marrow’s blood cell manufacturing capabilities. Thus decreasing the overall body resistance.
It is important to keep in mind that while these health problems are recognized as secondary bone cancer symptoms, they can indicate a number of other medical conditions as well. Diagnostic methods include X-rays, blood tests, and advanced detection tools such as Extreme Drug Resistance Assays, Gamma PET Imaging, and MRI. These tests help determine the location and severity of the disease and can help the doctor develop an accurate secondary bone cancer prognosis.
Bone Cancer Treatment
The Bone cancer treatment includes surgery, radiation therapy, and/or chemotherapy.
The doctor often uses a combination of treatment methods, depending on the patient’s needs.
The chance of recovery (prognosis) and choice of treatment depend on the size, location, type, and stage of the cancer i.e. how far the cancer has spread, how long the patient had symptoms, how much of the cancer is taken out by surgery and/or killed by chemotherapy, and the patient’s age, blood and other test results, and general health.
If it is suspected that the problem is osteosarcoma, before the first biopsy, then the doctor may recommend a specialist called an orthopedic oncologist. Not all patients are cured with standard therapy, and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information.
There are treatments for all patients with osteosarcoma. Treatment for osteosarcoma, (a type of primary bone cancer) depends on the stage of the disease, where the cancer is found, and the patient’s age and general health. Three kinds of treatment are used:
- Surgery (taking out the cancer in an operation).
- Chemotherapy (using drugs to kill cancer cells).
- Radiation therapy (using high-dose x-rays to kill cancer cells).
Surgery: All patients with localized osteosarcoma should have surgery to remove the tumor, if possible. Sometimes all or part of an arm or leg may have to be removed (amputated) to make sure that all of the cancer is taken out. In the past, amputation was common for bone cancer in an arm or leg.
Today, advances in surgical techniques and chemotherapy before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy) and radiation therapy make limb-sparing surgery possible in many cases.
With osteosarcoma, limb-sparing surgery involves replacing the cancerous bone with an artificial device (prosthesis) or bone from another part of the body or from another person (transplant).
If cancer has spread to lymph nodes, the lymph nodes will be removed (lymph node dissection). In patients with osteosarcoma that has not spread beyond the bone, researchers have found no difference in overall survival whether patients have limb-sparing surgery or whether they have surgery with amputation.
When the cancer can be taken out without amputation, artificial devices or bones from other places in the body can be used to replace the bone that was removed.
Chemotherapy: uses drugs to kill cancer cells. Chemotherapy may be taken by pill or put into the body by a needle in a vein or muscle. Chemotherapy is called systemic treatment because the drug enters the blood stream, travels through the body, and can kill cancer cells throughout the body. Chemotherapy with more than one drug is called combination chemotherapy.
Sometimes chemotherapy is injected directly into the area where the cancer is found (regional chemotherapy). In osteosarcoma, surgery is often used to remove the local tumor and chemotherapy is then given to kill any cancer cells that remain in the body.
Chemotherapy given after surgery has removed the cancer is called adjuvant chemotherapy. Chemotherapy can also be given before surgery to shrink the cancer so that it can be removed during surgery; this is called neoadjuvant chemotherapy.
Radiation therapy: Radiation therapy also called radiotherapy or X-ray therapy, involves treating cancer with beams of high-energy particles, or waves (radiation), such as gamma rays or X-rays. Although radiation can affect healthy cells as well as cancer cells, it’s much more harmful to cancer cells because cancer cells divide more rapidly than most healthy cells do.
Cells are more vulnerable to damage when they’re dividing, making cancer cells more susceptible to radiation than normal cells are. In addition, normal cells can recover from the effects of radiation more easily than cancer cells can. Many people with cancer undergo some type of radiation therapy.
Some cancer treatments cause side effects that continue or appear years after cancer treatment has ended. These are called late effects. Late effects of cancer treatment may include physical problems; changes in mood, feelings, thinking, learning or memory; and having second cancers (new types of cancer). Some late effects may be treated or controlled.
Bone Cancer Prognosis
Staging is a process that tells the doctor how widespread a cancer may be. This shows how much and how far the cancer has spread. The treatment and prognosis (outlook for survival) for bone cancer depend, to a large extent, on the patient’s stage at diagnosis.
The outlook depends on the type of tumor. The outcome is expected to be good for people with benign tumors, although types of benign tumors may eventually become malignant.
With malignant bone tumors that have not spread, most patients achieve a cure. Because the cure rate depends on the type of cancer, location, size, and other factors, the bone cancer prognosis in particular situations also differs.
In any event, one should plan for an interruption in one’s work schedule. Check with your employer regarding practical issues like insurance. What type of long term care insurance leads and short term options does your employer offer? Make sure you understand your situation before you go on an extended leave of absence.
Secondary Bone Cancer Prognosis
Prognosis (the outlook from an illness) can only be given by the doctor who has all the test scan and biopsy results of the patient. The prognosis of the secondary bone cancer will depend on where the cancer has spread from.
Having said that, once a cancer has spread from where it started to another part of the body, it is unlikely that it will be possible to cure it completely. This is a generalization as there are some types of cancer which can be cured after they have spread.
Unfortunately, the development of bone secondaries usually means that the cancer cannot be cured. But some people who have bone secondaries are able to survive for years with a very good quality of life and just the occasional treatment . However some cancers do progress more quickly. The length of survival depends on the type of the primary cancer, the rate of progress of the cancer, and the response to treatment.
Except for very rare occasions when hypercalcaemia cannot be controlled, people do not die directly as a result of their bone secondaries. It is almost always the progress of the cancer to affect other vital organs like the liver, lungs or brain, or just the general burden of a very extensive cancer spread which will finally prove fatal.
Bone Cancer Survival Rate
Bone Cancer survival rate depends on the type of bone cancer i.e. primary bone cancer or secondary bone cancer, stage of bone cancer, the rate of progress of the cancer and the response treatment, age of the patient and other factors.
Although it is not always possible to be certain, doctors are often able to tell whether or not a particular bone cancer might be cured. Even if bone cancer is incurable they will usually still offer treatment in the hope of prolonging life and, controlling, symptoms.
For some bone cancer patients these treatments can be very successful and they can keep the tumour under control for many months and sometimes for years.So lots of people with incurable bone cancer are still able to lead normal lives for long periods of time.
Only when the bone cancer or for that matter any type of cancer, finally fails to respond to all treatments does someone enter the ‘terminal‘ stage of their illness. Although there are no precise definitions for when a person becomes ‘terminal’ the word is usually used to describe the last few weeks, or months, of life.
A lot of men and women who have incurable bone cancer will live for a long time before their bone cancer becomes terminal. With some slow growing bone cancers, especially in older people, it may be possible to have a normal life expectancy and die of another illness rather than of cancer.This analysis implies for almost all types of cancers.