Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Bone cancer is a rare disease in which cancer cells grow in the bone tissue. Cancer occurs when cells in the body (in this case bone cells) divide without control or order. Normally, cells divide in a regulated method. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms. This is called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor does not invade or spread.

Cancer may form in the bone or spread to the bone from another site in the body. When cancer starts in bone tissue, it is called primary bone cancer. When cancer cells travel to the bone from another site in the body, it is called secondary or metastatic cancer to the bone. Types of bone cancer include:

The sooner bone cancer is treated, the better the outcome. If you suspect you have this condition, contact your doctor right away.

Causes

The cause of primary bone cancer is unknown. Genetics play a major role in most cases. Conditions that cause increased bone breakdown and regrowth over an extended period increase the risk of tumor development. This explains why osteosarcoma in children is most common during the adolescent growth spurt.

Risk Factors

Risk factors that can increase your chance of getting bone cancer include:

  • Paget's disease (a noncancerous bone condition)
  • Exposure to radiation
  • Family history of bone cancer

Certain types of bone cancer have specific risk factors:

  • Osteosarcoma:
  • Chondrosarcoma:
    • Age: older than 20 years old
    • Multiple exostoses (an inherited condition that results in bumps on bones)
  • Ewing’s sarcoma:
    • Age: younger than 30 years old
  • Fibrosarcoma and malignant fibrous histiocytoma:
    • Age: middle-aged and elderly
  • Giant cell tumor:
    • Age: young and middle-aged

Symptoms

Symptoms of bone cancer vary, depending on the location and size of the tumor.

Symptoms may include:

These symptoms may also be caused by other, less serious health conditions. Anyone experiencing these symptoms should see a doctor.

Diagnosis

The doctor will ask about symptoms and medical history. A physical exam will be done.

Treatment

After cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what extent. Treatment depends on the type, stage, and location of the cancer. It also depends on your overall health. Talk with your doctor about the best treatment plan for you. Treatment options include:

Radiation therapy for bone cancer uses radiation to kill cancer cells and shrink tumors. Radiation may be:

  • External radiation therapy—radiation directed at the tumor from a source outside the body
  • Internal radiation therapy—radioactive materials placed into the body near the cancer cells

Radiation of Tumor

Radiation of Tumor
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Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms, including: pill, injection, and via a catheter (tube). The drugs enter the bloodstream and travel through the body, killing mostly cancer cells, but also some healthy cells. The most common chemotherapy drugs used to treat bone cancer include:

  • Methotrexate with calcium
  • Leucovorin
  • Doxorubicin
  • Cisplatin
  • Ifosfamide
  • Etoposide

Surgery for bone cancer involves the removal of a cancerous tumor, nearby tissues, and possible nearby lymph nodes. Surgery may require amputation of the limb with cancer. Whenever possible, doctors try to remove the cancerous part of the bone without amputating. In this case, metal plates or a bone graft replaces the cancerous tissue that has been removed.

Sometimes, adding radiation therapy or chemotherapy can help avoid the need for amputation. If the tumor is large or aggressive, or the risk of it spreading is high, chemotherapy and radiation therapy may be added to help prevent it from returning. This is also done to prevent it from spreading to distant organs.

For cancer that has spread, intense chemotherapy is sometimes given to kill cancer cells. This therapy also destroys the bone marrow. Stem cells, which have the ability to develop into other types of cells, are then given to replace the lost bone marrow.

  • Osteosarcoma—Chemotherapy given before and after surgery will often cure osteosarcoma and can allow for limb-sparing surgery in people who might have otherwise required amputation.
  • Ewing’s sarcoma—Since Ewing’s sarcoma is very responsive to chemotherapy, its treatment often involves several weeks of chemotherapy followed by surgical removal or radiation therapy, then several more months of chemotherapy.
  • Fibrosarcoma and malignant fibrous histiocytoma—These conditions are usually treated with surgery to remove the cancerous tumor and a one-inch margin of healthy tissue surrounding it.

Prevention

There are no guidelines for preventing primary bone cancer. Early diagnosis and treatment improve your chance of successful treatment.