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Bone Cancer: Medical Information on Causes, Diagnosis, Symptoms and Treatment

cancer of the bonesQuick Answers about Bone Cancer

  • Bone Cancer Overview
  • Bone Cancer: Possible Causes
  • Common Signs and Symptoms of Bone Cancer
  • Diagnosing Bone Cancer
  • Treating Bone Cancer
  • Clinical Trials

Bone Cancer

Bone Cancer Overview

Bone cancer involves cancerous cells that destroy normal bone tissue. The disease can create malignant or benign tumors. While malignant tumors can cause significant health issues and be a threat to life, benign tumors do not destroy bone tissue or spread throughout the bone or other parts of the body.

Less than 3,000 new cases of bone neoplasm (bone tumor) occur in the United States every year, and out of those, 2300 new diagnoses of primary bone cancer. Medical diagnosis involving imaging and lab tests is required to detect and verify these cases. Known causes of bone neoplasm include abnormal healing of an injury, radiation therapy and inherited conditions. While any individual can be affected by bone tumors, the most common age for detecting developing bone cancer occurs between 19 and 40 years of age.

Malignant bone cancer that starts in bone tissue is often referred to as primary bone cancer. Eventually, the form of cancer can spread (metastasize) to other parts of the bone, other bones and other areas of the body that could include the lung, breasts or prostate gland. The disease is categorized by the type of bone tissue where cancer starts. These categories include:

  • Osteosarcoma – This form of cancer begins in osteoid bone tissue (compact or hard) where tumor forms, usually in the upper arm or knee. This condition is most common during younger years between the ages of 10 and 19.
  • Chondrosarcoma – This form of cancer starts in cartilaginous tissue (flexible and tough) including in cartilage pads, joint lines and in the ends of bones. It can also be found between the hip bones in the pelvis, along with the shoulder and upper leg. This form of bone cancer usually affects individuals 40 years and older and is rare among adolescents and children.
  • Ewing Sarcoma Family of Tumors (ESFT) – This bone cancer often starts in the body’s soft tissue (blood vessels, fibrous tumors, fat, muscle) especially in the pelvis and along the backbone and the arms and legs. Boys 18 years and younger are more susceptible to ESFTs than are girls and it is very rare among African-American children.

Bone Cancer: Possible Causes

While the cause of bone cancer has not yet been clearly defined, researchers and scientists are identifying various factors that increase the potential of developing bone tumors. Researchers have noted a connection between high-dose external radiation therapy and the development of osteosarcoma. In addition, a correlation has been found between developing bone cancer and the use of certain anti-cancer medications. This correlation is especially high in children.

Hereditary bone defects and some metal implants used by surgeons to repair fractures seems to increase the development of osteosarcoma. Scientists have yet to find strong correlations of radiation exposure, congenital childhood diseases and hereditary cancer syndromes with Ewing sarcoma.

Common Symptoms of Bone Cancer

Individuals suffering from bone cancer often experience various signs and symptoms that might become progressively worse over time. This is because as the bone tumor expands and grows, it often causes pressure on unhealthy bone tissue and eventually kills off healthy cells. The most common symptoms of bone cancer include:

  • Pain – During the initial stages of developing bone cancer, the individual usually experiences swelling and pain at the tumor site. The pain may or may not be consistent. However, over time, the pain can become steady, severe and more intense. In addition, movement may cause the pain to exacerbate as the tumor swells and pushes nearby soft tissue.
  • Joint Stiffness and Swelling – Tumors developing at or near a joint can often cause the joint to swell significantly, becoming extremely stiff or tender. Usually, the tumor will cause a significantly limited range of motion and severe pain with or without movement of the joint.
  • Limping – The tumor can cause a significant fracture in the leg causing a pronounced wobble or limp when walking. Usually, this symptom is the result of bone cancer in its later stages.
  • Overall Poor Health – In some rare cases, the individual may suffer a general sense of feeling unwell and suffer from a fever, anemia (resulting in weakness or feeling tired), low red blood cell count and weight loss.

Diagnosing Bone Cancer

Diagnosing any form of bone cancer requires a physical examination and numerous diagnostic tests and imaging. For a comprehensive diagnosis, the doctor will likely order numerous tests that include:

  • X-rays – An x-ray image will help the doctor determine the shape, size, and location of the detected bone tumor. In addition, the x-ray can reveal if there are abnormal cells growing in the body. However, further testing might be required to determine if the abnormal cells are benign or if the individual is experiencing ongoing pain. These tests could include:
  1. Bone Scan
  2. CT (computed tomography) Scan
  3. MRI (magnetic resident imaging)
  4. PET (positron emission tomography) scan
  5. Angiogram, which is an x-ray image of the patient’s blood vessels
  • Biopsy – The doctor may obtain a biopsy by removing bone tumor tissue samples to confirm that abnormal cancer cells have developed. The biopsy is typically obtained through an incision usually performed by an experienced orthopedic oncologist. The cells are then analyzed by a pathologist trained identifying the disease under a microscope.
  • Blood Tests – The doctor may be able to diagnose the condition through blood tests to determine the level of alkaline phosphatase enzyme. This enzyme is usually present in large amounts in the bloodstream whenever there is high activity in the formation of blood tissue. These conditions might involve growing children, amending broken bone or tumor or disease is producing abnormal bone tissue.

Treating Bone Cancer

The doctor will likely recommend various treatment options based on the stage, location, size and type of cancer the patient has. In addition, the doctor will take into consideration the patient’s overall health and age. The most common options for treating bone cancer include:

  • Surgery – Surgical procedures are common forms of treating bone cancer where surgeons will remove the entire cancerous tumor usually past the border edge (margin) where the tumor exists. Removing a minimal amount of healthy tissue that surrounds the tumor helps to ensure ever existing cancer cell is excised.
  • Chemotherapy – Anti-cancer medications are known to destroy cancer cells. Doctors might recommend that their patient suffering from bone cancer receive one or more of these drugs. Currently, chemotherapy is not an option for treating chondrosarcoma.
  • Radiotherapy – This procedure involves radiation where high energy x-rays destroy cancer cells. This treatment is used in conjunction with bone cancer surgery and can be highly effective at treating chondrosarcoma and Ewing Sarcoma Family of Tumors.
  • Cryosurgery – As an alternative to conventional surgery, liquid nitrogen can be highly effective at destroying cancer cells by freezing the area.

Clinical Trials

The development of new and effective treatments or enhancing ways to improve the outcome of current treatments often involves clinical trials managed by the National Institute of Health. Clinical trials are crucial for developing new treatments and procedures to ensure that patients receive a safe and effective drug when available for general use. The first step in becoming involved in research studies and clinical trials requires a recommendation by the doctor.

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