Bone Cancer

Definition

Bone cancer is a growth that destroys normal bone tissue. It can also spread beyond the bone. It may be:

• Primary bone cancer—starts in bone tissue
• Secondary or metastatic bone cancer—cancer started somewhere else and travel to the bone

There are many different types of bone cancer including:

• Osteosarcoma—a tumor of the bone, usually of the arms, legs, or pelvis often in people 10-30 years old
• Chondrosarcoma —begins in the cartilage
• Ewing sarcoma —tumors that usually develop in the cavity of the leg and arm bones
• Fibrosarcoma and malignant fibrous histiocytoma—develop in soft tissues such as tendons, ligaments, fat, and muscle, and move to the bones of the legs, arms, and jaw
• Giant cell tumor—a primary bone tumor, most common in the arm or leg bones
• Chordoma—primary bone tumor that usually occurs in the skull or spine

Causes

Bone cancer occurs when cells divide without control or order. These cells grow together to form a tumor. These tumors are malignant. That means they can invade nearby tissues. It causes damage to nearby healthy tissue and can spread to other parts of the body.

The exact cause of primary bone cancer is unknown. Genes most likely play a role. Genetics play a major role in most cases.

Risk Factors

Factors that may increase your chance of bone cancer include:

• Paget's disease —a noncancerous bone condition
• Exposure to radiation
• Family history of bone cancer
• Conditions that increase cycle of bone breakdown and regrowth

There may be more risk factors for specific types of bone cancer.

Symptoms

Symptoms will vary. The size of the tumor and its location will affect the symptoms. General symptoms include:

• Pain at the tumor location
• Swelling or a lump at the location of the tumor
• Deep bone pain that is severe enough to wake you up
• Unexplained weight loss
• Fatigue
• Trouble breathing
• Fever or night sweats

Diagnosis

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

Signs of cancer can be found through:

• Blood tests—for signs of abnormal bone activity
• Biopsy —to confirm presence of cancer cells

Your doctor can use images to see where the tumor is and how large it may be. The images can also show if a cancer has spread. Tests may include:

• X-ray
• CT scan
• MRI scan
• Bone scan

The results from tests will be used for staging. This will outline how far the cancer has spread and how aggressive it is. It will be used to help make a treatment plan.

Treatment

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:

Surgery

Surgery is a common option for bone cancer. It is done to remove the cancer and healthy tissue around the area. This will help to make sure all cancer has been removed. Some nearby lymph nodes may also be removed. They will be tested to see if the cancer has spread.

Sometimes large areas of bone will need to be removed. Metal plates or bone grafts may be needed to support the bone after the cancer is removed. Sometimes the entire limb may need to be removed.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms, including: pill, injection, and through a tube called a catheter. The drugs enter the bloodstream and travel through the body. It may help to treat cancer that has spread. It is not used for all types of bone cancer.

Radiation Therapy

Radiation will kill cancer cells. It can be used to clean area of cancer cells and to shrink tumors. It may be used:

• To treat tumors that cannot be removed through surgery.
• After surgery to kill any cancer cells that remain.
• To shrink tumors before surgery to reduce need for amputation.

Radiation may be:

• External—from a source outside the body
• Internal—radioactive materials placed into the body near the cancer cells

Radiation of Tumor

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Myeloablative Therapy with Stem Cell Support

Intense chemotherapy may be needed for some cancers. However, it will also destroy the bone marrow. Donated stem cells will help to regrow the marrow.

Prevention

There is nothing that has been shown to prevent bone cancer.

References

• Bone cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/bone-cancer.html. Accessed October 9, 2017.
• Bone cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/bone/bone-fact-sheet. Updated March 13, 2008. Accessed October 9, 2017.