Bone Cancer

Although bone appears to be the most static of all the tissues in the body, it is actually very dynamic and active. In fact, the active processes that constantly take place in bone are critical to maintaining healthy bone.

What is bone cancer ?

Bone tumors may be benign (noncancerous) or malignant (cancerous). Benign bone tumors are more common than malignant ones. Both types may grow and compress healthy bone tissue and absorb or replace it with abnormal tissue. However, benign tumors do not spread and are rarely life-threatening.
Cancer that arises in the bone (primary bone cancer) is not the same disease as cancer that spreads to the bone from another part of the body (secondary bone cancer). Primary bone cancer is rare, with approximately 2,500 new cases diagnosed each year in the United States. More commonly, bones are the site of tumors that result from the spread (metastasis) of cancer from another organ, such as the breasts, lungs, and prostate.

What types of cancer arise in the bones?

The most common type of bone cancer is osteosarcoma, which develops in new tissue in growing bones. Another type of cancer, chondrosarcoma, arises in cartilage. Evidence suggests that Ewing’s sarcoma, another form of bone cancer, begins in immature nerve tissue in bone marrow. Osteosarcoma and Ewing’s sarcoma tend to occur more frequently in children and adolescents, while chondrosarcoma occurs more often in adults.

What are symptoms of bone cancer?

Symptoms of bone cancer 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 symptoms should consult a doctor.

How bone cancer is diagnosed ?

Usually you begin by seeing your GP (family doctor), who will examine you and arrange any tests or x-rays which may be necessary. Your GP will probably refer you to a local surgeon who specialises in bone diseases, known as an orthopaedic surgeon.
The orthopaedic surgeon at the hospital will take your full medical history before doing a physical examination. This will include an examination of the affected bone to check for any swelling or tenderness. You will probably have a blood test done to check your general health.If tests suggest that there might be a primary bone tumour your doctors are likely to arrange for you to be seen at a specialist hospital, or bone tumour centre, which will have a team of specialist doctors and nurses who are experienced in the treatment and care of people with these cancers. Many of the specific tests for diagnosing bone tumours, such as the biopsy, require experience and specialist technique.
The doctors may use to diagnose a bone cancer:
X-rays of the bone are the simplest way of diagnosing bone cancer and telling whether the cancer has started in the bone (primary bone cancer) or has spread into the bone from a cancer elsewhere in the body (a secondary bone cancer). Sometimes the x-rays give a characteristic picture that helps the doctor to diagnose a particular type of bone cancer (this is often the case for osteosarcoma). More commonly, however, the x-rays will show either an area of bone that has been destroyed by cancer or an increased amount of new bone cells growing around the cancer.
Bone scans are also known as isotope bone scans. They are very sensitive and can detect cancer cells before they show up on x-ray. A very small amount of a mildly radioactive substance is injected into a vein, usually in your arm. A scan is then taken. As abnormal bone absorbs more of the radioactive substance than normal bone, this shows up on the scan as highlighted areas (sometimes referred to as ‘hot spots’).
After the injection you will have to wait for up to three hours before the scan can be taken, so you may want to take a magazine or book with you, or a friend to keep you company.
The level of radioactivity used in these scans is very low and is not harmful. The radioactivity disappears from the body within a few hours.
What types of treatment are used?
Most people with primary bone cancer will need a combination of different treatments. The treatments that are used are surgery, chemotherapy and radiotherapy. The treatment you have will depend on your age, general health, and the stage and type of the bone cancer.
Surgery is a very important part of treatment and is used to remove the tumour in the bone. If surgery is not possible then radiotherapy, which is particularly effective in Ewing’s sarcoma, may be used instead.
Chemotherapy is an important treatment for most people with osteosarcoma, Ewing’s sarcoma and fibrous histiocytoma. It is often given before surgery and may shrink large tumours enough to avoid amputation. The course of chemotherapy will then continue after surgery.
When radiotherapy is used to treat Ewing’s sarcoma, it is most often given after or instead of surgery. Although radiotherapy is used less often to treat osteosarcoma and chondrosarcoma, it is still helpful in certain situations.
If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse. It often helps to take a close friend or relative to the consultation with you to help you remember what is said.
Some people find it reassuring to have another medical opinion to help them decide about their treatment. Most doctors will be pleased to refer you to another specialist for a second opinion, if you feel this will be helpful.

Bone cancer sites

• MedlinePlus: Bone Cancer - From the National Institutes of Health; Bone Cancer: Questions and Answers … (American Cancer Society); What Are the Key Statistics for Bone Cancer? …
• Frequently Asked Questions About Bone Cancer - CancerIndex - The FAQ has a section on general questions about bone cancer and separate pages about … Primary bone cancer refers to cancers which start in the bone. …
• Bone Cancer: Questions and Answers - The most common type of bone cancer is osteosarcoma, which develops in new tissue in … Evidence suggests that Ewings sarcoma, another form of bone cancer, …
• Primary bone cancer information centre : CancerBACUP - Information on primary cancer of the bone. … Different types of primary bone cancer · References. Causes & diagnosis …
• Bone Cancer - Cancer information on MedicineNet.com - Information on many different cancers includes symptoms, cancer detection and prevention, and treatment options.

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