What is Bone Cancer ?

Bone cancer is considered as a rare cancer that develops in a bone. This cancer can start in any bone in the body and mostly long bones are affected that make up the legs and arms. Many bone tumors are benign that means they are non-cancerous and does not spread to any part of the body. Normal bone tissue is destroyed by this cancer and can spread to different body parts (known as metastasis).

Types of Bone Cancer

Primary Bone Sarcoma: This tumor first develops in the bone. There is no exact cause of bone sarcoma but heredity can be considered as one of the causes. Bone cancer can be categorized into different types that include -

• Chondrosarcoma: This type is most commonly seen in those people who are in between the age of 40-70. This cancer starts in cartilage cells and its common sites include leg, shoulder, hip, arm and pelvis.
• Ewing's Sarcoma: This type is most commonly seen in young people who are in between the age of 5-20. The most common sites of this cancer include the upper arm, ribs, leg and pelvis.
• Osteosarcoma: This type is most common in the upper arm and knee and it starts from the bone cells. Osteosarcoma is usually seen in young adults and teens.

Benign Bone Tumors

The most common types of benign tumors include -

• Enchondroma: This type appears in the bones of the feet and hand. This usually involves no symptoms and is also considered as the most common type of hand tumor.
• Giant Cell Tumor: This tumor is a benign tumor that affects the leg.
• Osteoblastoma: This is a single tumor that takes place in the feet and the hand. This is usually seen in young adults.
• Osteochondroma: This is considered as the most benign bone tumor and is mostly people who are under 20 years of age are afflicted with it.
• Osteoid Osteoma: This usually occurs in the long bones that is seen commonly in those people who are in their early 20s.

Metastatic Cancer

Metastatic cancer is the cancer that spreads to the bones from elsewhere in the body. Metastatic cancer spreads to a bone but it is still not known as bone cancer as the tumor cells are from the primary cancer.

The cancers that spread to the bone are -

• Lung Cancer
• Prostate Cancer
• Breast Cancer

Causes of Bone Cancer

The causes of bone cancer are unknown. The patients, who are suffering from chronic inflammatory diseases such as Paget's disease, have more chances of developing a bone cancer. The bone cancer starts due to an error in the DNA of a cell. This error tells a cell to divide and grow in an abnormal way. The cells then go on multiplying instead of dying at a given time. The build-up of these mutated cells creates a tumor that can affect surrounding structures or can also spread to different body areas.

Symptoms of Bone Cancer

• Unintended weight loss
• Bone pain
• Broken bone
• Tenderness and swelling close to the affected area
• Fatigue

Stages of Bone Cancer

Stage 1: At this initial stage, the cancer is limited to bone and has not spread to any other part of the body. The cancer at this stage is also considered as low grade. This stage can be further categorized into -

• Stage 1A: The cancer is entirely within the bone from where it started. Swelling can be caused as the cancer may be pressing on the bone wall.
• Stage 1B: The cancer here is low grade and may have developed through the bone wall.

Stage 2: In the second stage, the cancer is considered as high grade and has not spread to any part of the body beyond the bone. This stage can be further categorized into -

• Stage 2A: Here the cancer is entirely within the bone from where it has started and is also of high grade.
• Stage 2B: Here the cancer has developed through the bone wall and is of high grade.

Stage 3: At this final stage, the cancer could be of any grade and has spread to different body parts including the lungs.

Diagnosis of Bone Cancer

A number of imaging tests are performed in evaluating the area of concern that include -

• X-ray
• Bone Scan
• Magnetic Resonance Imaging (MRI)
• Positron Emission Tomography (PET)
• Computerized Tomography (CT)

Different biopsy procedures are used for diagnosing bone cancer such as -

• Surgery for removing a tissue sample for testing: An incision is made through the skin in this surgical biopsy procedure. Through this incision, a portion of the tumor (incisional biopsy) or the complete tumor (excisional biopsy) is removed.
• Inserting a needle through the skin and inside the tumor: A thin needle is inserted through the skin in this needle biopsy procedure. This needle is then advanced inside the tumor for removing small pieces of tissue from it.

Treatment of Bone Cancer

Bone cancer can be treated with the help of different treatment options that include -

Chemotherapy : This treatment makes use of certain chemicals for destroying cancer cells. This is usually given through a vein that travels in the entire body. Radiation therapy is often combined with chemotherapy for shrinking the cancer to a manageable size so as to enable a surgeon to carry out a limb-sparing surgery. This therapy is used in those people who have bone cancer that has spread to different body parts.

Surgery : A surgery entirely removes the bone cancer. There are different types of surgery for treating bone cancer such as -

• Surgery for cancer that does not affect the limbs : The surgical procedure is performed for removing bone and some nearby tissue if the bone cancer takes place in the bones apart from legs and arms. This removed bone is then replaced with a part of bone from a different area of the body or can also be replaced with the help of special metal prosthesis.
• Surgery for removing the cancer while sparing the limb : The surgical procedure can be performed for removing the bone cancer while sparing the limb if the bone cancer can be separated from other tissue and nerves. The lost bone is then replaced with some other bone from a different area of the body or can also be replaced with the help of a special prosthesis.
• Surgery for removing a limb : The surgical procedure is required for removing a part or all part of a limb when the bone cancer is very large and is located on a complicated point on the bone.

Radiation Therapy : High-powered beams of energy are used in this therapy for destroying cancer cells. The high-powered beams of energy are targeted at precise points in the body. This therapy is meant for those people who are suffering from bone cancer that cannot be removed with the help of surgery. The radiation therapy may control symptoms and signs that include pain in those people who have advanced bone cancer.