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Bone Cancer

By Editorial Team (2)
September 15, 2021

Bone cancer is a complication that starts in your bone. It is an uncommon type of cancer which can begin in any bone in your body. Most bone cancers start in the long bones of your arms and legs.

This type of cancer happens when the cells in your bones begin to grow out of control, causing a malignant tumor that can cause the destruction of your normal bone tissue.

Malignant Vs. Non-malignant bone tumors

There are in fact, non-malignant bone tumors and they occur more frequently than cancerous or malignant ones. But both malignant and non-malignant tumors can grow and compress the tissue in your bones that are healthy. However, Benign (non-malignant) tumors, unlike malignant ones do not spread to your bones, and as a result, do not destroy healthy bone tissue in the process.

The 3 different types of Bone Cancer

There are different types of bone tissue in your body, namely three, and bone cancer can affect any one of them. Thus, bone cancer has three different types that are differentiated from one another by the type of bone tissue they affect:

  1. Chondrosarcoma – Is a type of bone cancer that affects the cartilaginous tissue in your body. Cartilaginous tissues are tough flexible tissues that are located in the ends of bones and also lines the joints.
  1. Osteosarcoma – This type of bone cancer can affect the osteoid tissues in the bones (hard and compact tissues). Tumors of the osteosarcoma classification commonly affect the upper arm and knees of the body.
  2. ESFT’s – These are the Ewing Sarcoma Family of tumors that mostly occur in bones but can also affect soft tissue such as muscle, fat, fibrous tissue and blood vessels. This type of bone cancer is commonly diagnosed in the backbone, legs, and arms, as well as the pelvis.

What Causes Bone Cancer?

Most researchers are not clear on what is the actual cause of the condition. As with most cancers, bone cancer starts as an error in your DNA that tell the cells to grow and divide uncontrollably. The cells then go on and form accumulated cells that turn into a mass that is known as a tumor. Although this is what happens in most cases, some researchers have deduced factors which increase the likelihood of the condition:

  • Hereditary – Having someone from the family tree that has experienced bone cancer can be a cause for contacting bone cancer. Children that have hereditary cases of retinoblastoma (another uncommon cancer, this time afflicting the eye) can also cause them to have bone cancer later on.
  • High doses of external radiation therapy
  • Previous treatments involving anti-cancer drugs
  • Having metal implants – Having had metal implants on your bones before can likely cause osteosarcoma.

Risk Factors That Increase Your Chances of Having Bone Cancer

Just like the causes of bone cancer, the risk factors of the condition are also similarly unclear. However, there are still certain factors that doctors have found out which they believe can cause bone cancer in most people.

  • Hereditary – Inheriting certain genetic syndromes especially rare ones such as Li-Fraumeni syndrome and hereditary retinoblastoma can increase your likelihood of being affected by the condition.
  • Radiation therapy – Exposure to external radiation therapy for cancer, especially in very large doses can increase your risk of having the condition in the future.
  • Chemotherapy – this is in conjunction with radiation therapy. Being exposed to cancer treatment drugs can increase your chances of getting the condition. Some of these drugs include alkylating agents, as well as anthracyclines.
  • Paget’s disease of the bone – Another factor that can increase your chances of being affected by the condition is Paget’s disease of the bone, that is most commonly associated with adults.
  • Having Metal Implants – as mentioned previously, if you have had metal joints or parts implanted in your body before, then you run a higher risk of having the condition in the future.
  • Benign Tumors – Having benign tumors such as the aforementioned Paget’s disease of the bone, as well as other bone conditions such as fibrous dysplasia may increase the risk of having osteosarcoma.

Complications Associated with Bone Cancer

  • There are a lot of complications that can stem from having bone cancer. Some of these complications are mostly from the cancer treatments used to remedy the condition, but some are from the condition itself:
  • Pain – Cancer generally involves a lot of pain, especially in the part where the tumor is.
  • Increased Calcium in blood – This can cause psychotic episodes in people.
  • Broken Bones – Your bones become weak as the condition progresses and may ultimately break.
  • Metastasis – Cancer will spread to neighbouring organs.
  • Osteomyelitis
  • Chemotherapy complications
  • Radiation therapy complications

Bone Cancer Symptoms and Diagnostic Procedures

Most Common Signs and Symptoms of Bone Cancer

There will be bodily changes you experience whenever you have bone cancer. These bodily changes can signal a problem and can be a symptom that you have bone cancer. What happens mostly with bone cancer is that bone tumors affect a healthy bone tissue and destroy it, often spreading to nearby tissues as well. This process can cause one or more of the followings symptoms:

  1. Pain – A clear-cut way of knowing whether you have bone cancer is the experience of pain and swelling in your bones, most especially in the part where the tumor is located. Pain is considered as one of the earliest conceivable signs and symptoms of bone cancer. Pain is usually accompanied by swelling, and will periodically get worse as the condition worsens.
  2. Fractures – Bone cancer begins as a malignant tumor that destroys healthy bone tissue. This process can cause the surrounding bone tissue to weaken and become brittle. Most fractures associated with signs and symptoms of bone cancer are first plagued by pain in a limb that will one day suddenly progress to a severe pain.
  3. Swelling – Another one of many common signs and symptoms of bone cancer is the feeling of stiffness in your joint that leads to swelling. This swelling is caused by a tumor occurring directly or near it. The joints that have swollen then become either stiff or tender to the touch.
  4. Limping – limping is one of the many signs and symptoms of bone cancer that can be caused by a number of factors. Limping can be caused by a fracture in the leg, swelling and a feeling of stiffness, or it can be caused by a tumor in the leg. Limping isn’t necessarily an early symptom of bone cancer, as this symptom occurs in late-stage bone cancer.
  5. Fever – experiencing fever, or generally, a feeling of being unwell can also be a bone cancer symptom.
  6. Nausea and Vomiting
  7. Weight loss – this is accompanied by fever, nausea, and vomiting, as these conditions can cause a general loss of appetite that leads to weight loss.
  8. Anemia
  9. Psychotic episodes – this is caused by the calcium unused by your bones due to bone cancer being released into your bloodstream, causing psychotic episodes.

Bone Cancer Diagnostic Procedures

If you have experienced any of the signs and symptoms of bone cancer listed above then you should definitely get yourself checked. Make an appointment to see your doctor if you notice any worrying bone cancer symptoms, especially symptoms in line with those listed above.

Bone cancer is diagnosed in a number of ways, and your doctor can choose to subject you to any one of these procedures to confirm the signs and symptoms of bone cancer you have previously experienced are indicative of the condition:

  • X-rays – X-rays are a good diagnostic procedure to easily determine if you have bone cancer or not. X-rays are usually first in the line of many diagnostic imaging tests, as they suggest if an abnormal area may be affected by cancer, and that area will be subjected to more tests to confirm the assessment.
  • Bone scans – since the affected area is the bone, bone scans are an effective way to determine bone cancer. Bone scans are done by injecting a small amount of radioactive material in your blood vessel, that eventually collects in your bones. These radioactive materials are then picked up by a scanner.
  • CT Scanners – just like x-rays, Computed Tomography or CT scans can provide an effective way of producing detailed images of parts of your body. This includes your bones, where CT Scans can produce detailed images taken from different angles.
  • PET Scan – or Positron Emission Tomography is done in coordination with a CT scan. PET Scans are done by injecting a small amount of radioactive sugar substance into the patient’s body.
  • Magnetic Resonance Imaging or MRI – is the same with x-rays and CT scanners, providing images inside your body. MRI uses a powerful magnet linked to a computer.
  • Biopsy – Biopsy involves removing a small amount of tissue from the affected area, in this case from a bone that has been affected by signs and symptoms of bone cancer and subjects them to further examination and testing. Needle biopsy and incision biopsy are the two types of biopsy most commonly used.
  • Blood tests – Blood tests can also effectively diagnose bone cancer. The blood test will determine the levels of a certain enzyme, namely alkaline phosphatase. Alkaline phosphatase is present in large amounts in your bloodstream whenever there is an ongoing active process in your bones. This enzyme is most commonly present in growing children which have constantly growing bones, in cases of broken bones where the bone is working to repair itself, but can also be indicative of activity in your bones that lead to bone cancer.

Bone Cancer Treatment and Care

Your bone cancer treatment will vary depending on what kind of cancer you have (osteosarcoma, chondrosarcoma, Ewing’s sarcoma) and will depend on what stage the cancer is in. Bone cancer treatment will also depend on your overall health preferences, which the doctor will most likely assess for you, as well as your surgical risk as a patient. Different treatments are in place depending on the bone cancer you have, as most bone cancers are remedied by surgery, others are treated with chemotherapy and/or radiotherapy.

What are the most common Bone Cancer Treatments?

  1. Surgery – Perhaps the most common bone cancer treatment made available for a patient is surgery. The primary focus of surgery as a bone cancer treatment is for the successful removal of the entire area affected by bone cancer. There are a few types of surgery in place in case you opt for this choice:
  • Surgery for cancer itself – There are times when the bone cancer doesn’t occur directly in the bones of our arms and legs, such as bone cancer in the bones of our torso. Doctors will choose to remove cancer affected tissues while preserving as much of the bone as possible. In the case where a bone is removed, the lost parts are replaced with a replacement bone, sourced from another bone in your body, or made from another material such as metal.
  • Surgery for the removal of the bone/limb – this type of surgery is reserved for the cases in which the bone cancer affects a large area or in some cases, situated at a risky location. However, this bone cancer treatment is less common nowadays with the development of more advanced technology and surgical procedures to improve bone cancer treatment.
  1. Chemotherapy – Another viable bone cancer treatment you can choose from is chemotherapy. Chemotherapy is used in most cancers as a primary form of treatment, and in this case is also a good option. Chemotherapy is commonly done by introducing cancer-combating drugs into your bloodstream through an intravenous tube. The drugs then reach and destroy the bone cancer cells in your body. Chemotherapy is an ideal bone cancer treatment if the condition has spread to other parts of your body, affecting not just the bones.
  2. Radiation Therapy – Radiation therapy commonly goes hand in hand with chemotherapy and is commonly used before an operation. Radiation therapy helps to potentially avoid the possibility of using surgery on the patient, as this bone cancer treatment is commonly used in patients who have a tumor that is risky to remove by surgery. Instead of opting for amputation, some doctors will suggest this treatment instead.Radiation therapy is done by using high powered beams of energy, for example, X-rays to kill cancer cells in your bones. A special machine aims energy beams at precise points in your body during radiotherapy, and all you have to do is to mostly lie there while the machine does its work.
  3. Cryosurgery – Cryosurgery is done by using liquid nitrogen to freeze and therefore kill cancer cells in the process. In most cases, follow up treatments are done as cancer most often metastasizes even if the doctor has successfully removed most of the cancer-ridden bones in your body. The best course of action for a patient who has been treated is to report regularly to their doctor for routine check-ups. Patients should report to their doctor immediately at the first sign of recurring bone cancer symptoms.

Bone Cancer Treatment Aftercare

What happens after a bone cancer treatment is not aftercare, but coping. Patients who have undergone bone cancer or any cancer for that matter need to come to the various changes they are subjected to including physical, emotional, social, and financial changes. The first line of support for a bone cancer patient is the presence of his/her family and friends to help the patient cope with the struggles related to cancer. Difficult emotions and situations may arise during the treatment and family and friends should always be there to help the patient. Cancer care families or organizations are also available and act as a support team for each other. These organizations are made up of survivors of the same condition, as well as those who are still battling with the treatment.

Aftercare for patients who have been treated for bone cancer involves constant checking for recurrence of symptoms. Once a person has developed cancer, small areas where cancer cells have been developed may remain undetected to most, and over time will develop and increase in number.

Side effects are also common to people who have undergone bone cancer treatment, and most often, these side effects linger long after the treatment has finished. However, more often than not, long-term side effects will disappear over time. Some side effects include physical and emotional changes caused by the medicines you are exposed to during chemotherapy.

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