Bone Cancer

Bone Cancer - malignant (cancerous) tumor of the bone that destroys normal bone tissue that causes approximately 1500 deaths every year in the United States. It has a survivability rate of nearly 50% and is divided into two types:

• Primary Bone Cancer - rare form of cancer (less than 1 percent of all cancers and approximately 2500 cases a year in the U.S) that forms in cells of the bone. Some types of primary bone cancer are:
  • Osteosarcoma - common between ages 10 and 19, it arises from osteoid tissue in the bone and occurs most often in the knees and upper arm
  • Ewing sarcoma (ESFTs) - most common in young males under 20 years old. These cancers usually occur in bone but may also arise in soft tissue (muscle, fat, fibrous tissue, blood vessels, or other supporting tissue).ESFTs occur most commonly along the backbone and pelvis and in the legs and arms.
  • Malignant fibrous histiocytoma
  • Chondrosarcoma - common in the older population and begins in cartilaginous tissue and occurs most often in the pelvis, upper leg, and shoulder. When the cells are cancerous, it is considered Osteosarcoma
• Secondary Bone Cancer - spreads to bones from other parts of the body and is understood on a case by case basis by looking at the different cancers which started elsewhere in the body and spread to the bones.

Benign vs. Malignant Tumors

• Benign Tumors - noncancerous tumors that may obstruct other tissues, but do not spread and do not destroy other tissue. People very rarely die from benign tumors and they are more common than malignant tumors
• Malignant Tumors - tumors who want to live, multiply and spread. They are dangerous because they can grow out of control and multiply rapidly in the body.

Metastasis

Metastasis is the spreading of cancer. In bone cancer it is the spreading of cancer from bones to other parts of the body and from other parts of the body to the bones. Primary bone cancer(starts in the bone) is far less common than cancer that spreads to the bones.

Factors Increasing Likelihood of Bone Cancer

• Hereditary predisposition
• People who have metal inplants
• People who have hereditary bone defects
• Prior high-dose external radiation therapy or treatment with certain anticancer drugs
• People who have had Osteosarcoma before
• Children

Testing, Symptoms and Diagnosing Bone Cancer

Pain or swelling are the most common symptom of bone cancer, but bone cancer does not always show itself through pain. To help diagnose bone cancer, it is important to consider personal and family medical history. If a parent or grandparent has had primary bone cancer, the patient is at an increased risk.

To diagnose bone cancer, a doctor typicaly does a physical exam combined with lab and diagnostic tests:

• x-rays - show location, size, and shape of a bone tumor. If x-rays show abnormalities, the doctor recommends special imaging tests:
  • Bone scan
  • Computed tomography (CT or CAT) scan
  - detailed pictures taken from different angles, created by a computer linked to an x-ray machine
  • Magnetic resonance imaging (MRI) - detailed pictures of areas inside the body without using x-rays
  • Positron emission tomography (PET) scan - pictures of areas inside the body where the glucose is used to locate possible glucose-absorbing cancer cells
  • Angiogram - x-ray of blood vessels
• Biopsy -(removal of a tissue sample from the bone tumor) to determine whether cancer is present
  • Needle biopsy - a sample of tissue from the tumor is taken from a small hole in the bone
  • Incisional biopsy - surgeon cuts into the tumor and removes a sample of tissue
• Alkaline phosphatase test to check its presence in the blood because it shows when bone tissue are experiencing abnormal growth

Treatement for Bone Cancer

Treatment options depend on the type, size, location, and stage of the cancer, as well as the person's age and general health.

• Surgery - most common bone cancer treatement where the entire tumor and some surrounding area is removed
• Chemotherapy - drugs to kill cancer cells. Currently, chemotherapy is not used to treat chondrosarcoma
• Radiation - a treatement used together with surgery where high-energy x-rays kill cancer cells
• Cryosurgery - use of liquid nitrogen to freeze and kill cancer cells

Even after the cancer is cured, patients have to be careful of recurrances. A typical approach is drugs to help stop the cancer from coming back combined with healthy diet and reasonable exercise.

People who have had bone cancer, or any other cancer, should see a doctor regularly and undergo appropriate tests to ensure the cancer does not come back, and is detected early if it does.