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). As a whole, bone cancer is categorized based on whether the cancer originated in the bone (primary) or whether it spread from another location to the bone (secondary). Secondary bone cancer, or cancer that has spread to the bone from another part of the body, is much more common than primary bone cancer. Bone cancer symptoms may vary based on the type of bone cancer, but pain is the most commonly experienced symptom. Bone cancer most often occurs in the long bones of the body (arms and legs), so these are the most common sites for pain. Keep in mind that not all bone tumors are cancerous; some are benign. Bone pain is more often related to a benign condition, like an injury, than it is to cancer.
- Joint tenderness or inflammation
- Fractures due to bone weakness
Non-specific symptoms like fever, unintentional weight loss, fatigue, and anemia can also be symptoms of later stage bone cancer, but are also indicators of other less severe conditions.
• Stage I - At this stage, bone cancer is limited to the bone and hasn't spread to other areas of the body. After biopsy testing, cancer at this stage is considered low grade and not aggressive.
• Stage II - This stage of bone cancer is limited to the bone and hasn't spread to other areas of the body. But biopsy testing reveals the bone cancer is high grade and considered aggressive.
• Stage III - At this stage, bone cancer occurs in two or more places on the same bone. Biopsy testing shows this bone cancer is high grade and considered aggressive.
• Stage IV - This stage of bone cancer indicates that cancer has spread beyond the bone to other areas of the body, such as the brain, liver or lungs.
• OPD Consultations
• Computerized tomography (CT) Bone scan
• Magnetic resonance imaging (MRI)
• Positron Emission Tomography (PET)
• Biopsy A sample of tissue (Biopsy) from the tumor is removed for laboratory testing. Testing is done to know whether the tissue is cancerous and, if so, what is the type of cancer. Testing may also reveal the cancer's grade, which helps oncologists to understand how aggressive the cancer is.
Types of biopsy procedures used to diagnose bone cancer include:
• Inserting a needle through skin and into a tumor. During a needle biopsy, surgical oncologist inserts a thin needle through the skin and guides it into the tumor. The needle is used to remove small pieces of tissue from the tumor.
• Surgery to remove a tissue sample for testing. During a surgical biopsy, surgical oncologist makes an incision through the skin and removes either the entire tumor (excisional biopsy) or a portion of the tumor (incision biopsy).
Determining the type of biopsy patients need and the particulars of how it should be performed requires careful planning by the oncology team. Surgical Oncologists perform the biopsy in a way that will not interfere with future surgery to remove bone cancer.
The goal of surgery is to remove the entire bone cancer. To accomplish this, surgical oncologists remove the tumor along with a margin of surrounding healthy tissues that surrounds it. Types of surgery used to treat bone cancer include:
• Surgery to remove the cancer, but spare the limb. If a bone cancer can be separated from nerves and other tissue, the surgical oncologist is able to remove the bone cancer and spare the limb. Since some of the bone is removed with the cancer, the surgeon replaces the lost bone with some bone from another part of the body or with a special metal prosthesis. Intense rehabilitative therapy may be necessary after limb-sparing surgery to make the affected arm or leg to become fully functional.
• Surgery to remove a limb. Bone cancers that are large or located in a complicated point on the bone require surgery to remove all or part of a limb (amputation). As other treatments have been developed, this procedure is becoming less common. After surgery an artificial limb is fitted and training is given to do everyday tasks using new limb.
• Surgery for cancer that doesn't affect the limbs. If bone cancer occurs in bones other than those of the arms and legs, surgeons may remove the bone and some surrounding tissue, such as in cancer that affects a rib, or may remove the cancer while preserving as much of the bone as possible, such as in cancer that affects the spine. Bone removed during surgery can be replaced with a piece of bone from another area of the body or with a special metal prosthesis.
Radiation therapy uses specific type’s high energy beams of radiation to shrink tumors or eliminate cancer cells. Radiation therapy works by damaging a cancer cell's DNA, making it unable to multiply. Although radiation therapy can damage nearby healthy cells, cancer cells are highly sensitive to radiation and typically die when treated. Healthy cells that are damaged during radiation are resilient and are often able to fully recover.
Chemotherapy is an important part of the treatment for most osteosarcomas, spindle cell sarcomas and Ewing's sarcomas. Chemotherapy is usually given before you have surgery or radiotherapy. When given before surgery, it can shrink the tumour and make it easier to remove. It can also reduce symptoms such as pain and reduce the chances of the cancer spreading. If you have an osteosarcoma or Ewing's sarcoma, you will also have chemotherapy after surgery or radiotherapy. This is to destroy any remaining cancer cells that may have spread to other parts of the body.
You may want to ask some questions before your treatment begins: