Bone Cancer

Bone Cancer

Bone cancers are the cancers that arise from the bone tissue. When malignant cells develop in a bone, they can harm the normal bone tissue. The type of bone cancer is determined by the type of cell and tissue where the cancer originates.

Cancers that develop in the bone itself are referred to as primary bone cancers. Some cancers begin in other body parts or organs and spread to bones. These are referred to as secondary or metastatic bone cancers. Prostate cancer, breast cancer, and lung cancer are some of the common cancers that spread to the bone.

Primary bone cancers are quite rare. Although they can occur at any age, they are more common in children than in adults.

Where bone cancer starts depends on its type. Primary bone cancers are divided into the following four categories:

  • Osteosarcoma
    It is the commonest type of bone cancer and develops in the cells where new bone tissue develops from. Although it can affect any bone, it usually originates from the ends of large bones like the legs and the arms. It is more commonly seen in children and teenagers.
  • Ewing sarcoma
    This cancer is further divided into many different types of cancers, all of which share similar characteristics and are believed to have originated from the same types of cells. These cancers either develop in the bone tissue or the surrounding soft tissues. These are most commonly seen in the ribs, hips, shoulder blades, and long bones like those of the legs.
  • Chondrosarcoma
    It originates in the tissue called cartilage, the soft connective tissue that allows movement between joints and bones. When the body adds calcium to cartilage, some of it transforms into bones. This type of cancer is typically seen in the leg, arm, or pelvic bones. Unlike Ewing sarcoma and osteosarcoma, chondrosarcoma is more commonly seen in adults than in children or teenagers.
  • Chordoma
    It is a relatively rare tumour that originates from the bones of the spine— usually at the base of the skull or the spine. Chordoma is also more commonly found in older adults. Also, males are more susceptible to developing chordoma than women.

Yes, benign bone tumours can sometimes turn cancerous but it is very rare. Apart from that, those with benign bone tumours still require treatment to reduce the risk of other complications such as joint problems, weak bones, and damage to healthy bone tissue.

After the diagnosis of cancer is established, tests are done to stage it. Staging of tumours is very important to form a treatment plan appropriate for the stage and predict the prognosis. The stages of bone cancer are denoted by Roman numerals, ranging from 0 to IV. Stage 0 indicates that the tumour is small and less aggressive, while stage IV indicates that the cancer is more aggressive and has spread to other body parts. The following factors are considered while staging the bone cancers:

  • Tumour size
  • Rate of growth of the cancerous cells
  • Metastasis of cancer to distant body parts
  • The number of bones affected

Primary bone cancers are usually divided into the following four stages:

  • Stage 1
    These are low-grade tumours where the cancer cells are still localised and confined to the area of their origin.
  • Stage 2
    Even though the cancer cells are localised, the tumour has turned high-grade.
  • Stage 3
    Not only is the tumour high-grade, the malignant cells have spread to other areas within the bone at this stage.
  • Stage 4
    At this stage, the malignant cells have spread from the bone to other body parts such as the liver or the lungs.

Some patients who have bone cancer are asymptomatic. The only symptom they have is a painless lump. Others, however, experience a variety of symptoms. Sometimes these symptoms are present because of other medical conditions like Lyme disease or arthritis, which delays the diagnosis. Some common symptoms of bone cancer include unexplained swelling, pain that worsens at night, difficulty moving around, fever, and fatigue.

The exact cause of bone cancers is not known. However, the presence of certain risk factors increases your chances of developing the disease. The most important of these risk factors is exposure to radiation or certain drugs while undergoing treatment for other cancers. Some bone cancers are hereditary in nature, that is, they occur due to conditions that are passed down in families.

To establish a diagnosis of bone cancer, the doctor will often use X-rays to visualise the images of the bones. CT scans and MRI provide more detailed pictures of the areas around the bones. These tests are usually performed before starting any new treatment. Your healthcare provider will also perform a biopsy to confirm the diagnosis. During this procedure, a small piece of tissue is removed from the bone and then it is examined under the microscope. A biopsy provides more detailed information regarding the cancer, including its primary site of origin. This information helps the healthcare providers stage the cancer and determine the ideal course of treatment that will work best for the particular cancer.

The treatment of bone cancer depends on their type, extent of spread, and certain other factors. The treatment is often delivered by a team of healthcare providers who work together to treat the condition. This group consists of oncologists and doctors who specialise in bones and joints and doctors who specialise in cancer treatment.

The treatment plan for bone cancers usually consists of a combination of approaches. The duration and type of these treatment modalities varies depending on several factors, including the size of the tumour, the type of the cancer, and whether it has spread to other body parts. The most commonly used treatment options for bone cancer include:

  • Surgery
    The tumour along with a portion of the surrounding healthy tissue is removed. The affected bones are sometimes rebuilt with real or artificial bone grafts. Sometimes, an entire limb needs to be resected to treat the cancer and an artificial limb is used instead. If all of the cancer cells were not removed by the surgery, a repeat surgery may be needed to remove the remaining malignant tissue.
  • Radiation therapy
    During this treatment, high doses of X-rays are used to shrink the tumour. Sometimes, radiation therapy is used before surgery to shrink the tumour. This makes surgery easier and much more feasible.
  • Chemotherapy
    This treatment destroys the cancer cells through the body with the help of certain medications. It is either injected into a vein or given orally. Chemotherapy can be used to treat both primary and secondary bone cancers.

As there is no known cause that leads to the formation of bone cancers, there are no known ways to prevent these cancers. The most important known cause is radiation exposure. But, as radiation exposure occurs as a result of treatment for other cancers, it can’t be completely avoided.

If you notice swelling or pain in your bones, you must talk to a healthcare provider. If you have already been diagnosed with bone cancer and are undergoing treatment for the same, you must inform your provider if you notice any new symptoms.

Understanding your diagnosis fully can help you make the best decision about your health and treatment options. Following are some questions you might want to ask your doctor about your condition:

  • What type of bone cancer do I have?
  • What tests do I need?
  • Has it spread?
  • What is my outlook?
  • What are my treatment options?

Although bone cancers are rare, being diagnosed with one can be quite distressing. When diagnosed and treated early, most bone cancers can be successfully treated. You must discuss your treatment options with your healthcare provider and ask any questions you have about your diagnosis. You can also join a support group to help dealing with the emotional aspects of the diagnosis. Talking with people who are going through the same situation can be helpful for your emotional, mental, and spiritual health.

We at Kokilaben Dhirubhai Ambani Hospital, Indore acknowledge that a cancer diagnosis can be overwhelming and frightening, but you will find ways to cope with the negative feelings with time. Consult the best oncologists in Indore at our hospital and understand the various treatment options and their prognosis. You can ask your doctor questions regarding your condition, including your test results and the treatment options. It may help you be more confident in making decisions about the treatment plan. You can also consider joining support groups and meeting with people who are suffering from or have recovered from the same cancer as you. Keep your friends, and family members close and do not hesitate to share your emotional problems with them. Also, do not hesitate to share your symptoms and mental health problems with the oncology team at our hospital throughout the treatment journey. There are medicines available for every symptom, so you do not need to tolerate those unnecessarily. Cancer specialists at Kokilaben Dhirubhai Ambani Hospital, Indore aim not only to treat your physical symptoms but also to ensure your mental and emotional well being at all times.