What is Bone Cancer?
As the name suggests, bone cancer affects the bone cells. It can begin in any body bone when the bone cells lose their ability to control division and grow uncontrollably.
There are several early symptoms of bone cancer that help to indicate the condition of a person suffering from bone cancer. The treatment process involves radiation therapy, chemotherapy or surgery, depending on the condition of the tumour.
The uncontrolled growth of cells is known as a tumour which could be benign or malignant.
The main difference between benign and malignant bone cancer is given below:
- The benign tumour means that the tumour may expand in size but not invade other body parts. Even if it increases in size, it will not spread to other organs and only affect the bone where it started. As the size increases the chances of bone fracture may also increase significantly.
- A malignant tumour means that the tumour will spread into other parts of the body. The tumour may enter the bloodstream and invade other body organs via metastasis, especially the lungs.
Bone cancer can begin in any bone but most commonly it starts from the pelvis or long bones including arms and legs.
Bone cancer is rare, and it can occur in people of any age group, but teens are the most prevalent bone cancer.
Types of Bone Cancer
Based on origin, bone cancer has been classified into two main types, namely – Primary and secondary.
Primary bone cancer is the rarest and most dangerous and forms directly in the bone or the nearby tissues such as cartilage.
Whereas secondary bone cancer starts from other organs and later invades the bones.
Compared to primary bone cancer, secondary bone cancer is more frequent.
Some common primary bone cancers are:
1. Osteosarcoma
Osteosarcoma is a prevalent bone cancer which generally affects children and young adults. It is the most prevalent type of primary bone cancer, being the cause of 2 of 3 bone cancer cases.
Originating from the tips of long bones such as arms and legs it reaches the other bones also. The commonly affected bones are the hip bones, shoulders and other locations majorly damaging the other layer of bones.
2. Ewing’s Sarcoma
Similarly, Ewing’s Sarcoma affects young children and teenagers. It begins from the soft tissue around the bone or sometimes directly from the bone. It is also prevalent in affecting the long bones and pelvic regions.
3. Chondrosarcoma
Chondrosarcoma is a rare type of cancer which begins mostly in cartilage cells except in a few cases where it starts in soft tissues surrounding a bone. It mostly occurs in the pelvic, hip and shoulder bones.
4. Chondroma
It’s not cancer but a slow-growing and non-invading tumour. This tumour could be made up of cartilage, bone, or soft tissues.
It usually occurs in the hands and feet and sometimes in the collarbone, pelvis, ribs, spine, or skull.
Common Symptoms of Bone Cancer
There are several early symptoms of bone cancer that can indicate the condition of bone cancer in many patients.
If you observe more than 2 symptoms in your body, consult a doctor immediately. Early detected bone cancer is more likely to get cured.
Apart from common symptoms of cancer such as fatigue, weight loss and nausea, there are some main signs and symptoms of bone cancer are:
1. Bone pain
The most prominent symptom of bone cancer is bone pain which feels like tenderness in the affected area.
This pain may persist for more than a week, during the day and night, which progress with time. Usually, the pain increases at night or when the bone is being constantly used.
Often the weakened part of the bone breaks which leads to sudden unbearable pain.
2. Inflammation
Swelling and redness in inflammation are also seen in the affected area or around the bone. Inflammation is a conditional symptom of bone cancer.
Typically, swelling does not affect until the bone cancer is around a joint. The tumour around a joint leads to lump formation and hence causes inflammation and movement restriction in the affected area.
Therefore, cancer weakens the bones in the affected area which could easily break.
3. Lump
A visible lump around the bone is usually observed due to the formation of a tumour. Although it is not a common symptom, this is a crucial sign of bone cancer.
4. Fracture
Weakened bones and new bones forming in unwanted areas put pressure on long bones leading to fractures.
Usually, people experience mild pain in an area around the bone and when the bones become weak, fracture leads to severe pain.
Therefore, the fracture is considered a secondary symptom of bone cancer. Fractures due to bone tumours can lead to limping which is a symptom of a later stage of bone cancer.
5. Restricted movement
Usually, Inflammation in joints makes it more difficult to move the joint and hence causes problems in moving. A tumour that is around a joint grows and restricts the movement of the joint.
This leads to other symptoms of bone cancer such as pain and swelling around the joint.
What are the Causes of Bone Cancer?
Bone cancer is a life-threatening disease which could hinder a person’s life in many ways.
The main cause of bone cancer is still unknown, but researchers have found bridges between several factors and bone cancer.
The potential causes of bone cancer are as follows:
- Hereditary – The defective genes that could cause cancer has been passed on to the offspring and could be one of the leading causes of bone cancer.
- Radiation – Being exposed to radiation in any form can be a cause of bone cancer. As radiation alters the DNA of a cell and leads to changes in the genes involved in cell division.
- Injury – Abnormal healing of any injury or wound involving bones can lead to bone cancer. This case is rare but if a wound is healed correctly it affects the bone as well and can be a cause of cancer.
- Drug treatment – Medicines are given for the treatment of any other cancer that can have side effects on bone cells resulting in bone cancer.
- Other cancer – cancer in other body parts can spread to the bones and can cause bone cancer. This occurs when stage 4 cancer in another part of the body has metastasized to bone.
How to diagnose bone cancer?
People usually visit any orthopaedic (bone specialist doctor) or bone cancer specialist when they experience or find any lump or swellings in any bone or surrounding area.
There are separate ways to detect bone cancer in a patient, and most of them are painless as well.
Depending on the symptoms the patient is advised to go under various tests, such as
1. X-ray
Usually, the doctors firstly ask the patient to take an x-ray of the affected part, which is a process that creates an image of the bones inside the body.
The X-ray can give an honest answer to the question if you have bone cancer or if it is something else.
It helps to detect damage caused by bone cancer or new bones growing because of bone cancer. It can also suggest if the pain or swelling is due to cancer or any fracture.
2. Biopsy
The biopsy is the most definitive way to diagnose any type of cancer, where a sample of the tumour is taken to check it under a microscope and examine for defective bone cells.
A bone biopsy can be done in two ways, which are:
- A core needle biopsy is where after giving anaesthesia, a needle is inserted into the bone and used to remove the sample of the bone.
- An open biopsy, where under the influence of general anaesthesia, an incision is made, and the sample is taken out from the body
3. CT Scan
Computed tomography or CT scan is a process involving several x-rays taken to generate a 3D image of the body.
It is usually done to check that bone cancer has metastasized to other organs, especially the lungs.
4. MRI
Magnetic resonance imaging is the best way to get a detailed image of bone cancer. It uses strong magnetic fields and radio waves to produce detailed images of bones and soft tissues.
It is an effective way to evaluate the size of the tumour and the spread of the tumour around the bones
5. Bone scan
A bone scan is a better version of an x-ray and provides more detailed information about the inside of the bone.
It uses a radioactive material which is injected into the patient’s body, tumour cells absorb the material faster than normal cells and are hence observed as a hotspot.
6. Bone marrow biopsy
The commonly used diagnostic method in Ewing’s Sarcoma, Bone marrow biopsy is used to check if the cancer is spread to the bone marrow inside the bones.
It uses a needle to collect the bone marrow sample from a bone when the patient is under the influence of anaesthesia.
The sample is sent to the laboratory and examined there for cancerous cells.
Staging of Bone Cancer
Depending on the symptoms of bone cancer and the result of diagnostic tests, the doctor labels the bone cancer/tumour according to the size of the tumour and how fast it is growing/spreading to other body parts.
This process is known as staging. It assists in determining how much cancer has spread and its severity to access the best cancer treatment.
The most common staging system used is given below:
- Stage 1 – Low-grade bone cancer that has not spread at all.
- Stage 2 – High-grade bone cancer that has not yet metastasized outside of the bone but increased in size.
- Stage 3 – Cancer has spread to the surrounding area within the bone.
- Stage 4 – Cancer has spread to other parts of the body like the lungs, liver etc.
Staging helps the doctor to determine how much part of the bone is affected and which treatment plan will be most adequate for the specific patient with bone cancer.
Treatment and Conclusion of Bone cancer
Most treatment of bone cancer depends upon the type of bone cancer and which stage of cancer it is.
The doctor suggests the best treatment. Many patients go under combination method to control the growth of
Commonly used techniques are:
- Surgery – To remove the section of the area affected by cancerous cells, surgical methods are used. It is also the aim to reconstruct or replace the bone removed by surgery.
- Chemotherapy – Chemotherapy involves drugs that are administered into the body of patients via the oral, intravenous, or intraperitoneal routes. These drugs help to control the growth of cancer. This can be done when cancer has not spread to many parts. There are many side effects of chemotherapy as well.
- Radiation therapy – Most commonly used treatment for bone cancer is radiation therapy, as radiation therapy uses a high dose of ionising radiation to kill the cancerous cells. Some minor side effects are observed including damage to healthy cells.
Bone cancer is a rare disease which can be treated when detected at its initial stages. Approximately 6 out of 10 individuals with bone cancer will survive for at least 5 years following their diagnosis, and many of these individuals may be cured.
With the help of professionals, bone cancer can be treated effectively. Cancer rounds are associated with many cancer specialists who are working in this field for years and have treated many patients.
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