Bone Cancer

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Overview

Bone cancer happens when the bone cells start to grow uncontrollably. Pain is the first symptom of bone cancer and its severity increases as the disease progresses.

Bone cancers are rare, and they could either start in bones or spread from other organs to bones.

Types

Based on the origin, bone cancers are classified into two types – primary bone cancer and secondary bone cancer.

1. Primary Bone Cancers: Primary bone cancers are those that arise from the bone. Primary bone cancers are further classified into many types:

a. Osteosarcoma (osteogenic sarcoma) is one of the common types of primary bone cancer that originates from the bone cells of limbs and the pelvic region. This cancer is more common among men, and it occurs between the ages of 10 and 30.
b. Chondrosarcoma is the second most common type of bone cancer. It forms in the cartilage cells, and one’s risk of developing chondrosarcoma increases with age.
c. Ewing’s Sarcoma is the third most common type of bone cancer. It usually starts in the bones, but it may also form in muscles and other tissues. This form of bone cancer is usually seen in children and teenagers and is rarely seen in adults.
d. Fibrosarcoma forms in the soft tissues that line the bones, such as fat or muscles, tendons and ligaments. The risk of developing fibrosarcoma increases with age, and among older adults, we see this cancer usually affecting the arms, legs or jaws.
e. Giant Cell Tumour of Bone could present itself in benign or malignant form, with the former being more common. In most cases, it occurs in the limbs of young and middle-aged adults and rarely spreads to other parts of the body. However, these tumours show a higher tendency to relapse, and the chances of cancer spreading to other organs increases with each recurrence.
f. Chordoma is another type of bone cancer that forms in the spine and the base of the skull. This cancer is more common among men aged 30 and above. It is a slow-growing cancer and rarely spreads to distant organs. However, if this tumour is not removed completely, the patient may be at risk of a relapse.

2. Secondary Bone Cancers: Secondary bone cancers are those cancers that begin in different organs of the body and later spread to bones. Secondary bone cancers are more common than primary bone cancers.

HCG has the best bone cancer specialists in India who are experienced in treating bone cancers with customised and result-oriented treatment plans that lead to successful clinical outcomes.

Symptoms

The most common symptom associated with bone cancer is pain, and this increases as the disease progresses and lesions are created in the bones. Other symptoms of bone cancer include:

Swelling in the affected bones
Palpable hard mass in the bones
Fatigue
Anaemia
Fever
Bone Fractures
Unintentional weight loss

In many cases, patients may not experience any symptoms, and this makes the prognosis difficult. Some tumours may also weaken the bone structure and lead to pathological fractures.

Courses

Although there are no clearly defined causes for bone cancer, a few risk factors associated with this disease have been identified:

Age: Bone cancers are more common among children and individuals below age 20. However, one’s risk of getting chondrosarcoma increases with age.
Family History: Those with a family history of bone cancer have an increased risk of developing this disease.
History of Radiation Therapy: Those who have undergone radiation therapy in the past have a higher risk of developing bone cancer.
Paget’s Disease: Underlying condition of Paget’s disease increases the risk of bone cancer
Li-Fraumeni Syndrome: Certain rare genetic syndromes such as Li-Fraumeni syndrome are linked with bone cancer development.
Umbilical Hernia during Birth: Babies born with umbilical hernia are at higher risk of developing bone cancer.

Diagnosis

There are various ways to detect and diagnose bone cancers.

If an individual is suspected to have a bone tumour, the doctor will start with taking a complete medical history to find out other symptoms that could point towards bone cancer. The doctor may physically examine the suspected area for an abnormal mass or other signs of a bone tumour.

If the physical examination suggests the possibility of bone tumour, the doctor may recommend additional tests, namely:

a. Bone Scan: During a bone scan, a radioactive compound is injected into the vein, and the patient is made to wait for some time. This radioactive compound gets accumulated in the regions where there is bone damage; it is taken up by regions that have high blood flow. Later, a special camera is used for scanning the bones and regions, and the regions that have high amounts of radioactive compounds appear as dark spots. This procedure helps in diagnosing various bone disorders, including bone cancers.

b. Imaging Tests: Imaging procedures, such as PET/CT, MRI and X-ray, are used to obtain detailed information about bone cancer. These tests help in performing a biopsy, disease staging, planning treatment, checking if cancer has spread to other organs and monitoring the treatment that is administered.

c. Bone biopsy: To obtain a confirmed diagnosis, a sample of bone tissue is collected and examined under the microscope for the presence of cancer cells. This is considered to be the most reliable way to diagnose bone cancer.

HCG has the best orthopaedic oncologists in India who strive to deliver the best and result-oriented bone cancer treatment via superior quality diagnostic support and innovative treatment approaches.

Treatment

The treatment recommendations for bone cancer are made based on key factors such as the type of the tumour, stage of the tumour, size and location of the tumour, patient’s age and the overall health of the patient.

Surgery, radiation therapy and chemotherapy are the main lines of treatment for bone cancer.

a. Surgery: Surgery completely removes the tumour along with a small portion of the healthy tissues that surround it. The primary goal of surgery is to achieve remission.

Initially, the surgical management of bone cancer involved amputation. Today, not all bone cancer cases require amputation, and surgeons focus on organ preservation surgeries, which focus on preserving both the structure and functioning of the organ that is affected by cancer. Limb salvage surgery or limb-sparing surgery is a surgical approach that treats bone cancer without amputation. During the procedure, the lost bone will be replaced with a bone from another part of the body or an artificial bone.

By adopting latest advancements in the field of cancer care, HCG delivers the best bone cancer treatment in India.

b. Radiation Therapy: This treatment approach involves destroying the cancer cells using high-dose radiation beams. Radiation therapy is combined with other treatment approaches such as surgery and chemotherapy to enhance the overall efficacy of the treatment. Following are the goals of radiation therapy:

To suppress the tumour
To relieve the symptoms such as pain
To shrink the tumour before the surgery (neoadjuvant therapy)
To destroy the cancer cells left behind after the surgery (adjuvant therapy)

c. Chemotherapy: This treatment modality uses potent drugs to destroy the cancer cells by stopping their growth and multiplication. Following are the treatment goals of chemotherapy:

To remove cancer completely
To prevent cancer from relapsing
To delay the progression of the disease in advanced stages
To relieve the symptoms such as pain among patients with advanced bone cancers

Early detection and accurate diagnosis are important for beating bone cancer with positive clinical outcomes. Therefore, it is important for patients to not ignore any symptoms.

Frequently Asked Questions

1. Are bone cancers treatable?

Bone cancers are treatable. Be it early-stage or advanced-stage bone cancers, there are multiple treatment options available that not only manage the disease effectively but also help patients have a better quality of life after the treatment.

Today, we have more advanced and patient-centric treatment approaches, such as organ preservation surgeries that remove only the tumour while leaving the entire bone structure intact. These approaches support the overall wellbeing of the patients after the treatment.

Nevertheless, for any cancer to be treated the best, it has to be detected in the early stage. Therefore, no symptom should be ignored and any symptom that lasts for more than two weeks should be brought to the physician’s attention.

2. What is the difference between ‘Bone Cancer’ and a ‘Bone Tumour’?

Any abnormal development from or in the bone, whether benign or malignant, is referred to as a bone tumour, and a malignant bone tumour is referred to as bone cancer.

3. Which bones can be affected by cancer?

Cancer can affect any bone in the body. Certain bone cancers, however, predominantly arise from specific bones. The bones around the knee are usually affected by osteosarcoma. The upper leg, pelvis, and other bones of the trunk are more commonly affected by Ewing’s sarcoma. Chondrosarcomas arise from the pelvic bones in most cases.

4. How are secondary bone cancers treated?

Metastatic bone cancers or secondary bone cancers may need a multimodal treatment approach. However, before planning the treatment for secondary bone cancers, various factors such as the type of bone cancer, the extent of metastasis, previous treatments, the goal of the treatment (cure or symptom relief) and other factors are considered.

Various treatment options available for secondary bone cancers include chemotherapy, radiation therapy and stem cell transplantation.

5. How do cancers spread to bones?

Cancers spread to bones largely through the vein system. Blood can flow from one vein to another. Once cancer cells enter the bloodstream, they can travel to any part of the body from head to toe. This is how cancers travel from organs to bones or from bone to bone. The spine has a wide network of veins, and therefore, its bones are more vulnerable to cancer formation.

6. Can I prevent bone cancer?

Currently, there are no proven methods to prevent bone cancers. Nevertheless, early detection increases the chances of a successful treatment; thus, those with known risk factors should see their doctor on a frequent basis to review their personal risk of developing bone cancer.