What is Bone Cancer?

Cancer can spread to the bones from other organs (secondary bone cancer) but, in some very rare cases, cancer may begin in the bones (primary bone cancer). People can develop three types of primary bone cancer:

• Osteosarcoma - Osteosarcoma arises in new bone tissue and is the most common type of bone cancer. It is usually found in children and adolescents.
• Chondrosarcoma - Usually only found in adults, this cancer starts in the cartilage.
• Ewing's sarcoma - Primarily affecting children and adolescents, this cancer develops in immature nerve tissue in the bone marrow.

Risk Factors

Different diseases, including cancer, have different risk factors. Understand that although these factors may put you at greater risk, it does not mean they necessarily cause the disease. Risk factors for bone cancer include:

• Family history (inherited genes)
• Bone exposure to radiation
• Bone marrow transplantation
• Having paget's disease, multiple exostoses, multiple osteochondromas, or multiple enchondromas

Common Symptoms

In order to diagnose bone cancer at an early stage, prompt attention to the signs and symptoms of this disease is incredibly important. Symptoms include:

• Pain in the affected bone that may worsen and become more constant over time
• Swelling in the area of the pain due to a lump or mass
• Weight loss
• Fatigue
• Fever
• Anemia

Screening and Diagnosis

A doctor will review a patient's medical history and conduct an examination before diagnosing bone cancer. The patient's doctor may also use some of the following tests to help make a diagnosis:

• Blood test
• X-ray
• Bone scan
• Computed Tomography (CT) scan
• Magnetic Resonance Imaging (MRI)
• Angiogram
• Biopsy

Common Treatment Options

Treatment for bone cancer is based on the type, stage and size of the tumor, as well as the patient's personal preferences, prognosis and ability to tolerate certain medical procedures or medications. Preserving healthy tissue while destroying tumors at their point of origin, and destroying those cancer cells that have spread throughout the body, is the goal of treatment.

Surgery

Depending on the type and stage of the bone cancer, surgery may be used to remove the cancer and some of the nearby tissue. The surgeon takes out the cancerous tissue while sparing as much healthy tissue as possible. Because only very specific situations may call for amputation of a limb, patients should ask their surgeon to explain the best method for removing the cancer while keeping as much use of the limb as possible.

Radiation Therapy

Radiation therapy is a non-surgical method of treatment using penetrating beams of high-energy waves called x-rays or gamma rays. Radiation injures or kills tumor cells by damaging their genetic material, making it impossible for these cells to continue to grow.

The two types of radiation therapy are:

• External-beam radiation therapy
  Specialized medical equipment is used to deliver radiation to the tumor site from outside the body.
• Internal radiation therapy (also called Brachytherapy)
  Also known as implant radiation, radioactive material is placed in the body near the cancer cells.

The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Sometimes used as the primary treatment of bone cancers, radiation can be used as an adjuvant (additional) therapy to kill very small clusters of cancer cells that cannot be seen and removed during surgery. This process will be performed after surgery. Radiation therapy can also be used to ease the symptoms of bone cancer. It is most commonly used as the main treatment for Ewing's tumors.

Chemotherapy

Chemotherapy is a type of treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Depending on the type and stage of bone tumor, chemotherapy may be given as the primary treatment or as an adjuvant (additional) treatment to surgery. Chemotherapy drugs can be taken orally or by injection depending on the type and stage of the cancer, and the drug protocol the doctor has prescribed. It is important that each patient has a discussion with the treatment team so any possible side effects are known.