Bone cancer

Bone cancer

Definition:
Bone cancer is an uncommon cancer that begins in a bone. Bone cancer can begin in any bone in the body, but it most commonly affects the long bones that make up the arms and legs.

Several types of bone cancer exist. Some types of bone cancer occur primarily in children, while others affect mostly adults.

The term "bone cancer" doesn't include cancers that begin elsewhere in the body and spread (metastasize) to the bone. Instead, those cancers are named for where they began, such as breast cancer that has metastasized to the bone. Bone cancer also doesn't include blood cell cancers, such as multiple myeloma and leukemia, that begin in the bone marrow — the jelly-like material inside the bone where blood cells are made.


Symptoms:

Signs and symptoms of bone cancer include:

• Bone pain
• Swelling and tenderness near the affected area
• Broken bone
• Fatigue
• Unintended weight loss

When to see a doctor
Make an appointment with your doctor if you or your child develops signs and symptoms that worry you.


Causes:
It's not clear what causes most bone cancers. Doctors know bone cancer begins as an error in a cell's DNA. The error tells the cell to grow and divide in an uncontrolled way. These cells go on living, rather than dying at a set time. The accumulating mutated cells form a mass (tumor) that can invade nearby structures or spread to other areas of the body.

Types of bone cancer
Bone cancers are broken down into separate types based on the type of cell where the cancer began. The most common types of bone cancer include:

• Osteosarcoma. Osteosarcoma begins in the bone cells. Osteosarcoma occurs most often in children and young adults.
• Chondrosarcoma. Chondrosarcoma begins in cartilage cells that are commonly found on the ends of bones. Chondrosarcoma most commonly affects older adults.
• Ewing's sarcoma. It's not clear where in bone Ewing's sarcoma begins. Scientists believe Ewing's sarcoma may begin in nerve tissue within the bone. Ewing's sarcoma occurs most often in children and young adults.

Treatments and drugs:
The treatment options for your bone cancer are based on the type of cancer you have, the stage of the cancer, your overall health and your preferences. Bone cancer treatment typically involves surgery, chemotherapy, radiation or a combination of treatments.

Surgery
The goal of surgery is to remove the entire bone cancer. To accomplish this, doctors remove the tumor and a small portion of healthy tissue that surrounds it. Types of surgery used to treat bone cancer include:

• Surgery to remove a limb. Bone cancers that are large or located in a complicated point on the bone may require surgery to remove all or part of a limb (amputation). As other treatments have been developed, this procedure is becoming less common. You'll likely be fitted with an artificial limb after surgery and will go through training to learn to do everyday tasks using your new limb.
• Surgery to remove the cancer, but spare the limb. If a bone cancer can be separated from nerves and other tissue, the surgeon may be 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 area of your body or with a special metal prosthesis.
• 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
Radiation therapy uses high-powered beams of energy, such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table while a special machine moves around you and aims the energy beams at precise points on your body.
Radiation therapy may be used in people with bone cancer that can't be removed with surgery. Radiation therapy may also be used after surgery to kill any cancer cells that may be left behind. For people with advanced bone cancer, radiation therapy may help control signs and symptoms, such as pain.
Chemotherapy
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy is most often given through a vein (intravenously). The chemotherapy medications travel throughout your body.
Chemotherapy alone or combined with radiation therapy is often used before surgery to shrink a bone cancer to a more manageable size that allows the surgeon to perform a limb-sparing surgery. Chemotherapy may also be used in people with bone cancer that has spread beyond the bone to other areas of the body.