Bone Cancer

Bone Cancer is a relatively rare disease in which cancer cells grow in the bone tissue. Cancer may form in the bone or spread to the bone from another site in the body. When cancer starts in bone tissue, it is called primary bone cancer. When cancer cells travel to the bone from elsewhere, it is called secondary or metastatic cancer to the bone. Two common types of primary Bone Cancer are osteosarcoma and Ewing's sarcoma. These two types most commonly affect children and adolescents. Cancer occurs when cells in the body (in this case bone cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer usually refers to malignant tumors, which can invade nearby tissues and can spread to other parts of the body. Both osteosarcoma and Ewing's sarcoma are malignant. A benign tumor does not invade or spread, and is far more common than a malignant tumor. Osteochondromas, which often go unnoticed, are the most common type of benign bone tumors found in children.

The cause of primary bone cancer is unknown. Genetics plays a major role in most cases. Conditions that cause increased bone breakdown and regeneration over an extended period of time increase the risk of tumor development. This explains why osteosarcoma in children is most common during the adolescent growth spurt.

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors for primary Bone Cancer in children include:

• Receiving radiation or chemotherapy for a different cancer
• Genetic predisposition
• Retinoblastoma
• Li-Fraumeni syndrome
• Multiple hereditary exostosis (abnormal bone overgrowths)

Risk factors for primaryBone Cancer in adults include:

• Paget's disease
• Exposure to radioactive materials

Risk factors for metastatic Bone Cancer include:

• Breast cancer
• Lung cancer
• Prostate cancer
• Kidney cancer
• Gastrointestinal tract cancer
• Thyroid cancer

Symptoms vary depending on the location and size of the tumor.

Symptoms may include:

• Pain at the tumor location
• Deep bone pain severe enough to wake you up
• Progressively enlarging lump or swelling at the tumor site; may or may not be painful
• Joint swelling and tenderness if the cancer is near a joint
• A bone break in response to a minor injury
• Fatigue
• Unexplained weight loss
• Fever or night sweats

These symptoms may also be caused by other, less serious health conditions. Anyone experiencing these symptoms should see a doctor.

The doctor will ask about symptoms and medical history, and perform a physical exam.

Tests include:

Blood Test – to check the level of the enzyme alkaline phosphatase. An increased amount of this enzyme is released in patients with bone tumors and when healthy children are growing.

X-ray – a test that uses radiation to take a picture of structures inside the body, especially bones

Bone Scan – a test that looks for evidence of bone tumors; a radioactive substance injected into the bloodstream is absorbed by bone tissue, and is then tracked by the bone scan

CT Scan – a type of x-ray that uses a computer to make pictures of structures inside of the body

MRI Scan – a test that uses magnetic waves to make pictures of structures inside of the body

Biopsy – removal of a sample of bone tissue to test for cancer cells.

Once cancer is found, staging tests are done to find out if the cancer has spread and, if so, to what extent. Treatment depends on the type, stage, and location of the cancer, and your overall health.

Treatments include:

Surgery –surgicalremoval of a cancerous tumor and nearby tissues, and possibly nearby lymph nodes. Surgery may require amputation of a limb with cancer. Whenever possible, doctors try to remove the malignant part of the bone without amputating. Metal plates or a bone graft replace the cancerous tissue that has been taken out.

Radiation Therapy (or Radiotherapy) – the use of radiation to kill cancer cells and shrink tumors. Radiation may be:

External Radiation Therapy – radiation directed at the tumor from a source outside the body

Internal Radiation Therapy – radioactive materials placed into the body near the cancer cells

Chemotherapy – the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.

Myeloablative Therapy with Stem Cell Support – in metastatic disease, intense chemotherapy is sometimes given to kill the cancer cells. This therapy also destroys the bone marrow. Stem cells, which have the ability to develop into other types of cells, are then given to replace the lost bone marrow.

There are no guidelines for preventing primary bone cancer. Early diagnosis and treatment improve your chance of successful treatment.