Medical Article

Fact about bone cancer

Bone cancer is a malignant tumor of the bone that destroys bone tissues, but  all bone tumors are not malignant. A malignant tumor spreads within the affected part as well as other organs. It will recur, if not treated completely. Both malignant and benign tumors grow and compress healthy bone tissue, but remains localized to the affected part, it does not destroy bone tissue.

Two types of bone cancer

Primary bone cancer: A primary bone cancer originates from the cells of the bone. This bone cancers starts in bone, muscle, connective tissue, blood vessels or fat, and can be found anywhere in the body. There are several types of primary bone cancer which includes the following:

  Osteosarcoma or osteogenic sarcoma: This is the most common type of bone cancer which starts in bone cells in the arms, legs or pelvis. It occurs at the age between 10 and 30, and more common in males than females.

  Chondrosarcoma: It forms in cartilage cells and is the second most common bone cancer. It rarely occur under the age of 20.

  Ewing Sarcoma Family of Tumors (ESFTs): It typically starts in the bones, but can also start in soft tissues like muscle, fat, fibrous tissues and blood vessels. It occurs most frequently in children and teenagers.

Secondary bone cancer : A secondary cancer in the bones has spread from somewhere else in the body. It originates from sites like the breast, lung or prostate and then spreads to the bone. This is also called metastatic cancer. The cancer cells are like the cells of the original tumour. The spread takes place in the later stages of the cancer, so this bone cancer is difficult to treat.

Rare bone cancers

Malignant fibrous histiocytoma: It typically develops in the soft tissue around the bones, tendons, ligaments, fat or muscle. Usually affect the arms, legs or jaw.

Fibrosarcoma: It is a very rare type of bone cancer most commonly occur middle-aged adults. The thigh bone is the most common site for fibrosarcoma.

Giant cell tumor of bone: It can be benign and malignant forms. It starts in the arm or leg bones of young middle-aged adults.

Secondary bone cancers are more common than primary bone cancers. Bone cancers commonly spreads to the lungs.

Cancers can also develop from bone marrow, the inner part of the bone that produces blood cells. These cancers are classified as blood cancers rather than bone cancers. Leukemia, lymphoma and multiple myeloma are bone marrow cancers.

Symptoms and Signs of bone cancer

Bone pain: Pain is the most common symptom of bone cancer. The pain varies depending on the location and size of the cancer.  The pain gets worse at night or with activity, but be constant at later stages

Swelling over a bone: Tumors that occur in or near joints may cause swelling or tenderness in the affected area.

Increased fragility of bone: Bone cancer interfere with normal movements and can weaken the bones which will lead to bone getting fractured easily.

Other features normally associated with cancer like fatigue, fever and weight loss and anemia. None of the symptoms are sure signs of cancer, but it is important to check with doctor.

Diagnosing bone cancer

To diagnose bone cancer, the doctor takes patient’s personal and family medical history. Then complete medical examination of the patient. The doctor may suggest a blood test to determine level of an enzyme called alkaline phosphate.

Radiological tests

X-ray :  Most bone cancers show up on x-rays of the bone. In x-ray the site of the cancer appear ragged instead of solid or appear as a hole in the bone. Only biopsy can determine cancer absolutely.

Bone Scan: In this test, a small amount of radioactive material injected which accumulates in the tumor. The image is then detected by a scanner.

CT scan and MRI:  In CT scan a series of detailed pictures of the area inside the body, taken from different angles, that are created by a computer linked to an X-ray machine. In MRI powerful magnet linked to a computer create detailed pictures of area inside the body without using X-rays. These tests provide detailed imaging of bone cancer.

Positron Emission Tomography Scan (PET scan), in which a small amount of radioactive glucose is injected into a vein.  Since the cancers need more glucose, the radioactive glucose gets accumulated in the cancer, which is detected using a scanner. The computerized pictures give the details of the cancer cells in the body. This scan is also useful to find if the cancer has spread to other sites.

Biopsy of the tissue, in which the surgeon may perform a needle biopsy or an incisional biopsy. In needle biopsy, the surgeon makes a small hole in the bone and removes tumor using needle-like instrument. In an incisional biopsy, the surgeon cuts the tumor and removes a sample of tissue to determine whether it is cancerous.

Blood tests: It is used to determine the level of an enzyme called alkaline phosphatise. The level of the enzyme will increase in bone cancer, it may occur for other conditions as well, so the test is not specific to confirm bone cancer.

Treatment for Bone Cancer

The treatment for bone cancer depends on the type, size, location and stage of the cancer, as well as the person’s age and general health. Cancer treatments are of two types- curative and palliative. Early stage cancers are treated aggressively where there is a possibility of curing it. One the other hand for last stage cancers uses palliative treatment, which is mainly to relive the patient of symptoms of the cancer.

Type of Treatments

Surgery:  In the procedure surgeon remove localized bone cancer tissue along with some healthy tissue around it. If cancer is on a limb, the surgeon made maximum effort to preserve healthy tissue using special techniques. After the removal plastic surgery or prosthetic limb may be necessary.

Cryosurgery: It is the procedure where liquid nitrogen is used to freeze and kill cancer cells. 

 Chemotherapy :  In this procedure anticancer drugs are used to kill cancer cells. This procedure is used after surgery to kill any cancerous cells that may persist in the body and thereby prevent recurrence. Sometimes it is used before surgery to shrink the tumor. It is not used to treat chondrosarcoma.

Targeted therapy: In this molecules or genetic material acts within cancerous cells. To treat giant tumor cells Denosumab therapy usually uses.

Health Tips and Preventions

The cause of bone cancer is unknown. So there are not much preventive methods for bone cancer. Some standard tips to prevent cancer are:

Follow a healthy lifestyle with adequate exercise. Consume plenty of fruits and vegetables.

If you have any predisposing conditions do regular check up for cancer.

Stop smoking and reduce alcohol intake.

Stress can be predispose to cancer, so adopt measures like yoga to reduce stress. 

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