Rare form of cancer (abnormal growth of cells) originating in bones is termed as bone cancer. However, it does not include cancers such as leukemia and multiple myeloma that begin in bone marrow, a jelly like substance hidden inside the bones. Even cancers originating at other parts of the body such as breast cancer and has spread to bone are also not considered as bone cancers.
Triggering agents for bone cancer are not exactly known. Like any other type of cancer, bone cancer also starts due to a change in the sequence of DNA of the cell. This mutated gene causes the cell to grown uncontrolled resulting in formation of mass of cells that have the ability to spread to other areas of the body. Increased exposure to radiations at work or as a part of cancer therapy, diseases such as Paget’s disease of bone and hereditary diseases such as hereditary retinoblastoma and Li-Fraumeni syndrome increase the risk for bone cancer.
Types of bone cancer
Depending on the cell type in which the bone cancer originates different types of bone cancers are recognized.
- Osteosarcoma: This type of bone cancer commonly seen in children and young adults originates in bone cells. Upper arm and Knee are commonly affected.
- Chondrosarcoma: Observed commonly in older adults and originates in cartilage cells located at the ends of bones.
- Ewing’s sarcoma: This type of cancer is also most commonly observed in children and adolescents. It is believed to originate in nervous tissue located within the bone. Upper arm, ribs, leg and pelvis are at high risk of contracting this type of bone cancer.
Stages of bone cancer
Depending on the size of the tumor and whether the tumor is localized or metastasized there are four stages of bone cancer.
- Stage I: Bone cancer is restricted to only one specific bone and has not spread to other regions of the body.
- Stage II: Cancer is limited to the bone and has not spread to other regions but the cancer is aggressive showing abnormal growth.
- Stage III: Cancerous tissue appears at one or two places on the same bone. This stage of cancer is also highly aggressive.
- Stage IV: Cancer is not limited to the bones and has spread to other regions of the body such as brain, lungs or liver.
Bone cancer symptoms
- Painful and swollen bone. Tenderness of the region can be felt upon touching. Pain often gets worse with specific activities.
- Unexplained weight loss.
- Fractured bone.
It is important to consult a physician if the child shows bone cancer symptoms without delay to prevent amputation and spreading of the cancer to other regions of the body that hardens the treatment process.
Treatment of Bone Cancer
Diagnosing bone cancer before the disease spreads to other regions of the body increases the chances of treating the cancer successfully using radiotherapy, chemotherapy or by surgery.
Depending on the severity of the bone cancer symptoms and area being affected physician suggests different imaging tests to evaluate the disease. Commonly used imaging tests include bone scan, CT, MRI, PET and X-ray. Biopsy in which a tissue sample from the tumor is removed and examined is done to know if the tumor is benign or malignant and also to know the stage of bone cancer. Blood tests are also done to know the levels of alkaline phosphatase and lactate dehydrogenase that are normally high in patients with Ewing’s sarcoma and osteosarcoma.
Cancer treatment depends on the stage of the cancer, general health and also on the preferences of the patient. Generally, multiple therapies are used in treatment of bone cancer.
- Radiation therapy: If the bone cancer cannot be removed by surgery then it is treated using radiation therapy. In this treatment high energy rays such as X-rays are passed at specific points of the body so as to kill the cancerous cells. Bone cancer symptoms such as extreme pain can be controlled by using radiation therapy. If few cases, radiation therapy is used after surgery to kill any of the existing cancer cells.
- Chemotherapy: Cancer treatment done using chemicals is termed as chemotherapy. In this method of treatment, chemicals are passed intravenously in to the whole body. This is used in patients with stage IV of bone cancer.
- In certain conditions chemotherapy and radiation therapy are used before surgery to reduce the size of the tumor. This not only eases the surgical procedure but also prevents from removal of affected arm or leg (amputation).
- Surgery: Surgery involves removing the bone cancer as well as the surrounding healthy tissue. Bone cancer of arms or legs in which the cancerous tissue is present at multiple locations of the bone is treated by amputating the leg or hand. If the bone cancer is restricted to a small portion then the cancerous tissue along with surrounding healthy tissue is removed. The removed bone is replaced by another bone taken from any part of body or by placing metal prosthesis. Imaging tests are performed after surgery to identify the presence of leftover cancerous tissue which is then treated with radiotherapy or chemotherapy. After successful treatment of bone cancer imaging tests are conducted periodically to know if the tumor has started to grow again and also to identify second cancers that generally develop as side effects to treatment of primary cancer.
- Herbal treatment: Certain herbs such as Reishi mushroom, Cat’s claw, Milk thistle and fermented wheat germ extract offer anticancer effects and also strengthen the immune system to fight against cancerous cells.
By taking healthy diet rich in antioxidant foods such as fruits and vegetables, avoiding fatty foods and highly refined foods helps to relieve bone cancer symptoms to certain extent. Nutritional supplements should be taken to prevent nutritional deficiencies.