Bone Cancer: Types, Risk Factors, Symptoms, Diagnosis, Treatment, Outlook

Medically Reviewed by Dr. K on 19 May 2022

Bone Cancer

Bone cancer occurs as abnormal cells in the bone develop out of control. Normal bone tissue is destroyed. It could begin in your bone and spread to other areas of your body This is a process called metastasis.

Bone cancer is a rare disease. Bone tumours are usually benign, meaning they aren't cancerous and don't move to other parts of the body. However, they can weaken the bones, resulting in broken bones or other issues. Benign bone tumours come in a variety of shapes and sizes:

  • Osteochondroma: Most common. It is more common in people under the age of 20.
  • Giant cell tumour: Typically, it's in your leg. These may be cancerous in rare cases.
  • Osteoid osteoma: Long bones are susceptible to this, and it normally occurs in your early twenties.
  • Osteoblastoma: A rare tumour that mainly affects young adults and forms in the spine and long bones.
  • Enchondroma: It normally presents itself in the bones of the hands and feet. It often shows no signs or symptoms. The most prevalent type of hand tumour is this one.

Primary Bone Cancer

Primary bone cancer, also known as bone sarcoma, is a form of cancer that occurs in the bone. Experts aren't exactly sure what causes it, although it's possible that your genes are involved. The below are some of the more common forms of primary bone cancer:

  • Osteosarcoma: often develops around the knee and upper arm. It is more prevalent in teenagers and young adults, although it also affects adults with Paget's disease of the bones.
  • Ewing's sarcoma:  People between the ages of 5 and 20 are more likely to develop Ewing's sarcoma. The most prominent locations are your ribs, pelvis, leg, and upper arm. It may also begin in the connective tissue that surrounds your bones.
  • Chondrosarcoma: more often affects individuals between the ages of 40 and 70. This disease, which starts in cartilage cells, commonly affects the hip, pelvis, leg, arm, and shoulder.

Multiple myeloma is not predominant bone cancer, despite the fact that it occurs in the bones. It's a cancer of the marrow, the soft tissue that lines the insides of bones.

Secondary Bone Cancer

Cancer of the bones is normally the result of cancer elsewhere in the body. For example, secondary bone cancer occurs after lung cancer has spread to the bones. Metastatic cancer is any cancer that spreads from one section of the body to another.

The following cancers usually spread to the bones:

  • Breast cancer
  • Prostate cancer
  • Lung cancer

Risk Factors

Things that might make you more likely to get bone cancer include:

  • Cancer treatment: People who have undergone radiation, stem cell transplants, or certain chemotherapy treatments for other cancers are more likely to develop bone tumours.
  • Inherited conditions. Diseases passed on from your genes, such as Li-Fraumeni syndrome and retinoblastoma, an eye cancer, will increase the risk of having bone cancer.
  • Paget’s disease of bone. This non-cancerous bone condition could even increase the probability.

Symptoms

If a bone tumour is cancerous or not, you may not have any indications. When the doctor examines an X-ray for another condition, such as a sprain, they may see it. However, pain may be one of the symptoms:

  • Is in the area of the tumour
  • Is dull or achy
  • Worsens with activity
  • Wakes you at night

A bone tumour is not caused by an injury.

Other symptoms associated with bone cancers include:

  • Fevers
  • Night sweats
  • Swelling around a bone
  • Limping
  • Fatigue
  • Weight loss

Diagnosis

Your doctor will ask you questions regarding your conditions and personal records, as well as do a clinical examination. They'll use imaging scans to look at images of the bones, such as:

  • X-rays: These portray tumours and their sizes.
  • CT scans: X-rays are used by computers to create more accurate images.
  • MRI scans: This uses a powerful magnet to reveal what's going on within the body.
  • PET scans: Radioactive glucose (sugar) is injected into the vein by a technician. The cancer cells, which consume more glucose than normal cells, are then detected using a scanner.
  • Bone scans: A different radioactive material is injected into the vein by a technician. It collects in the bones, where it can be seen by a scanner.
  • Blood test: Blood tests can be ordered by the doctor to scan for two enzymes that may indicate blood cancer.
  • Biopsy: A biopsy is a test that may be used to affirm a diagnosis. The doctor takes a sample of the tumour, via a needle or an incision through the skin. Under a microscope, a qualified technician examines the tissue or cells. They will determine if the tumour is healthy or whether it is the result of a main or secondary cancer. They can even see how quickly it is growing.

Treatments

If your tumour is harmless, your doctor will either treat it with drugs or just monitor it for changes. They can remove benign tumours that have a higher chance of spreading or becoming cancerous. Tumours may reappear after treatment in certain situations.

Tumours that are cancerous need more aggressive monitoring and care by a variety of specialists. Your treatment can be determined by a number of factors, including the extent to which it has spread, which doctors use to assess the stage. Cancer cells that are only found in the bone tumour and its immediate surroundings are said to be “localised." More dangerous and difficult to handle are those that spread to or from other parts of the body.

Common treatments for bone cancer include:

  • Limb salvage surgery: Your doctor will surgically resect the cancerous portion of the bone but not the surrounding muscles, tendons, or other tissues. They replaced the bone with a metallic implant.
  • Amputation: Your doctor can remove a limb if a tumour is big or has reached your nerves and blood vessels. After that, you could get a prosthetic limb.
  • Radiation therapy: With the use of powerful X-rays, cancer cells are killed and tumours are shrunk. Doctors sometimes use it in conjunction with surgery.
  • Chemotherapy: Cancer medications are used to destroy tumour cells. It can be prescribed by the doctor prior to surgery, following surgery, or for metastatic cancer.
  • Targeted therapy: This treatment is used to treat cancer cells that have certain genetic, protein, or other differences in or around them.

You may be interested in participating in a clinical study that is evaluating new treatments.

Outlook

Treatments for bone cancer may trigger complications with the heart, lungs, brain, hearing, bones, or fertility over time. It's important to see a doctor on a frequent basis to keep an eye out for these symptoms and to ensure that the bone cancer doesn't return.

Your prognosis for bone cancer is determined by the condition and stage of the disease. More than 75% of those that have it survive for at least 5 years after being diagnosed.

Sources

Referenced on  2/5/2021

  1. AAOS: “Bone Tumor."
  2. National Cancer Institute: “Bone Cancer: Questions and Answers," “Primary Bone Cancer.”
  3. Bonetumor.org.
  4. https://www.webmd.com/cancer/bone-tumors 

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