Bone Cancer

Bone Cancer

Bone cancer is a disease in which cancer cells form in the tissues of the bone.

There are several different kinds of bone cancer, including:

· Benign (noncancerous)

· Malignant (cancerous)

· Cancers that start in the bone (primary bone cancer)

· Cancers that start somewhere else in the body and end up in the bone (secondary bone cancer).

Benign Versus Malignant

Bone tumors can be benign (noncancerous) or malignant (cancerous). Benign bone tumors are more common than malignant bone tumors. Although both types of bone cancer may grow and compress healthy bonetissue and absorb or replace it with abnormal tissue, benign tumors do not spread and are rarely life threatening.

Malignant Bone Cancer Types

The three malignant types of bone cancer are:

· Osteosarcoma

· Chondrosarcoma

· Ewing's sarcoma.

Osteosarcoma

The most common form of bone cancer is osteosarcoma, which develops in the new tissue of growing bones. Osteosarcoma is commonly diagnosed in people between the ages of 10 and 25. Common areas where this bone cancer type appears include the:

· Knees

· Upper legs

· Upper arms.

Chondrosarcoma

Chondrosarcoma is another type of bone cancer that develops in the cartilage. Chondrosarcoma is commonly diagnosed in people between the ages of 50 and 60. Common areas where this form of bone cancer appears include the:

· Pelvis

· Upper legs

· Shoulders.

Ewing's Sarcoma

Evidence suggests that Ewing's sarcoma, another form of bone cancer, begins in the immature nerve tissue in the bone marrow. Ewing's sarcoma is usually diagnosed in people between the ages of 10 and 20. Common areas where this bone cancer type appears include the:

· Pelvis

· Upper legs

· Ribs

· Arms.

Metastatic Bone Cancer

When cancer spreads (metastasizes) from its original place to another part of the body, the new tumor will have the same kind of abnormal cells and the same name as the primary tumor. For example, if bone cancer spreads to the lungs, the cancer cells in the lungs are bone cancer cells. The disease is metastatic bone cancer, not lung cancer, and it is treated as bone cancer, not as lung cancer. Doctors may call the new tumor "distant" disease.

Secondary Bone Cancer Types

Bone cancer that appears in the bone (primary bone cancer) is different from cancer that spreads (metastasizes) to the bone from another part of the body (secondary bone cancer). Secondary bone cancer is much more common than primary bone cancer. Common types of secondary bone cancer include:

· Breast cancer

· Lung cancer

· Prostate cancer.

Primary bone cancer is rare. In the United States, approximately 2,500 new cases are diagnosed each year.

What Causes Bone Cancer?

No one knows the exact causes of bone cancer, and doctors can seldom explain why one person will get bone cancer and another person will not. However, it is clear that this disease is not contagious and no one can "catch" bone cancer from another person.Bone cancer research has shown that people with certain risk factors are more likely than others to develop the condition. A risk factor is anything that increases a person's chance of developing a disease. While risk factors do not cause bone cancer, they may act together to increase a person's chances of developing it.

Know the Risk Factors

Specific risk factors for bone cancer include:

· Being a child or young adult

· Previous radiation or chemotherapy

· History of Paget's disease

· Family history of bone cancer

· People with hereditary retinoblastoma.

Bone cancer usually develops over time. As the cancer cells grow, the cells spread more deeply into the bone and to surrounding areas. When bone cancer spreads (metastasizes) outside the bone, cancer cells are often found in nearby lymph nodes, nerves, or blood vessels. If the cancer has reached the lymph nodes, it may spread to other organs. It is helpful to understand the progression of bone cancer in order to understand bone cancer symptoms, staging, and treatment.

Common Bone Cancer Symptoms

Pain is the most common bone cancer symptom. However, symptoms may vary, depending on the location and size of the bone cancer. Tumors that occur in or near joints may cause swelling, tenderness, and/or stiffness in the affected area. Bone cancer can also interfere with normal movements and can weaken the bones, occasionally leading to a fracture.

Other symptoms of bone cancer may include:

· Fatigue

· Fever

· Weight loss

· Anemia.

Diagnosing Bone Cancer

If a person has potential bone cancer symptoms, the doctor will need to perform a physical exam and ask about the patient's personal and family medical history. In order to make a diagnosis, the doctor will also recommend additional tests and procedures that examine the bones.

During the physical exam, the doctor will feel the affected area for any lumps or bumps. The medical history will entail questions about the patient's health habits and a family history of any medical conditions, past illnesses, and treatments.

Exams and Tests Used in Making a Diagnosis

Exams and tests that are used to make a bone cancer diagnosis may include:

· Blood tests

· X-rays

· Computed tomography (CT) scan

· Bone scan

· Magnetic resonance imaging (MRI) scan

· Angiogram

· Biopsy.

Bone Cancer Treatment

There are several treatment options that are available when treating bone cancer. They will vary based on:

· The type of bone cancer

· The stage of bone cancer

· Where the tumor is found and the size of the tumor

· The patient's age and general health.

Patients should work with their healthcare providers to develop a treatment plan that meets their medical needs and personal values. Choosing the most appropriate bone cancer treatment is a decision that ideally involves the patient, the family, and the healthcare team.

Getting a Second Opinion

Sometimes, it is helpful to have a second opinion about the bone cancer diagnosisand the bone cancer treatment plan. While some insurance companies require a second opinion, others may cover a second opinion if the patient or doctor requests it.

The doctor is the best person to describe the bone cancer treatment choices and to discuss the expected results of each treatment option. The doctor and the patient should work together to develop a treatment plan that fits the patient's needs.

Depending on the type and extent of bone cancer, treatment may include:

· Surgery

· Radiation therapy

· Chemotherapy

· A combination of these methods.

Surgery is often the primary treatment for bone cancer. Although amputation of a limb is sometimes necessary, chemotherapy has made limb-sparing surgery possible in many cases. When appropriate, surgeons avoid amputation by removing only the cancerous section of the bone and replacing it with an artificial device called a prosthesis.

Chemotherapy and bone cancer radiation may be used alone or in combination. Ewing's sarcoma tends to metastasize rapidly, which is why multidrug chemotherapy is often used, in addition to radiation therapy or surgery on the primary tumor.

Side Effects of Treatment

Treating bone cancer may damage healthy cells and tissues, which can lead to unwanted side effects. Specific side effects will depend on many factors, including the type and extent of the bone cancer treatment. Side effects may not be the same for each person, and they may even change from one bone cancer treatment session to the next. Healthcare providers should explain the possible side effects and ways to manage them before treatment for bone cancer begins.

Depending on the type of bone cancer, some treatments can cause side effects that continue or that appear years after treatment has ended. These are called late effects. Late effects of bone cancer treatment may include:

· Physical problems

· Changes in mood, feelings, thinking, learning, or memory

· Having second cancers (new types of cancer).

Some late effects may be treated or controlled.

Types of Alternative Treatment for Bone Cancer

Alternative bone cancer treatment methods can include:

· Acupuncture

· Massage therapy

· Herbal products

· Vitamins or special diets

· Visualization

· Meditation

· Spiritual healing.

Many people say that these approaches help them feel better. However, some types of alternative treatment may interfere with standard treatment, and combining alternative treatment for bone cancer with standard treatment may even be harmful. It is important to note that some types of alternative treatments are expensive, and health insurance may not cover the cost of alternative treatments.

Alternative Pain Treatment

Pain is a potential problem for people with bone cancer. It can be caused by a tumor that is pressing against nerves and other organs, or pain can be caused by the treatment for bone cancer itself.

The patient's doctor or a specialist in pain control can relieve or reduce pain in several ways, including:

· Pain medicine

· Radiation

· Nerve block.

The healthcare team may also suggest alternative treatment for pain, such as:

· Massage

· Acupuncture

· Acupressure.

Patients may also learn to relieve pain through relaxation techniques, such as listening to slow music or breathing slowly and comfortably.

Recommendations

Patients should discuss the potential benefits and harmful effects of alternative treatment forbone cancer with their doctor prior to trying them. Questions that patients may want to ask their healthcare provider include:

· What benefits can I expect from this approach?

· What are its risks?

· Do the expected benefits outweigh the risks?

· What side effects should I watch for?

· Will this alternative treatment change the way my bone cancer treatment works?

· Could this alternative treatment be harmful?

· Is this approach under study in a bone cancer clinical trial? If so, who sponsors the trial?

· Will my health insurance pay for this approach?

Factors Influencing the Bone Cancer Survival Rate

In general, the bone cancer survival rate will depend on:

· The size, the location, and the type of bone cancer

· The bone cancer stage (how far the cancer has spread)

· How long the patient has had symptoms

· How much of the cancer is taken out by surgery and/or killed by chemotherapy

· The patient's age, blood, and other test results

· The patient's general health.

Bone Cancer Survival Rate Based on Stage

The bone cancer stage plays a role in the bone cancer prognosis. Based on historical data:

· 41 percent of bone and joint cancer cases are diagnosed while the cancer is still confined to the primary site (localized stage)

· 36 percent of bone and joint cancer cases are diagnosed after the cancer has spread to regional lymph nodes or directly beyond the primary site

· 15 percent of bone and joint cancer cases are diagnosed after the cancer has already metastasized (distant stage)

· 8 percent of bone and joint cancer cases had staging information that was unknown.

The corresponding 5-year relative bone cancer survival rates were:

· 84.5 percent for localized

· 69.4 percent for regional

· 30.6 percent for distant

· 62.2 percent for unstaged.

Overall Bone Cancer Survival Rate

Survival rates can be calculated by different methods for different purposes. The survival rates presented here are based on the relative survival rate. The relative survival rate measures the survival of bone cancer patients in comparison to the general population to estimate the effect of cancer. The overall 5-year relative bone cancer survival rate for 1995-2001 was 69.4 percent.

The 5-year relative bone cancer survival rates by race and sex were:

· 67.5 percent for Caucasian men

· 72.1 percent for Caucasian women

· 70.0 percent for African-American men

· 68.4 percent for African-American women.

Bone Cancer Research

Bone cancer research scientists are currently studying surgery, radiation therapy, chemotherapy, and combinations of these treatments. In order for bone cancer research to be conducted, volunteers are needed. Although bone cancer research trials may pose some risks, scientists take careful steps to protect their patients, who can have the first chance at benefiting from promising, new treatments.