Bone Cancer

Bone tumors are comparatively uncommon, constituting only 0.5% of the total world cancer incidence. Bone cancer, a disease characterized by the uncontrolled growth of cells of the bone. It occurs when a tumor, or abnormal mass of tissue, forms in a bone. Bone cancer is rarer than most types of cancer, the risk is highest for those between 10 and 30 years of age, particularly during a teenage growth spurt. This could mean a link between rapid bone growth and the risk of developing tumors. The risk does decrease with middle age but again rises in older adults.

Types of Bone Cancer

Primary bone cancers are the most serious of all bone cancers. They form directly in the bones or surrounding tissue, such as cartilage
Cancer can also spread, or metastasize, from another part of your body to your bones. This is known as secondary bone cancer, and this type is more common than primary bone cancer.
Common types of primary bone cancers include:
- 1. Osteosarcoma- It arises in new tissue in growing bones. This is the most common type of bone cancer. It occurs most often in teens.
- 2. Chondrosarcoma- It arises in cartilage.
- 3. Ewing's sarcoma- It may arise in immature nerve tissue in the bone marrow.

Causes

The cause of bone cancer isn't exactly known, but certain factors may contribute to or increase a person’s chances of forming abnormal growths in the bone. These include:

Abnormal cellular growth
Radiation therapy

Risk factor

While doctors are yet to research the exact reason for bone cancer, certain risk factors have been associated with bone cancers.

Age
Having a family history of cancer, especially bone cancer
Having received radiation treatment or therapy in the past
Having Paget's disease, which is a condition that causes the bones to break down and then grow back abnormally
Currently or previously having had multiple tumors in the cartilage, which is the connective tissue in the bone.

Signs & Symptoms

The signs of bone cancer depend on where and how large the cancer is. Common signs include:

Pain in the bone and swelling. This is sometimes worse at night. Pain relievers don't reduce the pain.
Unexplained fractures due to weakened bones
Fatigue
Fever
Weight loss
Anemia
Difficulty moving

Diagnosis

Bone cancer is usually diagnosed based on the patient's symptoms, physical examination, imaging and other tests.

Physical Exam- In cases of bone cancer, the physical examination that a doctor performs will be essentially normal except perhaps for the “soft tissue mass” that may be felt at the primary site of cancer. This might be detectable as a lump, mound, or swelling extending out from the bone.
Biopsy- In the case of a bone biopsy, a small piece of the tumor will be removed and examined under a microscope. It's considered a simple surgery, usually performed under a general anesthetic, and you will be talked through it before and during the procedure. The biopsy will reveal if cancerous cells are present in the bone.
Imaging tests – Radiological imaging is one of the best early, non-invasive methods of a cancer diagnosis. It produces images of areas inside your body that help the doctor spot whether a tumor is present. These images can be made through various ways such as X-ray, Ultrasound, CT scan, MRI, bone scan, and PET scan. Imaging test can help show the spread of osteosarcomas to the lungs, other bones, or other parts of the body, and can also help in seeing how well the cancer is responding to treatment.

Management

The treatment options of bone cancer are based on the type of cancer, the stage of cancer, patient’s general health. Different bone cancers respond to different treatments, for example, some bone cancers are treated through surgery; some with a combination of surgery and chemotherapy; while some with surgery, chemotherapy, and radiation therapy.

Chemotherapy- Primarily, chemotherapy uses the drugs to destroy the cancerous cells. Chemotherapy drugs are usually delivered through a vein. A few of its primary functions are to starve cancer cells, impede their cell division, and trigger their suicide. While side effects remain, there is an attempt to research drugs that will minimize adverse effects, which are, nausea, weakness, fatigue, bowel-related issues, and blood-related issues, etc.
Radiation Therapy- In Radiation therapy, the cancer cells are destroyed using high-powered energy radiations.Radiation therapy is used in patients with bone cancer that cannot be removed through surgery. After surgery, radiation therapy may be used to kill any remaining cancer cells.

Surgery- The goal of surgery is to remove the cancerous tumor completely. In most cases, this involves special techniques to remove the tumor in one single piece, along with a small portion of healthy tissue that surrounds it.
Stem-Cell Transplants- When Ewing sarcomas are not particularly sensitive to chemotherapy, it may require radiation therapy and perhaps even stem-cell transplants. Stem cell transplants kill bone marrow cells of the affected region, and new cells are induced through the veins to replace destroyed cells through a blood transfusion. Eventually, these new cells adapt to settling down to make healthy bone cells. This process is known as engrafting.
Targeted Therapies- Targeted uses drugs to treat cancers but is different from conventional chemotherapy. It works by targeting specific proteins and genes to impede the growth and spread of cancer.

Follow-Up

Follow up after treatment, you will need check-ups every 3–12 months for several years to confirm that cancer hasn't come back and to help you manage any treatment side effects.

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