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Bone Cancer: Causes, Symptoms, Types, Stages and Treatments

Commonly asked questions about bone cancer:

What is Bone Cancer?

Bone cancer is a rare form of cancer that forms in the cells of bones. It can occur in any part of any bone in the body. Cancer begins when the healthy cells in the bone begin to change and grow out of control turning into a tumor.

What are the Types of Bone Cancer?

CancerCenter.com breaks up bone cancer into six types of primary bone cancer. These primary bone cancers are part of a subgroup known as sarcomas. Sarcomas can be found anywhere in the body and can begin forming in bones, muscles, connective tissue, blood vessels or fat.

  • Osteosarcoma: Is the most common of the six primary types of bone cancer. It usually begins in the bone cells of the arms, legs or pelvis.
  • Chondrosarcoma: The second most common form of bone cancer, and generally starts to form in the cartilage cells of the bone.
  • Ewing tumor: Typically starts in bone and is considered unusual due to the fact that it has also been known to start in other tissues and muscles.
  • Fibrosarcoma and malignant fibrous histiocytoma: Will normally begin forming in the soft tissue around the bones, such as tendons, ligaments, fat or muscle.
  • Giant cell tumor of bone: Often begins in the leg bones and rarely spreads to distant parts of the body. This type of cancer has a chance of returning after a surgical removal, and will become more likely to spread to other parts of the body with each occurrence.
  • Chordoma: The rarest of the six primary types of bone cancer, it will begin in the spine and the base of the skull. It is usually a slow-growing tumor, but also has a chance to reappear if not fully removed through surgery. If it reappears it has a chance of spreading to the lungs, liver or lymphnodes.

What are Risk Factors Associated with Bone Cancer?

The main cause of bone cancer is unknown. However, factors that increase a persons risk of developing bone cancer have been identified. CancerCenter.com and the American Cancer Society have identified several risks that may cause a person to get bone cancer and have broken them down into three main categories:

  • Genetic disorders: There are several genetic mutations that have been known to cause several types of bone cancer.
    • Li-Fraumeni Syndrome, Rothmund-Thompson syndrome and mutation of the retinoblastoma gene have all been associated with children having an increased risk of developing osteosarcoma.
    • Multiple osteochondromas syndrome is a form of inherited condition linked to the formation of bumps on the cartilage on bones and has been associated with an increased risk of chondrosarcoma.
    • Some osteosarcomas and chordomas have been found to be hereditary, however, the genetic mutation has yet to be identified.
  • Previous treatment: Certain previous surgeries or treatments have been linked to the development of bone cancer.
    • Radiation: Small amounts of radiation, such as the amount used for a typical x-ray are harmless, however, oftentimes bone cancer develops in an area that has been exposed to large amounts of radiation. Large amounts of radiation may be absorbed into the bone when using radiation to treat a different form of cancer.
    • Bone marrow transplant: Individuals who have gone through a bone marrow transplant may be at an increased risk of developing bone cancer.
  • Other conditions:
    • Paget’s disease: Is a non-cancerous condition that causes the bones to become thick and brittle. When bones are brittle it is considered a bone cancer risk factor. This disease has been responsible for the development of bone cancer in roughly one percent people diagnosed with bone cancer.
    • Multiple enchondromatosis: Patients with many benign cartilage tumors, known as enchondromas, are at an increased risk for developing bone cancer.

What are the Symptoms of Bone Cancer?

There are multiple symptoms that can occur as bone cancer develops and grows. Bone cancer has the potential to occur in any of the bones in the body, however, it is known to occur most often in the long bones of the arms and legs.

  • Bone pain/swelling: The most common symptom of bone cancer is pain around where the tumor is growing. The pain may only be noticeable at certain times or only when you are active, however, the pain will become more persistent over time as the tumor grows. You may notice swelling around the area where the pain is located, it may even form a lump or mass depending on where the tumor is located.
  • Fractures: Cancerous cells can cause a bone to weaken, which may result in a fracture. Most of the time patents describe a sudden or sever pain in the area that had previously been sore.
  • Decreased mobility: If the tumor is near a limb or joint it has the ability to make normal movements difficult.
  • Other symptoms: Unintended weight loss, fatigue due to pain or difficulty breathing may occur if the tumor has spread to other areas.

What are the Stages of Bone Cancer?

CancerCenter.com has identified a list of the four different stages of bone cancer, as well as the system used to diagnose the stage. Staging guidelines were put into place by the American Joint Committee on Cancer (AJCC), and is often referred to as the Tumor, Node and Metastasis (TNM) System.

  • TNM system: The TNM system is often used to help stage various kinds of cancer, but is also used to stage bone cancer.
    • T: “T” describes the tumors size.
    • N: “N” is used to indicate if the cancer cells have spread into the regional lymph nodes.
    • M: “M” indicates whether the cancer has spread to far areas of the body.
    • G: “G” Grades refer to how abnormal the cells look under a microscope.
  • Stage I: The cancer cells are still confined to the bone, and the tumor is considered a low grade. There are two sub categories that stage I is split into.
    • Stage IA: Tumor is less than 8 cm in size.
    • Stage IB: The tumor is larger than 8 cm in size or is located in several places in the same bone.
  • Stage II: The cancer cells are still confined to the bone, and the tumor is considered high grade.
    • Stage IIA: The main tumor is less than 8 cm in size.
    • Stage IIB: The main tumor is larger than 8 cm in size.
  • Stage III:Bone cancers in this stage are considered high grade and have spread to several places throughout the same bone.
  • Stage IV:In this stage the cancer has spread outside of the main bone and into other parts of the body. This stage of bone cancer can be broken down into two sub-categories.
    • Stage IVA: Bone cancer cells have spread, but only into the lung.
    • Stage IVB: Bone cancer cells have been found in near by lymph nodes or other organs aside from the lungs.

Is Bone Cancer Curable?

Yes, bone cancer is curable.

What is the Survival Rate of Bone Cancer?

Bone cancer survival rates are quite high for both adults and children. The following statistics were gathered from the American Cancer Society and are based on five-year survival rates for both children and adults.

Survival RatePercent
All cases of bone cancer in adults and children70%
Adults with chondrosarcoma80%

What Treatment Options are Available for Bone Cancer?

The American Cancer Society states that the four main types of treatment for bone cancer are: surgery, radiation, chemotherapy, and targeted therapy.

  • Surgery: Surgery is the main treatment for most kinds of bone cancer. Surgery might also be needed in order to obtain a biopsy of the cancer. Surgery is mainly used to remove all cancer cells in the area, if even a few cancer cells are left behind it may allow the cancer to re-grow.
  • Radiation: Involves using high energy rays to kill cancer cells, the rays are administered by a machine outside of the body. Radiation has advanced to several other forms that have become more successful at killing the cancer cells.
    • Intensity-modulated radiation therapy: Is an advanced form of external radiation beam therapy. This version allows the machine to change the size and shape of the beams so that it matches the size of the tumor. This makes it so less radiation goes through one area of tissue helping to prevent radiation damage.
    • Proton beam radiation:  A special form of radiation that utilizes proton beams instead of regular x-rays to kill cancer cells. Proton beams cause very little damage to skin cells as they pass through, but are very good at killing cells at the end of their path.
  • Chemotherapy: Uses drugs to kill the cancer cells, chemotherapy may be given by pill or administered by needle into the vein or muscle.
  • Targeted therapy: Newer drugs have been developed that are called targeted therapy drugs. They are drugs that are used to specifically target some of the changes in cells that cause cancer.

How to Prevent Cancer

Cancer prevention can vary based on different research, and opinionated studies or news reports. However, these simple lifestyle changes can make a difference in the prevention of developing or forming cancer:

  1. Eat healthy
  2. Limit or stop your use of tobacco
  3. Have a balanced lifestyle
  4. Avoid risky behavior
  5. Visit your doctor
  6. Immunization
  7. Protect your skin from the sun

What Drugs are Used to Treat Bone Cancer?

The American Cancer Society lists the drugs that are normally used to combat bone cancer.

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View Sources

  1. Bone cancer stages – CancerCenter.com
  2. Bone cancer risk factors – CancerCenter.com 
  3. Bone cancer types – CancerCenter.com
  4. What are the risk factors for bone cancer – American Cancer Society
  5. Survival statistics for bone cancer – American Cancer Society
  6. How is bone cancer treated – American Cancer Society
  7. Doxorubicin – Chemocare.com
  8. Cisplatin – Chemocare.com
  9. Carboplatin – Chemocare.com
  10. Etoposide – Chemocare.com
  11. Ifsoamide – Chemocare.com
  12. Cyclophosphamide – Chemocare.com
  13. Methotrexate – Chemocare.com
  14. Vincristine – Chemocare.com

Resources

Hawkins M, Wilson M, Burton H, Potok M, Winter D, Marsden B, Stovall M. Radiotherapy, Alkylating Agents, and Risk of Bone Cancer After Childhood Cancer, 1996, JNCI J Natl Cancer Inst, 88(5), 270-278

Evans H, Ayala A, Romsdahl M, Prognostic factors in chondrosarcoma of bone. A clinicopathic analysis with emphasis on histologic grading, 1977, TOC, Volume 40 issue 2, 818-831

Honroe P, Luger N, Sabino M, Schwei M, Rogers S, Mach D, O’keefe P, Ramnaraine M, Clohisy D, Mantyh P, Osteoprotegerin blocks bone cancer-induced skeletal destruction, skeletal pain and pain-related neurochemical reorganization of the spinal cord, 2000, Nature Medicine, 6, 521-528