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Bone Cancer: Symptoms, Causes, Diagnosis, and Treatment

Bone cancer occurs when a tumor or abnormal cells grow uncontrollably in the bone. This cancer can affect any bone.

Bone Cancer: Symptoms, Causes, Diagnosis, and Treatment

Bone cancer occurs when a tumor or abnormal cells grow uncontrollably in the bone. This cancer can affect any bone but is more common in the pelvis or the long bones of the arms and legs.

According to information from the American Cancer Foundation, bone cancer is one of the six types of cancer that often attacks children in the country (besides leukemia, retinoblastoma, neuroblastoma, lymphoma, and nasopharyngeal carcinoma). The prevalence of bone cancer in America, especially in children, has continued to increase since 2010.

According to the National Cancer Institute (NCI), bone cancer is a fairly rare type of cancer and the cases are less than 1 percent. Even so, we still need to be vigilant because it can be fatal if the sufferer does not receive proper treatment and is already in a severe stage.

Causes of Bone Cancer

The main cause of bone cancer is still not known with certainty. However, several factors can trigger the growth of abnormal cells in the bones. As reported by Healthline, here are some factors that can trigger the growth of abnormal cells in bones:

  • Abnormal cell growth: abnormal cells continue to grow and form a mass of tissue that turns into a tumor, while healthy cells die after continuing to divide and replace old cells.
  • Radiation therapy: radiation therapy, which is often used to kill cancer cells, turns into a cause of bone cancer because radiation is used in high doses. Osteosarcoma, which is a type of bone cancer, can form due to radiation therapy.

Types of Bone Cancer

There are two types of bone cancer, namely primary bone cancer and secondary bone cancer.

In primary bone cancer, cancer develops in the bone cells. While in secondary bone cancer, the development of cancer in the bones comes from other places in the body, for example, lung cancer that spreads to the bones.

Although many types of cancer can spread to the bones, patients with breast cancer, prostate cancer, and lung cancer have a higher risk of developing secondary bone cancer.

According to data from the NCI, primary bone cancer accounts for less than 1 percent of all cancers. Secondary bone cancer is more common than primary bone cancer.

However, cases of primary bone cancer are generally much more serious. This type of cancer forms in bone or surrounding tissue such as cartilage. As explained on the Cleveland Clinic page, primary bone cancer is divided into four types, namely:
  1. Osteosarcoma: is the most common type of bone cancer, osteosarcoma develops in the cells where new bone tissue is formed. It can start in any bone but usually starts at the ends of large bones such as the arms and legs. This cancer is most often diagnosed in children and adolescents.
  2. Ewing's sarcoma: Ewing's sarcoma includes many different tumors that are of similar quality and are believed to originate in the same cell type. These tumors can form in the bone and surrounding soft tissue. Ewing's sarcoma most often grows on the hips, ribs, and shoulder blades, or long bones such as the legs.
  3. Chondrosarcoma: chondrosarcoma begins in cartilage, which is the soft connective tissue that allows movement between bones and joints. Some cartilage becomes bone when the body accepts calcium into it. These cancers usually form in the arms, legs, or pelvic bones. Unlike osteosarcoma and Ewing's sarcoma, which are more common in children and young people, chondrosarcoma occurs more frequently in adults.
  4. Chordoma: This rare tumor starts in the spine, usually at the base of the spine or base of the skull. Like chondrosarcoma, chordoma is most common in older adults. Men are more likely to develop this type of bone cancer than women.

Symptoms of bone cancer

Symptoms of bone cancer that are generally first felt are intense and disturbing pain in the area that is attacked by cancer. Over time, the pain sensation will worsen and be accompanied by other symptoms.
Other common symptoms of bone cancer may include:
  • Pain and swelling in the affected bone
  • Hard palpable mass in the long bones of the leg
  • Feeling tired
In addition to the above symptoms, people with bone cancer may also experience weight loss and fractures easily. However, these two symptoms are less common than the others.

Bone cancer risk factors

It is not yet clear what causes bone cancer, but doctors have found several factors associated with an increased risk, including:
  • Inherited genetic syndromes: certain rare genetic syndromes that run in families can increase the risk of bone cancer, including Li-Fraumeni syndrome and hereditary retinoblastoma.
  • Paget's disease of bone: this is most common in older adults, and it can increase the risk of bone cancer developing later in life.
  • Radiation therapy for cancer: exposure to large doses of radiation, such as that given during radiation therapy for cancer, increases the risk of future bone cancer.

Diagnosis

In the diagnosis process, the doctor will ask about the patient's medical history and specific symptoms. A physical examination and blood tests will also be performed, as well as recommendations for several other tests to confirm the diagnosis.
Here are some of the types of tests your doctor may recommend:
  • Radionuclide bone scan or bone scintigraphy: these tests can show whether cancer has spread to other parts of the bone. In addition, this test is also able to identify smaller areas of metastatic cancer than X-rays.
  • CT scan: this test can show whether cancer has spread and how far it has spread.
  • MRI: this type of scan can give a general picture of the tumor.
  • PET scan: can be useful for scanning all parts of the body for the presence of cancer.
  • X-rays: this method can generally detect the presence of bone cancer. In addition, a chest X-ray can also show whether cancer has spread to the lung area.
To determine the stage of the tumor and determine whether the tumor is benign or malignant, the doctor may recommend a biopsy. A biopsy is a procedure of taking a small portion of tissue from a patient's body which will later be tested in a laboratory under a microscope.

Treatment

Treatment for bone cancer depends on the type of cancer, whether it has spread, and if so, where. Treatment usually involves several specialists, such as cancer specialists (radiation oncologists and radiation oncologists) and bone and joint specialists (orthopedic surgeons).

Bone cancer treatment usually involves a combination of approaches. The type and duration of treatment varies, depending on several factors, including the type of bone cancer, the size of the tumor, and whether it has spread to other parts of the body. The most commonly used treatments include:
  1. Surgery: the surgeon will remove the tumor and some of the healthy tissue around it. They can also repair or rebuild the affected bone with real or artificial bone grafts. Sometimes, the entire hand or foot must be removed to treat cancer. In this case, an artificial limb (prosthetic) can be used. Sometimes repeat surgery is needed if all the cancer cells are not removed successfully at the first surgery.
  2. Radiation therapy: this treatment shrinks the tumor with high doses of X-rays. This therapy is often done before surgery to shrink the tumor so that less tissue has to be removed.
  3. Chemotherapy: this type of treatment aims to kill cancer cells throughout the body with drugs. Chemotherapy drugs can be given in pill form or injected into a vein. Doctors may use chemotherapy to treat primary bone cancer or bone cancer that has spread.
The patient's recovery from bone cancer depends on the type of stage. However, overall, more than 75 percent of patients survive at least 5 years after diagnosis.

For example, according to the American Cancer Society (ACS), patients with chondrosarcoma that has not spread have a 91 percent chance of survival 5 years after diagnosis.

However, if cancer has spread to other parts of the body more distant, for example to the lungs, the 5-year survival rate is reduced to 33 percent.

Early detection and treatment are important keys. If you experience the symptoms mentioned above, especially if there is a history of cancer, especially bone cancer in the family, don't wait to see a doctor. If detected early, the chances of successful cancer treatment will be higher.
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