Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another part of the body is more common. A Bone Cancer can be cancerous or benign. A cancerous tumor is malignant, meaning it can spread to other parts of the body. A benign tumor means the tumor will not spread. Even though a benign tumor does not spread outside the bone, it can grow large enough to press on surrounding tissue and weaken the bone. A malignant tumor can destroy the cortex and spread to nearby tissue. If bone tumor cells get into the bloodstream, they can spread to other parts of the body, especially the lungs, through a process called metastasis. (WATCH ANATOMY OF BONE VIDEO)
Types of Bone Cancer
There are three types of bone cancer:
- Osteosarcoma – occurs most often between ages 10 and 19. It is more common in the knee and upper arm. ( Watch Osteosarcoma Bone Cancer Video)
- Chondrosarcoma – starts in cartilage, usually after age 40. (Chondrosarcoma bone cancer video)
- Ewing’s Sarcoma – occurs most often in children and teens under 19. It is more common in boys than girls. ( Ewing’s Sarcoma Bone Cancer Video)
Bone Cancer Symptoms
When a bone tumor grows, it presses on healthy bone tissue and can destroy it, which causes symptoms, including: (Bone Cancer Surgery Video)
Pain. The earliest symptoms of bone cancer are pain and swelling in the area in which the tumor is located. The pain may come and go at first, then become more severe and steady later. The pain may get worse with movement, and there may be swelling in the soft tissue nearby.
- Joint swelling and stiffness. A tumor that occurs near or in joints may cause the joint to swell and become tender or stiff, which means a person may have a limited and painful range of movement.
- Limping. A break, also called a fracture, in the bone with the tumor may cause a pronounced limp if the leg is affected. This is usually a symptom of later-stage bone cancer.
- Other less common symptoms. Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low red blood cell level.
Diagnosis of Bone Cancer
Imaging tests, such as an x-ray, may be used to diagnose bone cancer and find out whether the cancer has spread. Benign and cancerous tumors usually look different on imaging tests. A benign tumor has round, smooth, well-defined borders. A cancerous tumor has irregular, poorly defined borders because of aggressive growth. There may also be evidence of bone destruction on an image of a cancerous tumor.
Although imaging tests may suggest a diagnosis of bone cancer, a biopsy will be performed whenever possible to confirm the diagnosis and find out the sub-type. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. It is extremely important for a patient to be seen by a sarcoma specialist before any surgery or a biopsy is performed.
Bone Cancer Stages
Following are the stages of Bone Cancer
- Stage IA: The tumor is low grade (G1 or G2) and 8 cm or smaller (T1). It has not spread to any lymph nodes or to other parts of the body (N0, M0).
- Stage IB: The tumor is low grade (G1 or G2) and larger than 8 cm (T2). It has not spread to any lymph nodes or to other parts of the body (N0, M0).
- Stage IIA: The tumor is high grade (G3 or G4) and 8 cm or smaller (T1). It has not spread to any lymph nodes or to other parts of the body (N0, M0).
- Stage IIB: The tumor is high grade (G3 or G4) and larger than 8 cm (T2). It has not spread to any lymph nodes or to other parts of the body (N0, M0).
- Stage III: There are multiple high-grade (G3 or G4) tumors in the primary bone site (T3), but they have not spread to any lymph nodes or to other parts of the body (N0, M0).
- Stage IVA: The tumor is of any size or grade and has spread to the lung(s) (any G, any T, N0, and M1a).
- Stage IVB: The tumor is of any size or grade and has spread to the lymph nodes (any G, any T, N1, and any M), or the tumor is of any size or grade and has spread to another organ besides the lung (any G, any T, any N, and M1b).
Bone Cancer Treatment
Descriptions of the most common treatment options for bone cancer are listed below. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.
- For a low-grade tumor, the primary treatment is surgery. The goal of surgery is to remove the tumor and a margin of healthy bone or tissue around the tumor to make sure all of the cancer cells are gone.
- For a high-grade tumor, oncologists often use a combination of treatments. These include surgery, chemotherapy, and radiation therapy.
Risk Factors for Bone Cancer
The following groups of people may be at a higher risk of developing bone cancer (risk factors):
- Being a child or very young adult – most cases of bone cancer occurs in children or young adults aged up to 20.
- Radiation Therapy. Patients who have received radiation therapy (radiotherapy).
- Paget’s disease. People with a history of Paget’s disease.
- Family History. People with a close relative (parent or sibling) who has/had bone cancer. Individuals with hereditary renoblastoma – a type of eye cancer that most commonly affects very young children.
- Li-Fraumeni syndrome. People with Li-Fraumeni syndrome – a rare genetic condition.
- Umbilical Hernia. Babies born with an umbilical hernia.
Bone Cancer Survival Rate
This is the percentage of people who are alive 5 years after a bone cancer diagnosis, whether they have few or no signs or symptoms of bone cancer, are free of disease, or are having treatment for bone cancer. The bone cancer survival rate is based on large groups of people, and it cannot be used to predict what will happen to a particular patient. No two patients are exactly alike, and bone cancer treatment and responses to treatment vary greatly. For all cases of bone cancer combined (in both adults and children), the 5-year relative survival is about 70%. For adults, the most common bone cancer is chondrosarcoma, which has a 5-year relative survival of about 80%.
- Almost everyone with a stage 1A bone cancer lives for more than 5 years. More than 95% of people with a stage 1B bone cancer live for more than 5 years.
- More than 60% of people with stage 2A bone cancer live for more than 5 years. Just over 40% of people with stage 2B bone cancer live for more than 5 years.
- Stage 3 Cancer is difficult to manage; the prognosis of this cancer is about 1 to 3 years subject to the patient’s tolerating the treatments.