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Bone Cancer: Symptoms, Diagnosis, and Treatment Options

Reviewed by: Dr. Jacob George

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Bone tumours can arise in various forms within the body. While the majority are benign and non-life-threatening, a tiny minority are malignant and may develop into bone cancer. In 2021 alone, an estimated 91,375 new cases of malignant neoplasms of the bone and articular cartilage were reported worldwide.

Primary bone cancers originate directly in the bone and most commonly affect children, adolescents, and young adults. Secondary bone malignancies, also known as bone metastases, happen when cancer spreads to the bones from other organs, such as the breast, prostate, or lungs.

In this blog post, we’ll take a closer look at the bone cancer symptoms, causes, diagnosis and treatment. 

 

What is Bone Cancer?

Bone cancer is a wide phrase that describes tumours that grow in the bone. These tumours can arise in any bone; however, they commonly appear in the thigh, shin bone, or upper arm. Cancerous bone tumours are a serious medical condition and require prompt treatment.
 

Types of Bone Cancer

The most common types of bone cancer are:

  • Osteosarcoma: It is the most common kind of bone cancer and begins in the cells that create new bone structures. This type of cancer is common among teenagers but may also develop in children and adults. They are fast-growing and more likely to spread.

  • Chondrosarcoma: The tumour grows in the connective tissue that allows bones and joints to move. These are common among adults over the age of 40 and grow very slowly.

  • Ewing sarcoma: The bone tumours develop in the bones and surrounding soft tissues. This condition impacts children, teens, and young adults. Ewing sarcoma tends to grow fast and is more likely to spread.

Other rare types of bone cancer

  • Fibrosarcoma: Tumours generally develop in the fibrous connective tissue around the end of the bone.

  • Chordoma: Tumours grow in the spine or base of the skull. Adults above 50 years are affected by this type of bone tumour. They are more likely to spread to the brain or spinal cord, making it more challenging to treat.

  • Undifferentiated pleomorphic sarcoma: They are an aggressive kind of tumours that grow in soft tissue and bone.

  • Giant cell tumour: The benign tumour can turn cancerous in some cases. 

Some bone cancers can be locally aggressive, affecting the blood vessels supplying the lymph, causing soft tissue damage and fluid retention, and thereby causing numbness.
 

What are the Bone Cancer Symptoms?

Some individuals do not experience any bone cancer symptoms but only feel a lump, while others can develop various symptoms. Often, the symptoms are mistaken for those of other conditions.

Bone cancer symptoms

The most common bone cancer symptoms include:

  • Bone pain that becomes persistent

  • A throbbing or stabbing discomfort that gets worse at night

  • Difficulty moving around

  • A lump in the afflicted region, firm or soft to touch

  • Unexplained swelling around the affected area

  • Fatigue 

  • Fever

Bone Cancer Causes

The specific reason for developing bone cancer remains unknown, although it has been found that damage to bone cell DNA can be a marker of bone cancer. If left untreated, cancer can spread to other regions of the body, resulting in deadly effects.

Bone cancer risk factors include benign bone problems and genetics. In some patients, the development of bone cancer from prostate cancer treatment is also a possibility. Cancers in the breast or lungs can spread to the bones.
 

Diagnostic Tests for Bone Cancer

An X-ray, CT scan, or MRI may be useful in identifying the presence of bone cancer. A biopsy helps confirm the diagnosis. During a biopsy, a tiny bit of bone tissue is removed and viewed under a microscope. The procedure provides detailed information on the cancer type and helps develop a treatment plan that works best. 

Bone Cancer Treatment

Surgery is the primary treatment for bone cancer, which involves removing the tumour. The most popular procedure is Limb-sparing Surgery, which entails removing the tumour and surrounding healthy tissue while leaving the limbs intact. Following the surgery, a real or artificial graft is used to rebuild the bone.

If the cancer has spread to the whole bone, the surgeon may remove the entire limb. In this case, a prosthesis (artificial limb) will be fitted after surgery. A prosthesis allows the affected individuals to continue to perform their daily activities as before. 

In addition to surgery, various adjuvant therapeutic options are performed, such as chemotherapy and radiation therapy. For metastatic cases, although chemotherapy is the primary option, radiation therapy and surgery may be done for palliative reasons. Chemotherapy and radiation therapy are also used in neoadjuvant cases to reduce the tumour size before surgery. 

Osteosarcoma treatment often involves Surgery and Chemotherapy. Chondrosarcoma is primarily treated with Surgery, but in rare cases, Chemotherapy may be performed. Ewing sarcoma is treated with Chemotherapy, Surgery, or Radiotherapy. For bone cancers like Ewing’s sarcoma and osteosarcoma, the recurrence rate can be as high as 90% if not treated with chemotherapy.
 

Conclusion

Bone cancer, while rare, can be life-threatening if not detected early. Recognising bone cancer symptoms like persistent bone pain or swelling and seeking timely medical advice from an expert oncologist is crucial. With advances in diagnosis and treatment, many forms of bone cancer are now manageable, especially when caught early. Visit Manipal Hospitals, Goa, for early screening and treatment for bone cancer.

Frequently Asked Questions

Unfortunately, there are no recognised strategies to minimise the risk of bone cancer. Individuals who are at high risk for developing bone cancers should discuss their concerns with a healthcare provider for better guidance.
 

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