What is Bone Cancer?

Bone cancer is a rare cancer that begins in a bone, most frequently within an arm or leg bone. There are several types of bone cancer, some are more common in children while others primarily affect adults. Primary bone cancer doesn’t include cancers that have spread to the bones from other parts of the body.

The most common types of primary bone cancer include:

• Osteosarcoma, in which tumors arise from osteoid tissue in the bone, most often in the knee and upper arm. This type is most often found in children and young adults.
• Chondrosarcoma, which begins in cartilage that pads the ends of bones and lines the joints. Chondrosarcoma occurs most often in the pelvis, upper leg and shoulder. This type typically occurs in middle-aged and older adults.
• Ewing sarcoma tumors usually occur in bone but may also arise in soft tissue, like muscle, fat, fibrous tissue or blood vessels. Researchers believe Ewing sarcoma tumors arise from primitive nerve tissue in the bone or soft tissue. They most commonly occur along the backbone and pelvis and in the arms and legs. This type is most common in children and young adults.
• Chordoma, a type of bone cancer that usually starts in the lower spinal cord.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of bone cancer. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Bone cancer symptoms can vary from mild to severe and include:

• Anemia
• Bone pain
• Broken bone
• Fatigue
• Swelling or tenderness
• Unintended weight loss

Diagnosis

We use advanced diagnostic procedures and technology to effectively diagnose, stage, inform treatment and carefully monitor bone cancer. Common diagnostic procedures can include:

Angiogram: This test uses X-rays to examine blood vessels.

Biopsy: During a biopsy, a sample is removed from the tissue or tumor for laboratory testing. Testing can tell the physician whether the tissue is cancerous and, if so, what type of cancer is present. Testing will also reveal the cancer’s grade and its potential to become aggressive. This can be performed with a needle or through a surgical procedure.

Bone scan: During a bone scan, a small amount of radioactive material is injected into a blood vessel, travels through the bloodstream, collects in the bones and is detected by a scanner.

Computed tomography (CT) scan: During this test, a series of detailed pictures, taken from different angles, are created by a computer linked to an x-ray machine.

Magnetic resonance imaging (MRI): This test uses a large magnet, radio waves and a computer to produce pictures of the bones.

Positron emission tomography (PET) scan: This imaging test uses a radioactive substance called a tracer to look for disease in the body.

X-ray: An X-ray can show the location, size and shape of a bone tumor. If X-rays suggest that an abnormal area may be cancer, the physician is likely to recommend other imaging tests.

Causes

Bone cancers arise from an error in a cell’s DNA that cause a tumor to grow. Behaviors and lifestyle factors do not contribute to the tumor’s development.

Risk Factors

Risk factors that can contribute to bone cancer include:

Genetic syndromes: Certain rare syndromes passed through families, including Li-Fraumeni syndrome and hereditary retinoblastoma, increase the risk of bone cancer.

Paget’s disease of bone: In older adults, Paget’s disease of bone – a chronic disorder that can causes enlarged and misshapen bones – may increase the risk of bone cancer development.

Radiation therapy: Exposure to large doses of radiation increase the risk of developing bone cancer.

Chemotherapy: Chemotherapy for treatment of other cancers may cause bone cancer.

Hereditary disease: People with osteochondromas (benign bone tumors) may be at risk for bone cancer.

Prevention

No known lifestyle changes can prevent bone cancers.

Prognosis

For all bone cancers combined, the five-year survival rate is about 70 percent. This varies by cancer type, grade and stage. For osteosarcomas and Ewing sarcomas that are still localized, the five-year survival rate is between 60 and 80 percent. If the cancer has spread to distant parts of the body, the five-year survival rate is about 15 to 30 percent, with higher survival if it has only spread to the lungs. The five-year survival rate for chondrosarcomas is approximately 80 percent.

Treatment and Recovery

Bone cancer treatment depends on a person’s age and overall health, the type of cancer and whether it has spread to other parts of the body. Your treatment will require different types of cancer care specialists who will work together to formulate your treatment plan. Common treatments include:

Chemotherapy

Special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream.

Radiation Therapy

High-energy radiation is administered to the affected bone in order to kill cancer cells. Most often, radiation treatments are given five days a week for several weeks.

Surgery

The goal of surgery is to remove all bone cancer. Depending on the cancer’s location, type and stage, this may include:

• Surgery to remove cancer but spare the limb: In this case, the surgeon replaces lost bone with bone tissue from another area of the body or from a donor, or replaces it with a special metal prosthesis.
• Surgery to remove a limb: Bone cancers that are very large or located in a complicated place may require surgery to remove all or part of a limb. Most patients will receive a prosthetic device and therapy after surgery.
• Surgery for cancer not affecting the limbs: In this case, the surgeon preserves as much healthy bone as possible and replaces lost bone with bone tissue from another area of the body or from a donor, or replaces it with a special metal prosthesis.

Complications

Complications of bone cancer can stem from the cancer itself or its treatments. Complications of planned treatments will be addressed by your treatment team.