Bone cancer refers to malignant tumours that develop in the bones. It can either originate in the bone (primary bone cancer) or spread from other organs (metastatic bone cancer).
Types of Bone Cancer
- Osteosarcoma: Most common in children and young adults; arises from bone-forming cells.
- Ewing Sarcoma: Occurs in children and teenagers; typically affects long bones.
- Chondrosarcoma: Develops in cartilage cells; more common in adults over 40.
- Multiples Myeloma: Cancer of plasma cells in bone marrow.
- Malignant Fibrous Histiocytoma: Rare soft tissue tumour that can involve bone.
Symptoms of Bone Cancer
- Persistent bone pain that worsens at night or with activity
- Swelling or lump near the affected area
- Weakened bones leading to fractures
- Fever, fatigue, weight loss (in advanced cases)
- Limited range of motion if near a joint
Causes and Risk Factors
The exact cause is unknown, but risk factors include:
- Rapid bone growth during adolescence
- Previous radiation therapy
- Certain genetic syndromes (e.g., Li-Fraumeni syndrome, Retinoblastoma)
- Benign bone conditions like Paget’s disease
Diagnosis
Involves imaging (X-ray, MRI, CT, PET scan) and biopsy to confirm cancer type. Blood tests may also be used (e.g., alkaline phosphatase levels).
Treatment Options
Depends on the type, size, location, and stage of cancer, as well as the patient’s age and overall health.
Surgery
Goal is complete removal of the tumour while preserving limb function. Limb-salvage surgery is now preferred over amputation in most cases. Reconstructive techniques may involve metal implants or bone grafts.
Chemotherapy
Used before surgery (neoadjuvant) to shrink tumours and after (adjuvant) to kill remaining cells. Essential for osteosarcoma and Ewing sarcoma.
Radiation Therapy
Used when surgery isn’t possible or to treat residual disease. Also helpful for pain relief in metastatic cases.
Targeted Therapy & Immunotherapy
Emerging options for specific subtypes. Denosumab is used for giant cell tumour of bone. Clinical trials are ongoing.
Prognosis
With modern treatments, 5-year survival rates exceed 60–70% for localized primary bone cancers. Metastatic disease has a poorer prognosis but can be managed palliatively.