Bone cancer is a rare cancer that develops in bone cells. As the supporting frame of the body, the bones provide its structure and shape, act as pins for the muscles to produce movement and protect internal organs. Most of the bones are hollow and include a hard external part, a spongy internal tissue containing bone marrow (which produces and stores blood cells) and cartilage at each end of the bone (serves a cushion between bones). Despite its solid appearance, the bone is a very active tissue that is constantly found in the process of modification and regeneration. The bone itself contains three main types of cells that control this process: Osteoblasts (the new bone), osteocytes (help to maintain the bone), and osteoclasts (break down bone tissue). A cancer that originates from the bones (known as primary bone cancer) is different from cancer that begins in another part of the body and spreads (or sends metastases) to the bone (known as secondary bone cancer). Although it can occur in any bones of the body, primary bone cancer often occurs in the long bones of the arms and legs.
Primary bone cancer
The four most common types of primary bone cancer are:
- Multiple myeloma - the most common bone cancer. This is a malignant tumor that originates in plasma in the bone marrow and can affect any bone. Multiple myeloma accounts for 1% of all cancer cases, and it occurs in about 1 of 22,000 people a year in the United States. The most common treatment includes anti-cancer preparations that are going through the bloodstream. Chemotherapy and stem cells therapy are also effective with certain types of multiple myeloma. Radiation is sometimes used to treat bone lesions. Surgery is often required to stabilize the bone before or after a fracture is caused due to this cancer.
- Osteosarcoma - malignant bone tumor that often develops during puberty. Osteosarcomas develop from osteoblasts (cells that make up new bone tissue). Osteosarcoma is the most common bone tumor, usually affecting children. The average age at diagnosis is 15. The incidence of this malignancy is similar in boys and girls until late puberty, and after that it is more common in boys. This is a type of tumor that grows in osteoblasts, usually on the ends of the long bones of the leg. Other common locations include the waist and the shoulder.
Osteosarcoma is often treated with a combination of therapies that can include tumor removal, chemotherapy, and radiation therapy.
- Ewing’s sarcoma - the most common form of malignancy in children. These tumors often develop in the upper and lower legs, pelvic bones, or long bones (arm or femur), pelvis, upper arm and ribs. This tumor usually affects children and adolescents aged 10 and 20. This bone malignancy also requires multiple treatment methods, including surgery and chemotherapy, and sometimes even radiotherapy. Neoadjuvant chemotherapy and surgical alternatives confirm curing th e disease
- Chondrosarcoma - cancer that starts in the bones and produces abnormal malignant cartilage anywhere in the body, usually in the hip, pelvis or arm. Most people who develop chondrosarcoma are aged 20 and above. Surgical is a typical treatment for this rare bone tumor. It often affects the hands or the pelvis. While chemotherapy was not proven to be effective for this type of cancer, surgical removal of the tumor has a potential to cure the disease.
A tumor is a lump or mass of tissue that forms when cells divide uncontrollably. A growing tumor may replace healthy tissue with abnormal tissue. Bone tumors can be painful, often weaken the bone and cause fractures. Bone tumors can affect people of all ages, and they can be benign (non-cancerous) or malignant (cancerous). Common risk factors for bone cancer include genetic syndromes, radiation and smoking.
Soft Tissue Tumors
Soft tissue tumors of the limbs may be benign or malignant. They require careful evaluation by experienced physicians to establish an accurate diagnosis. Benign tumors may or may not require further treatment. Soft tissue tumors and malignancies of the limbs are often classified as sarcomas. There are many types of soft tissue sarcomas. Some grow slowly, while others are aggressive and rapidly growing and can spread (or metastasize) to other areas of the body, such as lungs. Almost all soft tissue sarcomas need surgical removal and often require additional treatment such as radiation and chemotherapy.
Benign tumors do not spread to other tissues and organs, and as a rule they are not life-threatening. They are usually treated by surgery.
Many benign tumors are developmental disorders that do not require treatment.
Others can be very aggressive and destroy the bone quickly.Common benign bone tumors requiring treatment include:
Common benign tumors that may require treatment include:
- Aneurysmal bone cyst
- Chondroblastoma - a type of benign bone tumor that begins in cartilage cells. The cartilage is a dense connective tissue that is present throughout the body. Although it can affect people of all ages, it is most common among young children and adolescents between the ages of 10 and 20 years. Chondroblastomas are not cancerous, but locally aggressive
- Chondromyxoid fibromas
- Giant cell tumor
- Osteoid osteoma
- Enchondromas are benign bone tumors originating from the cartilage cells. Enchondroma usually begins in the hand, the humerus, the thigh, or the tibia.
- Fibrous dysplasia
- Metaphyseal fibrous defects
- Unicameral bone cyst
Bone giant cell tumor (GCT)
Non-cancerous tumor (benign) that grows and destroys bones quickly. Bone giant cell tumor is most common near the knee. GCT is a local aggressive tumor which requires surgical treatment.
It usually occurs in adults between the ages of 20 and 40 years.
Malignant bone tumors
The most common bone-related cancer is the result of cancer that spreads from another part of the body, such as the breast, thyroid gland, prostate, kidney or lungs.
Primary malignant bone tumors are cancer that originates in bones. Most patients with primary bone cancer can recover, while in more than 90% of cases surgery may be used for treatment.
All malignant bone tumors require treatment. The likelihood of successful treatment increases when these tumors are diagnosed and treated early.
Soft tissue sarcomas
Soft tissue sarcomas are very rare. As the name implies, soft tissue sarcomas develop in soft tissue, such as muscle or fat, rather than bone. Usually occurs in the extremities or pelvic region. There are many types of soft tissue sarcomas, but most are treated the same way.The list of common soft tissue sarcomas includes:
- Malignant fibrous histiocytoma
- Synovial cell sarcoma
These anti-cancer drugs are used to treat bone and soft tissue cancer in two ways.
Neoadjuvant chemotherapy is given before surgery to reduce tumor size, so it can be removed more easily.
Adjuvant chemotherapy is used after surgery to destroy any cells that may remain or that may have spread to other parts of the body.
Provided by high-energy X-rays to shrink or destroy malignant tumor cells.
Surgical treatment for bone cancer
Cancer that affects the bone usually requires surgery, but not necessarily amputation. The surgeon tries to completely remove the primary cancer. When the second goal here is to minimize the effect of surgery on the function and appearance of the affected part of the body.
Every cancer can spread to bones. The most common types of cancer that may spread to the bones are the prostate, kidney, breast, lung and thyroid cancer. Bones are one of the most common sites for circulating cancer cells to settle and begin to grow.
Some people with metastatic cancer have no symptoms.
Type and frequency of symptoms will depend on the size and location of the metastases. For example, a cancer that spreads to the bones can cause pain and can weaken the bone and cause bone fractures.
Almost all malignancies can produce metastases.