Bone cancer can begin in any bone in the body, but it most commonly affects the pelvis or the long bones in the arms and legs. Bone cancer is rare, making up less than 1 percent of all cancers. In fact, noncancerous bone tumors are much more common than cancerous ones.
The term "bone cancer" doesn't include cancers that begin elsewhere in the body and spread (metastasize) to the bone. Instead, those cancers are named for where they began, such as breast cancer that has metastasized to the bone.
Some types of bone cancer occur primarily in children, while others affect mostly adults. Surgical removal is the most common treatment, but chemotherapy and radiation therapy also may be utilized. The decision to use surgery, chemotherapy or radiation therapy is based on the type of bone cancer being treated.
Signs and symptoms of bone cancer include:
Make an appointment with your doctor if you or your child develops bone pain that:
The cause of most bone cancers is unknown. A small number of bone cancers have been linked to hereditary factors, while others are related to previous radiation exposure.
Bone cancers are broken down into separate types based on the type of cell where the cancer began. The most common types of bone cancer include:
It's not clear what causes bone cancer, but doctors have found certain factors are associated with an increased risk, including:
Imaging tests can help determine the location and size of bone tumors, and whether the tumors have spread to other parts of the body. The types of imaging tests recommended depend on your individual signs and symptoms. Tests may include:
Your doctor may recommend a procedure to remove a sample of tissue (biopsy) from the tumor for laboratory testing. Testing can tell your doctor whether the tissue is cancerous and, if so, what type of cancer you have. It can also reveal whether the tumor cells are growing quickly or slowly.
Types of biopsy procedures used to diagnose bone cancer include:
Determining the type of biopsy you need and the particulars of how it should be performed requires careful planning by your medical team. Doctors need to perform the biopsy in a way that won't interfere with future surgery to remove bone cancer. For this reason, ask your doctor for a referral to a team of doctors with extensive experience in treating bone tumors before your biopsy.
If your doctor confirms a diagnosis of bone cancer, he or she tries to determine the extent (stage) of the cancer because that will guide your treatment options. Factors to be considered include:
The stages of bone cancer are indicated by Roman numerals, ranging from 0 to IV. The lowest stages indicate that the tumor is smaller and less aggressive. By stage IV, the cancer has spread to other parts of the body.
The treatment options for your bone cancer are based on the type of cancer you have, the stage of the cancer, your overall health and your preferences. Different bone cancers respond to different treatments, and your doctors can help guide you in what is best for your cancer. For example, some bone cancers are treated with just surgery; some with surgery and chemotherapy; and some with surgery, chemotherapy and radiation therapy.
The goal of surgery is to remove the entire cancerous tumor. In most cases, this involves special techniques to remove the tumor in one single piece, along with a small portion of healthy tissue that surrounds it. The surgeon replaces the lost bone with some bone from another area of your body, with material from a bone bank or with a replacement made of metal and hard plastic.
Bone cancers that are very large or located in a complicated point on the bone may require surgery to remove all or part of a limb (amputation). As other treatments have been developed, amputation is becoming less common. If amputation is needed, you'll likely be fitted with an artificial limb and go through training to learn to do everyday tasks using your new limb.
Chemotherapy uses strong anti-cancer drugs, usually delivered through a vein (intravenously), to kill cancer cells. However, this type of treatment works better for some forms of bone cancer than for others. For example, chemotherapy is generally not very effective for chondrosarcoma, but it's an important part of treatment for osteosarcoma and Ewing sarcoma.
Radiation therapy uses high-powered beams of energy, such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table while a special machine moves around you and aims the energy beams at precise points on your body.
Radiation therapy is often used before an operation because it can shrink the tumor and make it easier to remove. This, in turn, can help reduce the likelihood that amputation will be necessary.
Radiation therapy may also be used in people with bone cancer that can't be removed with surgery. After surgery, radiation therapy may be used to kill any cancer cells that may be left behind. For people with advanced bone cancer, radiation therapy may help control signs and symptoms, such as pain.
A cancer diagnosis can be overwhelming. With time you'll find ways to cope with the distress and uncertainty of cancer. Until then, you may find it helps to:
If you have any signs and symptoms that worry you, start by making an appointment with your family doctor. If your doctor suspects you may have bone cancer, you may be referred to a specialist. Bone cancer is often treated by a team of specialists that may include:
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared. Try to:
Preparing a list of questions for your doctor can help you make the most of your time together. List your questions from most important to least important in case time runs out. For bone cancer, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment.
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time to cover other points you want to address. Your doctor may ask:
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