By Causenta Wellness
Bone cancer most commonly affects the long leg and arm bones or the pelvis, but it can start in any bone. It’s one of the rarer types of cancer, but don’t let that stop you from talking to your doctor if you’re worried about it. That said, it’s more likely to have developed a noncancerous bone tumor than a cancerous one.
Bone cancer types
Several types of bone tumors exist, and they’re named based on their origin and type. Some aren’t actually cancer, but others are.
The most common kinds of primary bone cancer include:
- Osteosarcoma or osteogenic sarcoma — Osteosarcoma or osteogenic sarcoma occurs most often in adolescent males. Each year, about 1,000 Americans are diagnosed with it. It often begins around the knee, the arms, or the pelvis.
- Chondrosarcoma — Chondrosarcoma affects the cartilage cells. Over 40 percent of adult bone cancer is of this type, making it the most prevalent for adults. On average, patients are 51 when diagnosed, with the majority of cases occurring in those over the age of 40. Doctors tend to find this type of bone cancer early, and it’s usually low-grade. Benign tumors can grow just about anywhere where there is bone or cartilage in the body.
- Ewing’s sarcoma — Ewing’s sarcoma is another very prevalent form of bone cancer in adolescents. It also is the third most diagnosed in adults living with bone cancer. This form begins in the bones, the organs, or in the tissues, especially in the arms, legs, chest wall, and pelvis.
Bone cancer symptoms
When bone cancer is present, the patient starts to feel pain in the area where it grows. Over time, the pain becomes continuous and gets worse. Sometimes, the pain can be subtle, and it takes months for the patient to see a doctor as a result.
Ewing sarcoma tends to progress much more quickly compared to other forms of bone cancers. Typically, the pain is described as nagging, deep, and permanent. Other symptoms you may experience include:
- Unintentional weight loss
- Swelling in the area where the tumor is growing
- Weakened bones that lead to a much greater risk of fracture
- A lump in the area where the tumor is growing
- Chills, fever, and night sweats, although these are less common
Bone cancer diagnosis
The best way to treat bone cancer is to get an accurate diagnosis at the beginning. The wrong kind of biopsy might make it more challenging in the future to remove all parts of the cancer without amputation. Incorrectly performed biopsies can also lead to the cancer spreading.
If you experience symptoms that suggest you could have bone cancer, then your doctor will ask you about your health and family history before performing some tests.
A biopsy removes a small piece of bone and checks it for cancer. This tells the doctor whether it’s a cancerous tumor or something else wrong with your bones. This should only be performed by a surgeon who is familiar with treating bone tumors. There are two types of biopsies:
- Needle biopsy — The surgeon uses a long, hollow need to pierce the skin and obtain a sample of the affected bone.
- Surgical or open biopsy — Here, the surgeon makes a cut and removes the bone from this incision.
Your doctor will make the call regarding which biopsy works best for your situation.
Bone cancer stages
One common system used to stage bone cancer is the AJCC system:
- T refers to the tumor size
- N refers to whether it’s spread to the nodes
- M refers to metastasis to other organs
- G is the grade
The lifecycle begins at the T stage:
- TX — Cannot detect primary tumor
- T0 — No evidence of tumor
- T1 — Tumor is about 3 inches
- T2 — Tumor is bigger than 3 inches
- T3 — Tumor is in multiple places on the same bone
The N stages are simpler:
- N0 — Cancer has not spread to the lymph nodes
- N — Cancer has spread to the lymph nodes
The M stages:
- M0 — Cancer hasn’t spread beyond the nearby lymph nodes
- M1 — Cancer has begun to spread
- M1a — Cancer spread to the lungs
- M1b — Cancer has spread to other organs
- G1-G2 — Low grade
- G3-G4 — High grade
Though this is commonly used for most cancers, bone cancer specialists usually simplify the process down to Localized 1, 2, and 3, and then Metastatic serving as the fourth stage.
Bone cancer treatment
Treatment options depend on the exact type of cancer you have as well as your overall health and needs. Different treatments work for different kinds of bone cancer, and your doctor will help you figure out the best path.
The goal of undergoing surgery is to remove the full tumor in one go. Often, this requires special techniques that an experienced cancer surgeon has learned to do. Here, she’ll replace the lost bone with bone from another part of your body or with a hard plastic and metal replacement.
Large or complicated cancers could involve limb amputation. As treatment continues to evolve, though, this is becoming less likely.
Here, you’ll take strong anti-cancer IV drugs to kill off the cells. Some types of bone cancer don’t respond as well to this treatment as others. For example, chondrosarcoma won’t respond that well, but it’s very important for those living with Ewing sarcoma and osteosarcoma.
This form of treatment involves X-rays and other beams of energy to target cancer cells. You’ll rest on a table as a machine aims precise energy beams at the affected area. It’s often used before surgery in an effort to reduce the size of the tumor, or it may be used if you’re not a candidate for surgery.
Bone cancer survival rate
Like with other forms of cancer, a bone cancer patient’s outlook depends primarily on whether or not it has spread to the rest of the body. As long as the cancer is still localized, the outlook is good.
Always play an active role in your health; if you’re worried about that persistent bone pain, don’t be afraid about communicating your fears with your doctor. Clear and honest communication between you and your doctor is what facilitates making informed choices about your treatment and health. Here a few ways to help you start a dialog with your doctor at your next appointment:
- Write your questions to bring in advance.
- Consider having someone join you.
- Take notes on what the doctor says.
- Learn about accessing your medical history.
- Ask for contact information to get in touch with your doctor faster.
- Remember that pharmacists and nurses are also fountains of good information. They may be able to answer all the questions you have left about your concerns.