A malignancy of bone. Primary bone cancer (cancer that begins in bone) is rare, but it is not unusual for cancers to metastasize (spread) to bone from other parts of the body, such as the breast, lung, and prostate. The most common type of primary bone cancer is osteosarcoma, which develops in new tissue in growing bones. Another type of cancer
1) Chondrosarcoma, arises in cartilage. 2) Ewing's sarcoma begins in immature nerve tissue in bone marrow. 3) Osteosarcoma and Ewing's sarcoma tend to occur in children and adolescents. 4) chondrosarcoma occurs most often in adults. Pain is the most frequent symptom of primary and metastatic cancer in bone. Bone cancer can also interfere with normal movements and can weaken the bones, leading to fractures.Diagnosis of bone cancer is supported by findings of the medical history and examination:-
1) Blood tests (including measuring the level of the enzyme for the enzyme alkaline phosphatase)
2) X-ray studies
A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor notice. For example, pain may be a symptom while a rash may be a sign.
The patient initially experiences pain in the affected area. Over time the pain gets worse and continuous. In some cases the pain is subtle and the patient may not see a doctor for several months. The progression of pain with Ewing sarcoma tends to be faster than in most other bone cancers. Typically, bone cancer pain is deep, nagging and has a permanent character.
- There may also be swelling in the affected area.
- Often the bone will weaken, resulting in a significantly higher risk of fracture.
- The patient may find he/she loses weight unintentionally.
- A mass (lump) may be felt in the affected area.
- Although much less common, the patient may also experience fever, chills and/or night sweats.
The type of treatment for bone cancer depends on several factors, including what type of bone cancer it is, where it is located, how aggressive it is, and whether it is localized or has spread. There are three approaches to bone cancer:
- Radiotherapy (radiation therapy)
The aim of surgery is to remove the tumor, all of it if possible, and some of the bone tissue that surrounds it. If some of the cancer is left behind after surgically removing the tumor it may continue to grow and eventually spread. Limb sparing surgery, also known as limb salvage surgery means that surgical intervention occurs without having to amputate the limb. The surgeon may take some bone from another part of the body to replace lost bone (bone graft), or an artificial bone may be put in. In some cases, however, amputation of a limb may be necessary.
Radiation therapy is also known as radiotherapy, radiation oncology and XRT. Approximately 40% of patients of all types of cancer undergo some kind of radiotherapy. It involves the use of beams of high-energy X-rays or particles (radiation) to destroy cancer cells. Radiotherapy works by damaging the DNA inside the tumor cells, destroying their ability to reproduce. Radiotherapy can be used for different reasons:
- Total Cure - to cure the patient by completely destroying the tumor.
- To alleviate symptoms - radiotherapy is often used to relieve pain in more advanced cancers.
- Neo-adjuvant radiotherapy (before surgery) - if a tumor is large, radiotherapy can shrink it, making it easier and less harmful to then surgically remove it.
- Adjuvant radiotherapy - given after surgery. The aim is to eliminate the cancer cells that remained behind.
- Combination therapy (radiotherapy combined with another type of therapy) - in some cases, chemoradiation - radiotherapy combined with chemotherapy - is more effective
Chemotherapy involves the use of chemicals (medication) to treat disease. More specifically, it usually refers to the destruction of cancer cells. Cytotoxic medication prevents cancer cells from dividing and growing. In general, chemotherapy has 5 possible goals:.
- Total remission - to cure the patient completely. In some cases, chemotherapy alone can get rid of the cancer completely..
- Combination therapy - chemotherapy can help other therapies, such as radiotherapy or surgery have more effective results..
- Delay/Prevent recurrence - chemotherapy, when used to prevent the return of a cancer, is most often used after a tumor is removed surgically..
- Slow down cancer progression - used mainly when the cancer is in its advanced stages and a cure is unlikely. Chemotherapy can slow down the advancement of the cancer..
- To relieve symptoms - also more frequently used for patients with advanced cancer.