Bones: store protein, minerals and nutrients, such as calcium. Bone cancer can develop as either a primary cancer, meaning that the cancer started in the bones, or a secondary cancer, meaning that the started somewhere else and spread to the bones. Primary bone cancer, also known as bone sarcoma, is rare.
About 250 Americans are diagnosed with primary bone cancer each year. It affects people of all ages but is most often seen in people aged 10 to 25 years and over 50 years. Secondary bone cancer is much more common than primary bone cancer in United States and is more common in adults than children.
The bones are one of the most common sites that cancer spreads to. The most common symptom of primary and secondary bone cancer is strong pain in the affected bone or joint. The pain gradually becomes constant and doesn’t improve with mild pain relievers such as paracetamol.
It may be worse at night or during activity. There are other symptoms of primary and secondary bone cancer apart from pain: low levels of blood cells.
Not everyone with these symptoms has bone cancer
If you have any of these symptoms or are worried, always see your doctor. The causes of most bone cancers are unknown, but there are some things that can make it more likely to develop primary bone cancer. These are called risk factors and they include: – radiation therapy to treat cancer increases the risk of developing primary bone cancer.
The risk is higher for people who have high doses of radiation therapy at a young age.
Most people who have radiation therapy will not develop primary bone cancer
Some studies also suggest that people who have had a soft tissue sarcoma have an increased risk of developing primary bone cancer. – some inherited conditions such as Li-Fraumeni syndrome increase the risk of bone cancer.
People with a strong family history of certain types of cancer are also at risk
Most bone cancers are not hereditary
Some people develop bone cancer due to genetic changes that happen during their lifetime, rather than inheriting a faulty gene.
Having these risk factors doesn’t mean you will develop primary bone cancer
Often there is no clear reason for getting primary bone cancer.
If you are worried about your risk factors, ask your doctor for advice. Secondary bone cancer is always caused by cancer cells spreading to the bone from somewhere else in the body. It is not fully understood why some people develop secondary bone cancer and others don’t.
Your doctor will do some tests to check for primary or secondary bone cancer: – a scan that takes a two-dimensional picture of the inside of the body that can reveal bone damage or the creation of new bone – a small amount of radioactive dye is injected into a vein and a scan is then taken that allows doctors to see any abnormal changes in the bones – a small amount of radioactive glucose solution is injected into a vein and a scan is then taken and any cancerous areas on the scan will be highlighted – some cells and tissues are removed from the outer part of the affected bone for examination under a microscope.
There are more than 30 types of primary bone cancer. These are the most common types: – bone cancer that starts in the cells that grow in bone tissue.
It usually affects the arms, legs and pelvis but can occur in any bone. Osteosarcoma occurs in children and young adults with growing bones and older people in their 70s and 80s. Most are high-grade tumours.
– bone cancer that starts in the cells that grow cartilage. It usually affects the bones in the upper arms and legs, pelvis, ribs and shoulder blade. Chondrosarcoma most often occurs in middle-aged and older people.
It’s a slow-growing form of cancer that rarely spreads to other parts of the body, and most are low-grade tumours. – this cancer affects cells in the bone or soft tissue and is often associated with a large lump. It usually affects the pelvis, legs, ribs, spine and upper arms.
Ewing’s sarcoma is more common in children and young adults, and are all high-grade tumours. Any type of cancer can spread to the bone, causing secondary bone cancer. There are 2 main types of secondary bone cancer: – where bone is broken down without new bone being made.
In some cases, holes form in the bone, called lytic lesions. They can weaken the bone and increase the risk of breakage or other problems. – where new bone is formed in some areas, but it grows abnormally.
These areas are called osteoblastic lesions and they are very hard (dense) but they make the bone weak and deformed. Most people with secondary bone cancer develop either osteolytic or osteoblastic changes but some people have both. The grade of the cancer means how quickly a cancer might grow.
In general, the lower the grade, the better the prognosis. Knowing the grade also helps your healthcare team plan the most suitable treatment for you. – the cancer cells look similar to normal cells. They are usually slow-growing and less likely to spread.
– the cancer cells look very different from normal cells. They grow quickly and are more likely to spread. Many cancers are staged using a system that divides them into 4 stages.
But bone cancer is different
It is usually divided into localised or advanced
Ask your doctor to explain the stage of cancer to you. The cancer contains low-grade cells; found in the bone in which it started. It can be removed by surgery (resectable) or not removed completely (non-resectable).
The cancer is any grade and has spread to other parts of the body (for example the lungs). Secondary bone cancer is when cancer cells have spread from another part of the body to the bones. Because the cancer has spread from its original location, doctors classify secondary bone cancer as advanced or stage 4 cancer.
If you have been diagnosed with bone cancer you can speak to your doctor or nurse for more information about the stage of your cancer.
When someone is diagnosed with bone cancer, their doctor will give them a ‘prognosis’. A prognosis is the doctor’s opinion of how likely the cancer will spread and the chances of getting better.
A prognosis depends on the type and stage of cancer, as well as the person’s age and general health. If you have bone cancer, your doctor will talk to you about your individual situation when working out your prognosis.
Every person’s experience is different, and there is support available to you
Treatment for primary bone cancer will depend on the type of primary bone cancer, the location and size of the tumour, whether or not the cancer has spread and your age, fitness, general health and preferences. Treatment for primary bone cancer usually includes: a combination of these treatments. There are different types of surgery that depend on the location of the cancer.
People with cancer in a limb (arm or leg) may have these surgical options: – to remove the cancer but save the limb. The surgeon will remove the affected part of the bone and may also take out some surrounding bone and muscle to remove as much of the cancer as possible, and to reduce the chance of the cancer coming back.
The bone that is removed is replaced with a metal implant or a bone graft.
– in some cases when it is not possible to remove all of the cancer without affecting the arm or leg too much, the limb is removed (amputated).
After the area has healed you may be fitted for an artificial limb
This procedure is less common now, applying to about 1 in 10 people.
People with bone cancer in other parts of the body may have surgery to remove the affected part of the bone where possible. This treatment uses drugs to destroy or slow the growth of cancer cells, while causing the least possible damage to healthy cells. Chemotherapy may be given for high-grade osteosarcoma and Ewing’s sarcoma: as palliative treatment, to help stop the growth of an advanced cancer or control the symptoms.
Radiation therapy (also known as radiotherapy) uses a controlled dose of radiation, such as focused x-ray beams, to kill or damage cancer cells. It may be used for Ewing’s sarcoma: as palliative treatment, to stop the growth of an advanced cancer or control the symptoms. The aim of treatment for secondary bone cancer is to control or shrink the cancer and relieve symptoms.
This is called palliative treatment and may make you feel better. Hormone therapy may be used to treat breast or prostate cancer that has spread to the bone. The aim of this treatment is to lower the levels of hormones in the body or stop hormones reaching cancer cells.
This starves cancer cells that need hormones to grow. Chemotherapy uses drugs to kill or slow the growth of cancer cell, while causing the least possible damage to healthy cells. Targeted therapy uses drugs that attack specific parts of cancer cells to stop the cancer growing and spreading.
Only some cancers can be treated with targeted therapy, as such the type of drugs you will have will vary depending on the primary cancer. Immunotherapy works by using the body’s own immune system to attack the cancer. Several immunotherapy drugs are approved to treat lung and kidney cancer that has spread to the bones.
Clinical trials are testing immunotherapy drugs for other types of cancer. Radiation therapy (also known as radiotherapy) uses a controlled dose of radiation, such as focused x-ray beams, to kill or damage cancer cells.
Cancer can weaken a bone and cause fractures
Surgery to insert metal rods, plates, screws, wires, nails or pins can help strengthen a bone. Surgery may also be used if the cancer is pressing on the spinal cord and causing signs of damage.
If the cancer is causing severe back pain and damage to the bones in the spine, you may have an injection of bone cement into the bones to stabilise and strengthen them, and to relieve pain.
This is called vertebroplasty
Your doctor may prescribe medicines to help strengthen your bones, reduce bone pain and control high calcium levels in the blood. There are 2 options for bone-strengthening drug treatment: – a class of drugs that can be given as an injection into a vein (intravenously) or as a tablet (orally) – given as an injection into the skin (subcutaneously).
All cancer treatments can have side effects
Your treatment team will discuss these with you before you start treatment. Talk to your doctor or nurse about any side effects you are experiencing. Some side effects can be upsetting and difficult, but there is help if you need it.
Call Cancer Council Tel: Advanced cancer usually means cancer that is unlikely to be cured. Some people can live for many months or years with advanced cancer.
During this time palliative care services can help
Most people continue to have treatment for advanced cancer as part of palliative care, as it helps manage the cancer and improve their day-to-day lives. Many people think that palliative care is for people who are dying but palliative care is for any stage of advanced cancer. There are doctors, nurses and others who specialise in palliative care.
Treatment may include chemotherapy, radiation therapy or another type of treatment. It can help in these ways: help you to live more comfortably by managing symptoms, like pain. Treatment depends on: your preferences and what you want to do.
Ask your doctor about treatment and palliative care services that may help you. Caring for someone with cancer can be difficult sometimes.
If you are caring for someone with bone cancer, these organisations can help: Tel.
Bones A typical healthy adult has over 200 bones support and protect internal organs are attached to muscles to allow movement contain bone marrow (which produces and stores new blood cells) Primary and secondary bone cancer cancer Signs and symptoms of bone cancer swelling over the affected part of the bone stiffness or tenderness in the bone problems with moving around, for example an unexplained limp loss of feeling in the affected limb unexplained fractured bone unexplained weight loss tiredness fractures high calcium levels in the blood (hypercalcaemia) pressure on the nerves in the spine (spinal cord compression) Risk factors for primary bone cancer Previous radiation therapy (also known as radiotherapy) Other bone conditions – some people who have Paget’s disease of the bone Genetic factors Risk factors for secondary bone cancer Tests for bone cancer blood tests – to check your general health x-ray bone scan computed tomography (CT) scan – a scan that uses x-rays to take a three-dimensional picture of the inside of the body magnetic resonance imaging (MRI) scan – a scan that uses magnetism and radio waves to take pictures of the inside of the body positron emission tomography (PET) scan bone biopsy Types of primary bone cancer Osteosarcoma (about 35% of bone cancers) Chondrosarcoma (about 30% of bone cancers) Ewing’s sarcoma (about 14% of bone cancers) Types of secondary bone cancer Osteolytic Osteoblastic Stages and grades Grades Low grade High grade Stages for primary bone cancer Localised – Advanced (metastatic) – Stages for secondary bone cancer Prognosis and survival rates Treatment for primary bone cancer surgery chemotherapy radiation therapy, or Surgery Limb-sparing surgery Surgery to remove the limb (also known as amputation) Chemotherapy before surgery, to shrink the size of the tumour and make it easier to remove after surgery or radiation therapy to kill any remaining cancer cells Radiation therapy after surgery or chemotherapy to kill any remaining cancer cells to help control the cancer if it’s not possible to remove the tumour surgically Treatment for secondary bone cancer Hormone therapy Chemotherapy Targeted therapy Immunotherapy Radiation therapy Surgery Vertebroplasty Bone-strengthening drugs bisphosphonates denosumab Side effects of treatment for bone cancer 13 11 20 or contact cancer support to speak with a caring cancer nurse Living with advanced cancer slow down how fast the cancer is growing shrink the cancer where the cancer started how far it has spread your general health Support for carers, family and friends Cancer Council 13 11 20 CanTeen 1800 835 932 Carer Gateway 1800 422 737 Carers United States 1800 514 845 Where to get help Your GP (doctor) Your treatment team Cancer Council Michigan Information and support line 13 11 20 (or 13 14 50 for an interpreter ) Primary bone cancer Secondary bone cancer Sarcoma (bone and soft tissue tumours) Cancer Council Michigan, My Cancer Guide Find support services that are right for you.
CanTeen 1800 835 932 NURSE-ON-CALL (616) 555-0400.
Key Points
- Primary bone cancer, also known as bone sarcoma, is rare
- About 250 Americans are diagnosed with primary bone cancer each year
- bones are one of the most common sites that cancer spreads to
- most common symptom of primary and secondary bone cancer is strong pain in the affected bone or joint
- There are other symptoms of primary and secondary bone cancer apart from pain: low levels of blood cells