There are many different types of bone cancer, but generally they are some of the nastiest types of cancers that can attack humans. As with all cancers, early diagnosis and treatment gives a far better outcome.
The most common type of bone cancer is that which has spread from another site in the body. Many different cancers tend to spread to bone, including breast and prostate cancer. These have a far poorer outcome than most cancers that actually start in the bone.
The most common symptoms are bone pain and swelling, although many types of bone cancer may show no symptoms until the disease is quite advanced. Fractures that occur very easily, painful or swollen joints, and limitation of joint movement are other possible symptoms of bone cancer.
Diagnosis will involve X-rays, biopsy (taking a sample of a suspicious area) and blood tests to confirm the type of cancer that is present. An exact diagnosis is essential before treatment, as different tumors react in different ways.
Treatment will involve a combination of amputation, surgical removal, irradiation and drugs, depending on that exact diagnosis, and the experience gained over many years from patients with similar problems. The outcome of treatment is extremely variable, depending on the type of cancer, the stage at which it is diagnosed, the position in the body, the age of the patient and the response to treatment.
The different types of bone tumor include osteomas, fibrosarcoma, enchondroma (start in cartilage), chondrosarcoma, osteoclastoma (giant cell tumors), osteosarcoma and Ewing's tumors.
Osteosarcoma
Osteosarcoma (osteogenic sarcoma) is a cancer that occurs in teenagers and young adults, and is more common in males than females. The patient first notices gradually increasing pain in the arm or leg, and less frequently in other parts of the body. The knee and elbow are the most commonly affected areas. The cancer gradually swells, causing the covering skin to become warm, and the swelling is tender to touch. Blood tests can give clues to the existence of the cancer, but X-ray and biopsy are the more important investigations.
Amputation of the affected arm or leg is the usual treatment, with surgical removal of as much bone as possible if the cancer occurs in other areas of the body. Drugs and irradiation may also be used, particularly if the cancer has spread (most commonly to the lungs) or if it cannot be removed at operation.
The outcome is better the further out along the limb the cancer develops. The overall cure rate is only 50%, for cancer in the forearm or lower leg it is 70%, but for cancers in the pelvis or breast bone, there are virtually no survivors.
Ewing's Tumor
Ewing's Tumor is a form of bone cancer usually occurs in young adults but can develop in children too. Almost any bone in the body may be affected, including the vertebrae of the back. There is pain, swelling and tenderness at the site of the tumor, and the patient develops a fever and becomes anemic. The diagnosis is made by X-ray and biopsy, blood tests being of little use. Treatment involves surgical removal if possible, plus irradiation and potent anti-cancer (cytotoxic) drugs. With intensive treatment in good hospitals, a 50% cure rate can be achieved.
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