Bone cancer refers to a primary tumor that starts in the bone itself. It is usually a sarcoma, a class of cancers that begin in bone or soft tissue. Bone cancers can develop anywhere in the body. It is often confused with other cancers that metastasize (spread) to the bone, such as breast, prostate or lung cancer. Multiple myeloma and leukemia are also sometimes referred to as bone cancers, but they actually begin in the bone marrow rather than the bone itself.
There are many different types of bone tumors – each with distinct attributes – that tend to target specific age groups. Osteosarcoma is the most common, and usually develops in the bones of the arms, legs, or pelvis. It typically affects young people between the age of 10 and 30 and is more common in males than females.
Chondrosarcoma is the second most common bone cancer (and the most common in adults), affecting cartilage cells. The average age at diagnosis is 51; women are diagnosed as frequently as men. Most cases are diagnosed at an early stage and are low grade, meaning they are not likely to spread.
Ewing tumor (or Ewing sarcoma), named after the doctor who first recognized it, is the third most common bone cancer, and the second most common in children, adolescents, and young adults. Most Ewing tumors develop in the pelvis, chest wall, and arms and legs, although they can also start in other tissues. Ewing tumors are rare in adults over 30, occurring most often in Caucasians.
Most people with bone cancers do not have any apparent risk factors. A very small number of bone cancers (especially osteosarcomas) appear to be hereditary. However, most bone cancers are caused by gene mutations that occur during a lifetime. The exact cause of most bone cancers is not known.
Intermittent pain in the bone, particularly after activity, is often the first sign of bone cancer. It may become constant as the cancer grows. Swelling may develop or a lump or mass may become detectable. Fractures are a rare symptom. Weight loss and fatigue can be symptoms, just as with any type of cancer.
There are no special screening tests for bone cancer. Diagnosis is determined from a biopsy or X-Rays, CT Scans, MRIs or a number of other imaging tests.
Surgery is the most common treatment for bone cancer. As recently as the 1960s, the primary treatment for bone cancer in a limb was amputation. Thankfully, that is no longer the case. Today, 90 percent of patients can opt for limb-sparing surgery.
When surgery can’t remove all the cancer cells, radiation therapy and chemotherapy are other treatments that can be used. Radiation is not effective for all kinds of bone cancers, however. Chemotherapy is very effective in the treatment of many kinds of sarcomas. Progress being made in developing targeted drugs for certain subtypes of bone cancer.