What is Bone Cancer?
Bone cancer describes a group of cancers that affects the bone. Cancer involves abnormal cell growth and division, and the location in which cancer begins determines the type of bone cancer.
Primary bone cancers are cancers that begin to form in the bone. Secondary or metastatic bone cancers originate in another part of the body and then spread to the bone. (For example, breast, prostate, and lung cancers can spread to the bone.) Bone cancers are rare and can develop at any age but are more common in children and young adults.
When a tumor grows within the bone, it can press on the blood vessels and nerves that move throughout the bone layers, causing pain and preventing proper movement.
Types of Bone Cancer
Primary bone cancers are also referred to as bone sarcomas. Sarcomas are cancers that begin in connective tissues, including bones or soft tissues such as muscles, tendons, cartilage, fat, nerves, and blood vessels. Treatment for bone or soft tissue sarcoma depends on various factors, including type, stage, location, and more. There are four main types of primary bone cancer:
- Osteosarcoma is the most common primary bone cancer and typically affects people between the ages of 10 and 30. Osteosarcoma usually develops at the pelvis and the ends of large bones such as the arms or legs. This type of cancer targets the cells that make new bone tissue, and the bone tissue affected by osteosarcoma is not as strong as normal bone tissue.
- Ewing sarcoma involves tumors that start in bones and nearby soft tissue. Ewing sarcoma commonly affects pelvic bones, bones in the chest wall (such as ribs and shoulder blades), and long bones in the legs. These tumors are most commonly found in children and young adults.
- Chondrosarcoma begins in the cartilage, the flexible, connective tissue that supports bones. It can develop at any location where cartilage is found, but most commonly forms in pelvic, leg, or arm bones. It is more common in middle-aged adults.
- Chordoma specifically affects the bones of the spine. It most commonly develops in older adults and is more common in males than in females.
Stages of Bone Cancer
The stages of bone cancer are determined by the tumor’s location, size, and whether or not cancer has spread to other locations in the body. Staging can be done using physical examinations, biopsies, and imaging tests. Staging helps identify the severity of a person’s disease and best treatment options.
Bone cancer has four stages:
- Stage 1 - The cancer is localized, and the tumor cells are low-grade, meaning they look more like normal cells and do not spread as quickly as high-grade cancer cells
- Stage 2 - The cancer is still localized, but the tumor cells are high-grade
- Stage 3 - The cancer has spread to other locations in the bone, and the tumor cells are high-grade
- Stage 4 - The cancer has spread to other locations in the body
Symptoms & Signs of Bone Cancer
Though some patients do not experience any symptoms, some common symptoms of bone cancer include:
- Pain or a tingling sensation may be experienced as a result of a tumor pressing on nerves in the area. The pain may be inconsistent at first but often becomes more constant as the condition progresses. The pain may worsen at night or during physical activity.
- Fractures. A tumor can cause the bone to weaken, which can result in fractures and breaks
- Lump or swelling
- Weight loss
Some of these general bone cancer symptoms can be similar to those of other bone-related conditions, like arthritis or osteoporosis. A bone cancer specialist will be able to properly diagnose the condition.
What Causes Bone Cancer?
The general cause of bone cancer is not well known, but studies have suggested that the mutation in cancerous bone cells may be linked to exposure to radiation, possibly during treatment for other cancers. Certain inherited genetic conditions are also linked to the development of bone cancer, though these are rare. Researchers continue to explore other potential causes of bone cancer.
Certain factors can increase a person’s risk of bone cancer, including:
- Paget disease. A condition that develops in older adults and causes abnormal bone that can break more easily. People with this condition have a higher risk of developing bone tumors in the affected areas.
- Exposure to radiation. Receiving radiation therapy increases a person’s chance of developing bone cancer, particularly if the radiation treatment was in high doses or during childhood
- Fibrous dysplasia. A condition that causes the bone to create excess fibrous tissue that replaces normal, healthy bone tissue. Though the risk is low, fibrous dysplasia can develop into osteosarcoma.
- Noncancerous bone tumors can increase a person’s chances of developing chondrosarcoma
- Inherited genetic conditions. Certain genetic mutations cause bone conditions that increase a person’s chance of developing bone cancer. Examples of these conditions include:
- Tuberous sclerosis, which increases a person’s chance of developing chondroma during childhood, though this is rare
- Multiple osteochondromas, a condition that causes the formation of many noncancerous tumors made of cartilage. This inherited condition can be painful, and each tumor has the possibility of becoming chondrosarcoma.
- Multiple enchondromatosis, which involves the formation of noncancerous cartilage tumors and increases a person’s chance of developing chondrosarcoma
- Bone marrow transplants for medical conditions (such as leukemia) can lead to osteosarcoma
As of now, there is no known way to prevent bone cancer apart from avoiding radiation exposure. Since many risk factors for bone cancer do not involve lifestyle choices, they cannot be changed. However, scientists are conducting ongoing research to explore further causes of bone cancer and how to prevent it.
Trust NewYork-Presbyterian for Bone Cancer Care
Doctors at NewYork-Presbyterian are experienced in diagnosing many types of bone cancer and will determine the treatment that is best for each patient. Learn more about treatment options provided by our cancer specialists.