Bone Tumor

Overview

Bone Cancer

What is bone cancer?

In a simple language, bone cancer is cancer affecting the bones. However, bone cancer is of two types:

– Primary bone cancer:

This is a form of bone cancer where the cancer begins in the tissue of the bone itself. They can be of various types de1pending on the nature of the tumor tissue.

The common types of primary bone cancers are osteosarcoma, chondrosarcoma, and Ewing’s sarcoma. Primary bone cancer is quite rare and accounts for less than 1% of all cancers. In this section, we will be discussing primary bone cancers only.

– Secondary bone cancer:

This is also called bone metastasis or skeletal metastasis. This is a form of bone cancer, where cancer has spread to the bone from primary cancer arising in some other organ or tissue.

The most common cancers which spread to the bone are from the breast, prostate, lungs, kidneys, and thyroid. Secondary bone cancer is far more common than primary bone cancer. To know more about secondary bone cancer, To know more about secondary bone cancer, read the page on bone metastasis.

Diagnosed

How is bone cancer diagnosed?

Merely finding a suspicious problem in the bone on a radiological investigation is not a final diagnosis of bone cancer. Although, in a large number of cases, a plain X-ray does give definite clues about the nature of the lesion in the bone, including the likely diagnosis, it is always important to establish the diagnosis by doing a histological study of the tumor tissue (except in some well-known well-identified non-aggressive benign bone conditions).

This study is done by a pathologist on a sample of the tumor tissue which is obtained through a minor surgical procedure called a Biopsy. Bone cancer as we already know, could be either primary or secondary.

Moreover, there are different types of primary bone cancer and different sources of secondary bone cancer. It is very important to know the exact diagnosis of the cancer affecting the bone, as the treatment plan is different for different types of cancer.

It is also important to know that non-cancerous (benign) bone tumors are much more common than cancerous (malignant) bone tumors. Furthermore, there are certain non-tumorous conditions, which can behave and look like a bone tumor, both clinically and on radiological investigations.

One such common condition which can mimic a bone tumor is bone infection (more appropriately called as Osteomyelitis). A biopsy can easily settle these issues.

Primary & Secondary Bone Cancer Cure

Can primary bone cancer be cured?

If detected early and treated appropriately, cure is certainly possible in primary bone cancer. However, it is important to establish correctly, the diagnosis of sarcoma, the type of sarcoma, and the stage of the disease.

Can Secondary bone cancer be cured?

Even though secondary bone cancer cannot be cured, treatment reduces symptoms and improves your quality of life.

What Should I Do

If I have a suspected bone tumor, what should I do about it?

In such an event, the most important thing that you must do is, speak to your doctor and consult a bone tumor specialist. However, in the meanwhile, there are several things that you must NOT do. They are as follows:

• Do not massage the swelling under any circumstance. This is because, if it is a malignant tumor, massaging could cause some of the tumor cells to be released into the blood circulation or the lymphatic system, through which they could travel and lodge in some distant organ or tissue and form metastasis. Besides, massaging will not offer relief in the presence of a tumor; it could actually aggravate or trigger the pain. It can also cause a pathological fracture.
• For the same reason as above, do not apply any sort of compression bandage over the swelling. Also, avoid touching and examining the region frequently.
• Do not attempt or allow, any sort of chiropractic manipulation of the affected region. This could be dangerous in the presence of a bone tumor. Besides the risk of releasing tumor cells into the blood and lymphatic circulation, it can also cause a pathological fracture.
• A bone with tumor generally does not have the strength of a normal bone as most tumors tend to weaken them; which means such a bone is at a risk of fracture following trivial events like lifting a heavy object, a fall at home, walking, etc. (pathological fracture). Hence all precautions must be taken to avoid the possibility of such a fracture.

It is best to follow the following guidelines till your doctor examines you and decides what level and what kind of activity is safe for you:

Avoid unnecessary use of any limb which is painful or has a swelling.

1. Avoid any activity which triggers or aggravates the pain.
2. Do not attempt to lift heavy objects.
3. If the tumor is in the lower extremity, avoid putting weight on that limb while walking or standing. Use a ‘walker frame’ if necessary.
4. Avoid falling, at all costs. Any kind of local injury, in the presence of a bone tumor, carries a significant risk of causing a pathological fracture. This often happens where and when you least expect it – ‘at home’. Most often, this happens in the toilet or the bathroom due to a slip on the polished floor tiles, which may be wet and therefore, slippery. These are also situations when you are generally alone. Seek assistance while ‘going to’ and ‘coming from’ these places. Beware of wet floors. A pathological fracture, besides causing intense pain and serious disability, also complicates the treatment of the disease.
5. Avoid all sports which may involve physical activity, unless your doctor considers it as safe for you.

Treatment

What is the treatment for a bone tumor?

Bone cancer treatment depends on the type, stage, general health, and personal preferences.

– Surgery

Surgery removes the entire malignant tumor. Most of the time, this involves removing the tumor in one piece with a small amount of fine tissue surrounding it. A surgeon then replaces the missing bone with bone marrow, metal, or hard plastic from another part of the body.

– Chemotherapy

During chemotherapy, patients are injected with powerful anti-cancer drugs to kill the cancer cells. Sometimes, this therapy is ineffective. For example, chemotherapy is ineffective in chondrosarcoma, but successful in osteosarcoma and Ewing sarcoma.

– Radiation therapy

Radiation such as X-rays destroys cancer cells. Radiation treatment involves lying on a table while a machine rotates around you, aiming energy beams at specific parts of the body.

Radiation is used before surgery to reduce the tumor and make it easier to remove. Additionally, it can treat bone cancer that cannot be surgically removed. Additionally, these treatments can be used after surgery to destroy any remaining cancer cells.

Dr. Chetan Anchan is an expert and well-known orthopedic surgeon and oncologist from Mumbai. He has vast experience in treating all types of Malignant and Benign, Bone and Soft Tissue Tumors, and Skeletal Metastases.

Dr. Chetan holds an extensive expertise in managing and treating various bone malignancies.

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