Are you worried about a persistent pain or swelling in a bone somewhere in your body, perhaps in an arm, leg, or somewhere else? You might be scared. We all cringe a little when we hear the name "bone cancer." But before we get scared, let's talk about this condition in simple terms. Knowing everything properly will help us to eliminate unnecessary fear.
What exactly is bone cancer?
Simply put, bone cancer is when the cells in your bones start to grow rapidly and out of control. This is how cancer develops anywhere in our bodies.
But we need to understand something important here: There are two main types of bone cancer.
1. Primary Bone Cancer: This means that the cancer first starts in the bone cells . This is actually a relatively rare condition. It accounts for about 1% of all cancers reported in the world.
2. Secondary or Metastatic Bone Cancer: This is the most common type . This is when cancer that starts elsewhere in the body (such as the breast, lung, or prostate) later spreads to the bones.
So you see, when you say bone cancer, it doesn't necessarily have to start in the bones. In many cases, it can come from somewhere else.
The main types of cancer that start in the bones
There are several types of primary bone cancer. These are different from each other and affect different age groups. Let's look at the main types.
| Cancer type | Who is most often affected? | Important points |
|---|---|---|
| Osteosarcoma | It is more common in children and young people between the ages of 10-19. | It can grow and spread rapidly. It most often occurs in the long bones of the knee or shoulder. |
| Chondrosarcoma | It is common in adults over 40 years of age. | It starts in cartilage cells. It grows slowly. The risk of spreading is low. |
| Ewing's Sarcoma | Common in children and young people under the age of 19. | This can also grow rapidly. It is most common in the pelvis, legs, or ribs. |
| Chordoma | It is common in people over 50 years of age. | This is a very rare type. It occurs in the spine or base of the skull. It is challenging to treat because it can easily spread to the brain and spinal cord. |
Let's also learn about Benign Bone Tumors
Just because you have a "tumor" in a bone doesn't mean it's cancer. There are also non-cancerous, harmless tumors. These are called Benign Bone Tumors . These are most often seen in people under the age of 30, especially children and young adults whose bones are still growing. Although these tumors can sometimes be painful, they don't spread to other parts of the body. Therefore, they are not considered cancer.
What are the symptoms of bone cancer?
Sometimes bone cancer can be present without any symptoms. It is sometimes discovered incidentally when an X-ray is taken for another reason. However, if symptoms do occur, these are the main ones that are seen.
- Persistent bone pain: This is the most common symptom. At first, the pain may come and go, but over time, it can become constant and severe. In some types of cancer (such as Ewing sarcoma), the pain is worse at night.
- Swelling or a lump: The area of pain may begin to swell, or it may feel like a lump that can be caught in the hand.
- Limping: If you have cancer in a bone in your leg, you may have to walk with a limp.
- Unexpected bone fracture: If a bone breaks without any major accident, such as a minor fall, it may be due to weakened bones due to cancer.
- Joint stiffness: If the cancer is near a joint, it may be difficult to bend or straighten that joint.
- Unexplained fever: A persistent fever.
- Other symptoms: Fatigue and weight loss may also be seen if the cancer has spread.
Spinal tumors like chordoma can affect the nervous system. For example, symptoms such as double vision, facial numbness, or difficulty controlling urination/defecation may occur.
How does the doctor diagnose this disease?
When you go to see a doctor with the symptoms mentioned above, he will follow several steps to make a diagnosis.
1. Medical examination: First, you will be asked about your symptoms and your body will be examined.
2. X-ray: This is usually the first test done. The X-ray can check for any abnormalities or tumors in the bone.
3. Other scans: If there is something suspicious on the X-ray, these types of scans are used to find out more details.
- CT Scan: X-rays are used to take cross-sectional images of the body.
- MRI Scan: Uses a magnetic field to produce very clear, detailed images.
- Bone Scan: A small amount of radioactive material is injected into the body to look for abnormalities in the bones.
- PET Scan: This helps to find out if cancer cells are present anywhere in the body.
4. Biopsy: This is the test that is done to confirm the disease 100% . What is done here is to take a very small piece of tissue from the tumor and examine it under a microscope. This can tell you exactly whether the tumor is cancerous or not, if it is cancerous, what type it is, and how fast it is growing. It is very important to have this test done by an orthopedic oncologist who specializes in bone cancer.
5. Blood tests: The levels of certain enzymes (ALP, LDH) may be elevated in bone cancer. This is used as a clue to the diagnosis.
What are the treatments?
Treatment for bone cancer depends on several factors, including the type of cancer, its location, the extent to which it has spread (stage), the patient's age, and overall health. Usually, a combination of one or more treatments is used.
Surgery
The main treatment for most bone cancers is surgery . The goal is to completely remove the cancerous tumor. The surgeon removes the tumor and some healthy tissue around it.
- Limb Salvage Surgery: Whenever possible, doctors try to save the limb/leg by removing only the part of the bone with the cancer and replacing it with a metal prosthesis or a piece of bone taken from another location.
- Amputation: If the cancer is very large, or has spread to important blood vessels and nerves, the limb may not be able to be saved. In such cases, part of the limb may have to be removed.
Chemotherapy
This involves giving the body drugs that kill cancer cells. Chemotherapy is very important for cancers like osteosarcoma and Ewing's Sarcoma. Sometimes this treatment is given before surgery to shrink the tumor and to kill any cells that may be left after surgery.
Radiation Therapy
This involves using high-energy rays to destroy cancer cells. This treatment is used for some types of cancer, especially Ewing's Sarcoma. It is also used for cancers that are inoperable.
Targeted Therapy
These are the newest types of drugs. These drugs target specific genes or proteins that affect the growth of cancer cells, without harming normal healthy cells. They are used for cancers that do not respond well to chemotherapy, such as chordoma.
Life and rehabilitation after treatment
Rehabilitation is very important to get used to normal life after treatment. Especially if you have had surgery on an arm or leg, you need to exercise with the help of a physiotherapist and regain the function of that limb. Although this is a somewhat challenging and time-consuming process, it is very important to do it without skipping it.
Also, it is essential to see your doctor at regular intervals after treatment is complete (follow-up appointments) . You will need to have check-ups at least every 3-6 months for the first few years. This will help you quickly determine if the disease is returning.
Take-Home Message
- Primary bone cancer is a very rare condition.
- If you have persistent, unexplained pain or swelling in a bone, don't ignore it and definitely see a doctor .
- Not all tumors that form in a bone are cancerous. There are also benign tumors.
- There are several types of bone cancer, and treatment methods depend on the type and stage of the disease.
- Most bone cancers can be completely cured if detected early and treated properly. Therefore, it is best not to panic unnecessarily and seek medical advice if you have symptoms.
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