Bone tumours can cause symptoms such as persistent pain and unintended weight loss, or they might only be discovered when someone breaks a bone and X-rays show a lesion. Wendy Allen-Rhoades, MD, PhD, a paediatric oncologist at Mayo Clinic Comprehensive Cancer Center, describes the most common bone cancers in children and adults as follows:
A bone tumour is an abnormal growth of cells within the bone. Some bone tumours are benign, or non-cancerous, and may be monitored over time. Others are malignant, or cancerous, and require treatment because they can grow, damage the bone or spread to other parts of the body.
“Hearing that an imaging test found a bone tumour or bone lesion can be frightening. Fortunately, most bone tumours aren’t cancerous,” Dr. Allen-Rhoades said. “The key is finding out exactly what type of tumour or lesion you have, so your healthcare team can recommend the right care.”
Primary bone cancer is different from cancer that has spread to the bone from another part of the body, Dr Allen-Rhoades notes. Cancers are named for where they begin. For example, if lung cancer spreads to the bone, it’s still lung cancer, not bone cancer. Likewise, if bone cancer spreads to the lungs, it’s still bone cancer.
Pain in bones
Pain in bones, muscles or joints is common and is usually caused by conditions other than cancer. Pain that worsens, doesn’t improve, wakes you or comes with other symptoms, such as swelling, fever, weight loss or limping, deserves medical evaluation, Dr Allen-Rhoades explained.
“In children and teenagers, persistent pain shouldn’t automatically be dismissed as growing pains,” she adds. “While growing pains are common, ongoing pain that interferes with sports, school or daily activities should be evaluated by a healthcare professional.”
Persistent back pain in children is also uncommon and should be checked. Another warning sign is a fracture that occurs after little or no trauma. Some bone tumours can weaken the bone.
“Sometimes bone tumours don’t cause symptoms. Instead, they’re discovered when an X-ray or other imaging test is performed after a sports injury or another unrelated problem,” Dr Allen-Rhoades said. “In these cases, the injury didn’t cause the tumour; the imaging revealed something that was already there.”
The most common bone cancers include:
* Osteosarcoma starts in cells that form bones. It’s the most common type of bone cancer. Osteosarcoma tends to happen most often in teens and young adults. Osteosarcoma happens most often in the long bones of the legs and sometimes the arms. Osteosarcoma treatment most often involves surgery and chemotherapy.
* Chondrosarcoma usually begins in bones but can sometimes occur in soft tissue. Chondrosarcoma happens most often in the pelvis, hip and shoulder. It occurs most often in middle-age and older adults. Chondrosarcoma treatment often involves surgery to remove the cancer. Small and slow-growing chondrosarcomas in the arms and legs are sometimes treated with a procedure to scrape cancer cells from the bone. The surgeon might apply cold gas or a chemical to kill any cancer cells that remain. The bone can be repaired with a bone graft or bone cement, if needed.
* Ewing sarcoma starts in bones and the soft tissue around the bones. Ewing sarcoma mostly happens in children and young adults. It most often begins in leg bones and the pelvis. Ewing sarcoma treatment most often includes chemotherapy and surgery.
“Many benign tumours don’t require treatment and can simply be monitored if they’re not causing pain, limiting function or weakening the bone. Other benign bone tumours may require surgery,” Dr Allen-Rhoades noted. “Malignant bone tumours, however, require treatment. Depending on the type of cancer, treatment may include surgery, chemotherapy, radiation therapy or a combination.”
Innovations
Innovations such as 3D-printed models of a person’s tumour and the physical structures around it often help surgeons determine the best way to remove the tumour. Proton beam therapy may be used to deliver higher doses of radiation to bone tumours without damaging healthy tissue nearby.
The cause of most bone cancers isn’t known and there is no way to prevent it. Factors that can increase risk include certain rare genetic syndromes passed through families, such as Li-Fraumeni syndrome and hereditary retinoblastoma; other bone conditions such as Paget’s disease of bone and fibrous dysplasia; and radiation therapy and some types of chemotherapy for other forms of cancer.
Because bone tumours are rare, it’s important to be evaluated by a healthcare team with experience in diagnosing and treating your specific condition. Specialists, including radiologists, pathologists, orthopedic surgeons and medical oncologists, work together to make an accurate diagnosis and recommend the most appropriate treatment plan.
“If you’ve been told you have a bone tumour or bone lesion, try not to assume the worst. Many bone tumours are benign, and even malignant bone cancers can often be treated successfully,” Dr Allen-Rhoades stated. “If you have persistent pain, an abnormal imaging finding or symptoms that concern you, don’t ignore them. Talk with your healthcare team. An accurate diagnosis is the first step towards getting the care that’s right for you.”
Source: Mayo Clinic is a non-profit organisation committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.
