Bone Cancer (Sarcoma of Bone) - Page 3 of 8

Bone cancer (sarcoma of bone) is a tumor in the bone that occurs as a result of the growth of bone cells out of control. The tumor may have its origin in the bone, or it may have spread from cancer elsewhere in the body to the bones. Bone cancer is also classified as an uncommon malignant tumor. In any bone of the body, but it often affects long bones such as the bones of the leg and arm, and the feeling of pain in the bone is considered one of the early symptoms of bone cancer, as the patient feels pain and swelling in the place of the tumor, and the pain intensifies with movement, and increases at night, in addition to swelling and stiffness of the joints surrounding the tumor, in addition to other symptoms.

Types of bone cancer (sarcoma of bone)

Bone cancer is divided into two types:

Primary bone cancer:

It is cancer that arises from the bones themselves and is the most dangerous type of bone cancer. It is called the main type of primary cancer (sarcoma of bone).
Sarcomas are cancer of bone, muscle, fibrous tissue, blood vessels, adipose tissue, and other tissues, which can occur anywhere in the body.

Secondary bone cancer:

It is cancer that has spread to the bone from cancer found in another part of the body, such as breast cancer, prostate cancer, lung cancer, kidney cancer, and thyroid cancer.
Bone cancers may be benign or malignant. Malignant bone tumors occur when a cancerous tumor develops in the bones.
Benign bone tumors occur when a benign, non-cancerous tumor develops in the bones.

Types of benign bone cancers

Benign tumors do not spread to other organs or tissues, and are not even life-threatening. They usually heal with surgery. Types of benign bone tumors include:

Osteoid Osteoma.
Osteoblastoma.
Osteochondroma.
Enchondroma.
Chondromyxoid Fibroma.

Types of malignant bone cancers

Malignant bone tumors include:

Osteosarcoma

It begins in bone cells and usually forms in the bones of the arms, legs, and pelvis.
Osteosarcoma is more common in males than in females, and it often affects young people between 10 and 30 years old, but approximately 10% of cases grow and develop between the ages of 60 and 70, and it is rare in middle age.

Ewing’s sarcoma

It is the second most common primary bone cancer, and the second most common cancer in children and adolescents.
Most Ewing’s sarcomas grow in the bones, but they can start growing in other tissues and organs.
The most common places for this cancer to be present are the pelvis and long bones such as the legs and arms, and it is rare for those over the age of 30.

Chondrosarcoma

It occurs in people under the age of 20 years, while the risk of infection is higher in people over 40 years old. The incidence of Chondrosarcoma is equal in both sexes.
This type of cancer grows in the pelvic bones, leg bones, and arm bones, and can sometimes grow in soft tissues.
Chondrosarcoma is classified according to the degree, which measures the speed of its growth. The doctor classifies the degree after examining and diagnosing the cancerous tissue samples under the microscope. In the case of a lower degree and slower growth of cancer, the chance of the cancer spreading is less, and thus the cure rate is better.

Malignant fibrous histiocytoma

More often this type begins in soft tissues such as ligaments, tendons, fat, and muscles compared to bone, and this cancer is polymorphic.
When this tumor affects the bones, it usually affects the legs, around the knees, or the arms, and tends to grow rapidly and often spreads to other parts of the body.
Malignant Fibrous Histiocytoma often affects middle-aged and elderly adults and is rare in children.

Fibrosarcoma

It is another type of cancer that often grows in the soft tissues, affects the bones of the leg and arm, and usually affects middle-aged and elderly people.

Giant Cell Tumor of Bone

This type of primary tumor is divided into two types, benign and malignant, and benign is the most common.
Giant Cell Tumor of Bone usually affects the leg near the knees or arm bones in young and middle-aged people and does not often spread to other parts, but tend to return after surgery.

Chordoma

It affects the bones of the spine or the base of the skull. This type of cancer is characterized by its slow growth and often does not spread to other parts of the body, but it often returns to grow in the same area if it is not completely removed.
The spread is to the lymph nodes, lungs, and liver as they are among the most common areas for the growth of secondary tumors.
Chordoma develops most often in adults over 30 years of age.

Non-Hodgkin Lymphoma

It usually affects the lymph nodes, but sometimes it starts in the bones and often spreads due to the presence of lymph nodes in several parts of the body.

Multiple myeloma

It is always found in the bones, but it is not considered a primary bone cancer because it begins to grow in the plasma cells of the bone marrow (the soft inner part of the bone).
Although it destroys bones, it is considered leukemia rather than bone cancer, and it is treated as a widespread disease.

Causes of bone cancer (sarcoma of bone)

The causes of bone cancer are unknown, but some factors increase the chance of developing it, including:

Exposure to radiation, such as radiotherapy or radioactive materials.
Exposure to chemicals from environmental pollutants.
Paget’s disease.

How does bone cancer spread to other parts of the body?

Most cancers grow and spread to other parts of the body through the lymphatic system, which consists of a series of nodes spread throughout the body, so bone cancer travels unusually through the lymphatic system, and it can also spread through the blood, and this explains its spread to the lungs where cells leak Cancer from the bones travels through the bloodstream to the lungs, causing secondary lung cancer.

Symptoms of bone cancer (sarcoma of bone)

Bone cancer causes some symptoms, which include:

Feeling severe pain in the bones is one of the first symptoms of bone cancer.
Swelling in the affected area.
Weakness in the bones leads to fracture, which is one of the most important symptoms of bone cancer.
Exposure to fatigue and exhaustion.
Significant weight loss.
Loss of the ability to move and walk.
Breathing difficulties.
Stiffness and swelling of the joints and a feeling of severe pain when moving the affected joint, lead to an exacerbation of symptoms of bone cancer.
Fractures due to weak bones.
A feeling of numbness and weakness in the movement of the limbs, is one of the most common symptoms of bone cancer in people with bone cancer.
High body temperature, feeling tired and vomiting, and anemia.
Feeling a lump in the affected bone area.

How is bone cancer diagnosed?

Diagnosis of bone cancer begins by taking the patient’s medical and family history, then clinical examination and evaluation of the symptoms that the patient complains about.
After that, the doctor orders some tests and imaging tests to help in the diagnosis.
Imaging tests may indicate the presence of bone cancer, but in most cases, the doctor must confirm the presence of the disease by examining a sample of tissue or cells under a microscope, known as a biopsy to prove the presence of cancer cells, as there are other diseases such as osteitis whose symptoms are similar Symptoms of bone cancer, as well as imaging findings.

Tests to detect bone cancer (sarcoma of bone) include:

X-rays: Most bone cancers appear on bone X-rays, and the bone may appear rough instead of solid at the site of cancer. Cancer can also appear in the form of a defect such as a hole in the bone.
Computed tomography: CT scan helps detect cancer. It also helps to know if bone cancer has spread to the lungs, liver, or other organs. CT scan also shows lymph nodes and distant organs.
Magnetic resonance imaging: Because the symptoms of bone cancer may resemble symptoms of other diseases, the doctor usually resorts to magnetic resonance imaging, as it is the best test for detecting bone tumors. It also helps to see the bone marrow and the soft tissues surrounding the tumor, such as nerves and blood vessels.
Radioisotopic bone imaging: This procedure helps to show whether cancer has spread to other bones, and can find metastasized foci faster than regular X-rays. It also shows the extent of damage from cancer in the bones.

This test is done by giving the patient an injection of a radioactive substance that does not cause any long-term effects. This substance is attracted to diseased bone cells throughout the skeleton, and may also indicate the presence of areas of secondary cancer.

Arthritis, infection, or other bone diseases can present a picture similar to cancer as well as symptoms similar to those of bone cancer. To distinguish between these conditions, the doctor may use other imaging tests or take bone biopsies.

Positron emission tomography: Positron emission tomography is useful in searching for cancer throughout the body, and sometimes helps to know if the tumor is cancerous or benign, and it is combined with CT scans to determine the best types of cancer.
Biopsy: A biopsy is the taking of a sample of tumor tissue and examining it under a microscope. A CT scan is used to accurately guide the biopsy needle to the suspected malignancy.

A biopsy is the only way to confirm bone cancer when symptoms are mixed with those of bone cancer, as well as to confirm imaging results.

A biopsy can help the doctor determine whether the bone cancer is primary or secondary.

Bone cancer (sarcoma of bone) treatment

Bone cancer (sarcoma of bone) treatment depends on the severity and stage of the bone cancer symptoms. Where some types of bone cancer respond to different treatment methods, and the orthopedic doctor helps direct the most appropriate treatment for the type and stage of cancer, and the methods of treating bone cancer depend on surgery, chemotherapy, and radiotherapy, and some depend on surgery and chemotherapy or radiation together.

Surgical treatment

Surgical treatment aims to completely remove the cancerous tumor, and in most cases, part of the surrounding healthy tissue is removed.
Other cases may require surgery to remove all or part of a limb (amputation) as a result of the progression of the condition.

Medication treatment

Where the patient is given some medications, to reduce the spread of cancer cells and alleviate the symptoms of bone cancer.

Radiation therapy

Radiotherapy is used to eliminate cancer cells; They use high-energy beams, such as x-rays.
It is also used in some cases before surgery to reduce the size of the tumor, and facilitate the removal of the tumor to reduce the complications of surgery.
Radiotherapy is also used in cases of bone tumors that cannot be removed through surgical operations.
Radiation therapy enters after surgery to eliminate any remaining cancer cells.

Targeted treatment of bone cancer

Targeted treatment is based on targeting cancer cells that are found in the bones, with fewer complications on other normal cells in the body, unlike other treatments such as Chemical which does not distinguish cancer cells from others and destroys normal cells.

Chemotherapy

Here, this type of treatment is used in the form of powerful anti-cancer drugs, injected through a vein to kill cancer cells.
This type of treatment is used in some forms of bone cancer, but not in all cases. This type of treatment is not effective for chondrosarcoma, but it is effective for osteosarcoma and Ewing’s sarcoma.