What are symptoms of bone cancer?
Symptoms of bone cancer tend to develop slowly. They depend on the type, location, and size of the tumor.
Pain is the most frequent symptom of bone cancer. Sometimes a firm, slightly tender lump on the bone can be felt through the skin. In some cases, bone cancer interferes with normal movements. Bone cancer can also cause bones to break.
These symptoms are not sure signs of cancer. They may also be caused by other, less serious problems. Individuals who are experiencing symptoms should consult a doctor.
How is bone cancer diagnosed?
To diagnose bone cancer, the doctor asks about the patient's personal and family medical history and does a complete physical exam. In addition to checking the general signs of health, the doctor usually orders blood tests and x-rays. X-rays can show the location, size, and shape of a bone tumor. On x-rays, benign tumors usually look round and smooth, with distinct edges. Bone cancers generally have odd shapes and irregular edges.
If x-rays show that the tumor is possible cancer, some of the following special tests may be done. These tests can also show whether the cancer has begun to spread.
Bone scans outline the size, shape, and location of abnormal areas in the bone. A small amount of radioactive material is injected into the bloodstream. This material collects in the bones and is detected by a special instrument called a scanner.
CT or CAT scan is an x-ray procedure that gives detailed pictures of cross-sections of the body. The pictures are created by a computer.
MRI (magnetic resonance imaging) also creates detailed pictures of cross-sections of the body. MRI uses a very strong magnet linked to a computer.
Angiograms are special x-rays of the blood vessels. A dye that shows up on x-rays is injected into the bloodstream so that the vessels can be seen in detail. This test is also done to help plan surgery.
A biopsy is the only sure way to tell whether cancer is present. Biopsies are best done at a hospital where doctors are experienced in the diagnosis of bone cancers. The doctor removes a sample of tissue from the bone tumor. A pathologist looks at the tissue under a microscope. If cancer is found, the pathologist can tell the type of sarcoma and whether it is likely to grow slowly or quickly.
If a diagnosis of bone cancer is made, it is important for the doctor to know exactly where the cancer is located and whether it has spread from its original location. This information is very important for planning treatment. The results of exams, tests, x-rays, scans, and the biopsy are all used in staging the cancer. The stage indicates whether the disease has spread and how much tissue is affected.
How is bone cancer treated?
A number of factors are considered to decide on the best treatment for bone cancer. Among these are the type, location, size, and extent of the tumor as well as the patient's age and general health. A treatment plan is tailored to fit each patient's needs.
Treatment Methods
Bone cancer is treated with surgery, radiation therapy, and/or chemotherapy. The doctor often uses a combination of treatment methods, depending on the patient's needs. Patients may be referred to doctors who specialize in different kinds of cancer treatment. Often, the specialists work together as a team. The team may include a surgeon, a pediatric oncologist, and a radiation oncologist.
Surgery is part of the treatment for most bone cancers. Because the disease may recur near the original site, the surgeon removes the tumor and some healthy bone and other tissue around the tumor.
When bone cancer occurs in an arm or leg, the surgeon tries, whenever possible, to remove just the tumor and an area of healthy tissue around it. Sometimes, the surgeon can use a metal device to replace the bone that is removed. In some children, the surgeon may replace the bone with a metal device that can be lengthened as the child grows. This limb-sparing procedure will require additional operations to keep expanding the artificial bone.
Sometimes, however, when the tumor is large, amputation may be necessary. If the limb is removed, a prosthesis (artificial part) can be made. The artificial part takes the place of a leg, arm, hand, or foot.
Chemotherapy uses drugs to kill cancer cells. Often, a combination of three or more drugs is used. Chemotherapy can be given by mouth or by injection into a muscle or blood vessel. The drugs travel through the body in the bloodstream. Chemotherapy is given in cycles: a treatment period followed by a recovery period, then another treatment and recovery period, and so on.
Some patients have chemotherapy as an outpatient at the hospital, clinic, or doctor's office or at home. Depending on which drugs are given, however, the patient may need to stay in the hospital for a short while.
Chemotherapy is almost always used in combination with surgery for cancers of the bone. Sometimes, chemotherapy is used to shrink a tumor before surgery. It is also used as an adjuvant therapy after surgery to kill cancer cells that may remain in the body and to prevent the disease from recurring. In some cases, a patient may have chemotherapy both before and after surgery. For some bone cancer, chemotherapy is combined with radiation therapy. Chemotherapy can also be used to control bone cancer that has spread.
Radiation therapy (also called radiotherapy) uses high-energy rays to damage cancer cells and stop them from growing. In some cases, radiation therapy is used instead of surgery to destroy the tumor. This form of treatment can also be used to destroy cancer cells that remain in the area after surgery.
The patient goes to the hospital or clinic each day for radiation treatments. Usually, treatments are given 5 days a week for 5 to 8 weeks.
