WHAT YOU SHOULD
KNOW
We tend to think of the bones as
a solid mass of minerals, but in fact they are home to a wide
variety of cells. Like all cells, those in the bones normally
divide in an orderly way, creating new cells only when needed.
Cancer takes hold when these cells begin to divide and multiply
without control, often making excess tissue that becomes a
tumor.
Cancer may start in the bones and
spread to other parts of the body, or start elsewhere, then
invade the bones. All forms of bone cancer are relatively rare.
Here's a list of the most common varieties.
Multiple myeloma . This cancer develops from plasma
cells in the bone marrow, the soft, spongy tissue that fills
the center of bones. It is the most common type of bone cancer,
striking 2 to 3 people in each 100,000. It affects men and
women equally, and usually develops after age 40. It typically
appears in a number of bones.
Osteosarcoma . The next most common form of bone
cancer, osteosarcoma tends to strike young people (aged 10 to
20), but can surface at any age. Although it can develop in any
bone, it is most often found near the knee. It is considered
highly malignant, and often spreads to the
lungs.
Chondrosarcoma . This cancer develops in the
cartilage that cushions the bones, typically in the arms, legs,
pelvis, and ribs. It has a tendency to spread to surrounding
tissues.
Malignant lymphoma of bone. This bone-destroying
form of cancer can appear in any of the bones. The disease
usually strikes adults in their 40s and 50s.
Ewing's tumor . These tumors typically form in the
arms or legs, but may be found in any bone. Like osteosarcoma,
they tend to strike children and adolescents, and are rare in
adults over the age of 30.
Fibrosarcoma and malignant fibrous histiocytoma .
These cancers typically start in the soft tissues, such as the
ligaments or tendons.
Giant cell tumor of bone . Only about 10 percent of
these tumors are malignant. They are typically found in young
and middle-aged adults at the ends of the arm and leg
bones.
The prognosis for people with
bone cancer varies greatly depending on the specific type of
bone cancer and how far it has spread.
Causes
The cause of bone cancer is
unknown although certain factors are thought to increase the
risk of developing this type of cancer and include bone trauma,
bone disease, bone fractures, and radiation
exposure.
Signs/Symptoms
Symptoms vary according to the
type of cancer, but generally include bone pain. In
osteosarcoma and fibrosarcoma, the pain is often accompanied by
a mass at the site of the cancer. In malignant lymphoma and
Ewing's tumor, swelling accompanies the pain. Multiple myeloma
often combines pain with kidney problems, and a tendency to
infections. This form of cancer also may cause weakness and
fatigue, and often leads to fractures in the bones of the
back.
Care
The best treatment varies
according to the form of cancer the doctor discovers. To
determine exactly which type you have, the doctor will probably
order a number of tests, including blood work, x-rays, a bone
scan, and a biopsy (microscopic examination of a sample from
the tumor). Among the major treatment options
are:
-
Surgery: Depending on the type and stage of the bone
cancer, surgery is often used to remove the cancer and
about one inch of the surrounding tissue. As recently as 10
years ago, amputation of a cancerous limb was often
required. Today, however, advances in treatment have
largely eliminated the need for such radical measures. Now
it is practical to replace large segments of bone with bone
grafts or metal plates to maintain
functionality.
-
Chemotherapy: Often called "chemo," this type of
therapy uses drugs to kill or shrink new tumor cells. For
some types of cancer, such as multiple myeloma, it may be
the main form of treatment. For other types, such as
osteosarcoma, it may be used to shrink the tumor prior to
surgery, and to eliminate any cancer cells that remain
after surgery.
Many different chemo medicines are available. They may be
taken as a pill, a shot, or in an IV. For most types of
bone cancer, doctors typically use a combination of several
anticancer drugs. You will probably need frequent blood
tests to determine how your body is doing and how much
chemo you need. The drugs can produce many side effects and
may leave you susceptible to infection for a
while.
-
Radiation: X-rays or gamma rays can kill cancer and
help prevent it from spreading. They can also be effective
in reducing pain, controlling bleeding, and shrinking
cancerous tumors. Radiation and chemotherapy are often used
together. Radiation is also used after surgery to kill any
cancer cells that might have been missed during the
surgery.
-
Bone Marrow Transplant: In this form of therapy,
which is sometimes used for multiple myeloma, diseased or
damaged bone marrow is replaced with healthy marrow,
usually from a donor. (Your own marrow may be used if it
can be collected while your cancer is in remission.) The
transplant is given in the hospital through an IV. Although
the treatment can cure cancer, it may lead to other very
serious health problems, including severe infections. You
may have to stay in the hospital for a month after the
procedure.
Risks
Almost all forms of cancer
therapy have unpleasant side effects. However,
treatment---especially when performed early enough---can
dramatically improve your chances of recovery. Without
treatment, the cancer is likely to spread and ultimately prove
fatal.
Return to top
|
Email this page
Printer friendly
Bookmark this page
