Definition

Bone cancer is a rare disease in which cancer cells grow in the bone tissue.

Cancer may form in the bone or spread to the bone from another site in the body. When cancer starts in bone tissue, it is called primary bone cancer. When cancer cells travel to the bone from another site in the body, it is called secondary or metastatic bone cancer. Types of bone cancer include:

• Osteosarcoma—a cancerous tumor of the bone, usually of the arms, legs, or pelvis
• Chondrosarcoma —cancer of the cartilage
• Ewing sarcoma—tumors that usually develop in the cavity of the leg and arm bones
• Fibrosarcoma and malignant fibrous histiocytoma—cancers that develop in soft tissues such as tendons, ligaments, fat, and muscle, and move to the bones of the legs, arms, and jaw
• Giant cell tumor—a primary bone tumor that is malignant; most common in the arm or leg bones
• Chordoma—primary bone tumor that usually occurs in the skull or spine

Causes

Cancer occurs when cells in the body, in this case bone cells, divide without control or order. Normally, cells divide in a regulated method. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms. This is called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor does not invade or spread.

The cause of primary bone cancer is unknown. Genetics play a major role in most cases. Conditions that cause increased bone breakdown and regrowth over an extended period increase the risk of tumor development. This explains why osteosarcoma in children is most common during the adolescent growth spurt.

Risk Factors

Factors that may increase your chance of bone cancer include:

• Paget’s disease —a noncancerous bone condition
• Exposure to radiation
• Family history of bone cancer

Certain types of bone cancer have specific risk factors:

• Osteosarcoma, which is more common in males who are 10-30 years old:
  • Inherited cancer syndromes, including Li-Fraumani and Rothmund-Thompson syndromes
  • Retinoblastoma—a rare eye cancer
  • Bone marrow transplantation
• Chondrosarcoma, which is more common in people older than 20 years of age:
  • Multiple exostoses—an inherited condition that results in bumps on bones
• Ewing sarcoma, which is more common in people younger than 30 years of age

• Fibrosarcoma and malignant fibrous histiocytoma:
  • Increased age
• Giant cell tumor, which is more common in those who are young or middle-aged

Symptoms

Symptoms of bone cancer vary, depending on the location and size of the tumor.

Symptoms may include:

• Pain at the tumor location
• Swelling or a lump at the location of the tumor
• Deep bone pain severe enough to wake you up
• Unexplained weight loss
• Fatigue
• Trouble breathing
• Fever or night sweats

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids and tissues may be tested. This can be done with:

• Blood tests
• Biopsy

Images may be needed of your bodily structures. This can be done with:

• X-ray
• CT scan
• MRI scan
• Bone scan

Treatment

After cancer is found, staging tests are done to find out if the cancer has spread and, if so, to what extent. Treatment depends on the type, stage, and location of the cancer. It also depends on your overall health. Talk with your doctor about the best treatment plan for you. Treatment options include:

Prevention

There are no current guidelines to prevent primary bone cancer. Early diagnosis and treatment improve your chance of successful treatment.

National Cancer Institute http://www.cancer.gov

Caring for Kids—Canadian Paediatric Society http://www.caringforkids.cps.ca

Bone cancer. National Cancer Institute website. Available at:
http://www.cancer.gov/types/bone/bone-fact-sheet
Updated March 13, 2008. Accessed September 3, 2014.