Orthopaedic Conditons & Treatments

Bone Cancer, Causes and Symptoms

Bone cancer is a general term that includes all malignant tumors that occur in or on the bone.  This includes primary bone sarcomas, which are among of the rarest forms of cancer.  Bone cancer can also be used to describe tumors in the bone as a result of multiple myeloma, lymphoma, or metastatic carcinoma (a cancer in another body part that has spread to the bone).

Bone sarcomas most commonly occur in the long bones, such as in the arms or legs. A strong skeletal structure is essential for the health and stability of the human body. Bone cancers can cause this fragile skeletal structure to weaken dramatically, and in severe cases may result in fracture. It is estimated that each year approximately 2,800 new primary bone sarcoma cases will be diagnosed in the United States. Many of these malignancies can be highly aggressive, and potentially lethal.
 
According to the American Cancer Society, sarcomas that form in the bone that originate in the bone accounts for only 0.02% of all cancer cases. There are multiple forms of bone sarcomas. Some are primarily found in children and adolescents, while others are found mostly in older adults. The treatment for a bone sarcoma requires surgical removal of the tumor, and often necessitates chemotherapy for survival.

Anatomy of a Bone

The 206 bones in the adult human body are there to shape the body and provide stability. Each bone consists of the following:

  • Cartilage at the end of each bone to protect the subchondral tissues and provide a smooth gliding surface for joint movement
  • Periosteum, which is a layer of tissue that surrounds the bone, supporting bone growth, healing, and remodeling
  • Compact and cancellous bone, which make up the outer and inner portion of the shaft of the bone, and provide the primary supply of calcium in the body
  • Tunnels through the bone filled with blood vessels, along which nutrients are delivered and stored
  • Bone marrow, which is a major source of blood cells
     

Muscles attach themselves to the bones to help provide strength and stability as a person moves. Bones are also used to protect the vital organs in the human body. Inside each bone is marrow, which helps the body produce new blood cells that are vital to good health and survival. Because of the intricacy within each bone, there are many diseases that can affect their strength.

Types of Bone Cancers

There are a variety of bone cancers that affect both children and adults:

  • Osteosarcoma – This is the most common type of primary sarcoma, and the sixth most common form of cancer among children. It typically occurs in adolescents and young adults, though a smaller group of patients develop an osteosarcoma as older adults.  Its name originates from the aggressive tumor cells’ ability to make bone.
     
  • Chondrosarcoma – This is the second most common form of primary bone sarcoma. It most closely resembles cartilage and typically attacks the pelvis, legs or shoulders. The vast majority of people diagnosed with this type of cancer are over the age of 40.  Chondrosarcomas have a broad range of aggressiveness.
     
  • Ewing's sarcoma –This type of bone cancer is most common in adolescents and young adults and typically affects the pelvis or long bones.  It has been linked to specific genetic alterations within the tumor cells, making it a disease of particular research interest.
     

Causes of Bone Cancer

There is little information to determine what causes bone cancers. From what has been studied, scientists can see that it usually involves genetic alterations of some type. Usually this happens when the cells that should die off continue living and dividing. While the cause is still unclear, there are certain risk factors that have been identified.

  • Genetics – Sometimes, the genetic makeup of a person’s body can expose them to an increased risk of chromosome abnormalities. This is particularly true when Li-Fraumeni syndrome and hereditary retinoblastoma are seen in the family lineage.
     
  • Intense growth spurts –Some researchers speculate that when the body grows quickly, it to can increase the risk of alterations that can ultimately it can cause bone cancer to occur.
     
  • Paget's disease of bone – This is a rare disease in adults that can predispose to the development of a particular bone cancer, osteosarcoma, late in adulthood.
     
  • Radiation and chemotherapy for other cancers – Radiation and chemotherapy are extremely effective ways to combat many forms of cancer. However, sometimes this increases the risk of formation of other types of cancer. In this case, bone cancers known as sarcomas can sometimes develop years after radiation or chemotherapy treatments. This is especially true in the treatment of childhood cancers.
     

Symptoms of Bone Cancer

The most common symptom of bone cancer is pain in the affected area. This can also lead to swelling and tenderness in the area of the pain. In some cases, one may fracture the bone because of its increased fragility. However, not all pain and broken bones are signs of cancer.
The following are some of the most common bone cancer symptoms that you should be aware of. Every person’s body is different and will have various reactions to this disease.

  • Pain in a specific area of the body
  • Swelling or tenderness around that same area
  • A large or growing mass
  • Fatigue
  • Broken bones, particularly after minimal trauma

Each of these can also be symptoms for other diseases or traumas. Therefore, it is important to speak to your doctor before drawing any conclusions.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's musculoskeletal oncology services in New York treats Bone Cancers as well as many other conditions that affect the bones within the body.

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