Bone Cancer Facts

Bone cancer facts

  • Not all bone tumors are cancerous.
  • The majority of cancer involving the bones is metastatic, or secondary, disease from other remote cancers. Primary bone cancer is much rarer.
  • The most common symptom of bone cancer is pain. The pain is usually mild initially and gradually becomes more intense.
  • Treatment of bone cancer includes a combination of surgery, chemotherapy, and radiation therapy.
  • Treatment is based on the size and location of the cancer and whether or not the cancer has spread to or from the bone and into surrounding tissues.

What is cancer?

The body is made up of many tiny structures called cells. One billion cells would fill a sphere the diameter of your index finger. Cells organize to form tissues. Tissues are organized into organs. There are many different types of cells that grow to form the different parts of your body. During normal growth and development, these cells continuously grow, divide, and make new cells. This process continues throughout life even after you are no longer growing. The cells continue to divide and make new cells to replace old and damaged cells. In a healthy person, the body is able to control the growth and division of cells according to the needs of the body. Cancer occurs when this normal control of cells is lost and the cells begin to grow and divide in an uncontrolled manner. The cells also become abnormal in appearance and have altered functions in patients with cancer. The cancer cells can become very destructive to the surrounding cells and can spread both locally by direct invasion, and distantly through the lymphatic system and/or blood streams to and invade normal organs and tissues, disrupting their function.

There are many different type of cancer. The cancer is usually named based on the type of tissue or organ in which the cancer took origin and initially grew. For example, lung cancer is caused by uncontrolled cells that form within the lungs, and breast cancer by cells that form within the breast. A tumor is a collection of abnormal cells grouped together. However, not all tumors are cancerous. A tumor can be benign (not cancerous) or malignant (cancerous). Benign tumors are usually less dangerous and are not able to spread to other parts of the body. Benign tumors can still be dangerous. They can continue to grow and expand locally. This can lead to compression and damage to the surrounding structures. Malignant tumors are usually more dangerous and can spread to other areas in the body. The ability of cancer cells to leave their initial location and move to another location in the body is called metastasis. Metastasis can occur by the cancer cells entering the body's bloodstream or lymphatic system to travel to other sites in the body. When cancer cells metastasize to other parts of the body, they are still named by the original type of abnormal cell. For example, if a group of breast cells becomes cancerous and metastasizes to the bones or liver, it is called metastatic breast cancer instead of bone cancer or liver cancer. Many different types of cancer are able to metastasize to the bones. The most common types of cancer that spread to the bones are cancers of the lung, breast, prostate, thyroid, and kidney. Cancers arising from lymphatic or blood cells, including lymphoma and multiple myeloma, can also frequently affect the bones as they arise in or involve the bone marrow.

Metastatic versus Primary Bone Cancer

Most of the time, when people have cancer in their bones, it is said to be secondary or metastatic bone cancer. This means that such cancerous growths in the bones are caused by cancer that has spread from elsewhere in the body to the bones. It is much less common to have a true or primary bone cancer, a cancer that arises from cells that make up the bone. It is important to determine whether the cancer in the bone is from another site or is from a cancer of the bone cells themselves. The treatments for cancers that have metastasized to the bone are often based on the properties of the initial type of cancer.

If metastatic disease in the bones is from a type of cancer rarely sensitive to hormonal or chemotherapy, the first treatment may be surgery to stabilize the bone, then radiation. Conversely, unless the metastasis in bone results in an impending fracture, the treatment of drug or hormone sensitive cancers may just be the administration of the type of systemic treatment to which that type of cancer is most sensitive.

What are bones for?

The body has 206 bones. These bones serve many different functions. First, your bones provide structure to your body and help provide its shape. Muscles attach to the bones and allow you to move. Without the bones, your body would be an unstructured pile of soft tissues and you would be unable to stand, walk, or move. Second, the bones help to protect the more fragile organs of the body. For example, the bones of the skull protect the brain, the vertebrae of the spine protect the spinal cord, and the ribs protect the heart and lungs. Third, the bones contain bone marrow, which produces and stores new blood cells and their precursors. Within the bone marrow are also important cells for the production of proteins used as antibodies by your immune system. Finally, the bones help control your body's mineral levels and nutrients including calcium and phosphorus.

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References
Medically reviewed by Jay B. Zatzkin, MD; American Board of Internal Medicine with subspecialty in Medical Oncology

REFERENCES:

Bone tumors: Diagnosis and biopsy techniques. UptoDate.com

Osteosarcoma: Epidemiology, pathogenesis, clinical presentation, diagnosis, and histology. UptoDate.com