Bone cancer is also referred to as the sarcoma of bone. If it is in the leg, it may feel painful in the area where the tumor is located. The patient may feel aching, throbbing or stabbing pain. It may initially come and go. As the tumor grows, the pain may worsen during rest, at night or due to activities (for example, jogging can bring on the pain). It may persist and not go away. Other signs and symptoms of bone cancer include
- Swelling and tenderness in the affected area of the bone
- Fracture in the weaker areas of bone
- Joint swelling and stiffness (if the tumor is on the joint)
- Limited range of motion and movement (if the tumor is on the joint)
- Anemia (low level of hemoglobin due to decrease in red blood cells)
- Unexplained weight loss
Bone pain or joint pain can also be a sign of other conditions, such as osteoporosis and arthritis and not cancer. It is recommended to consult with the doctor to know the condition that is responsible for bone pain.
What causes bone cancer?
Primary bone cancer is the one that originates in the bone itself.
What exactly causes primary bone cancer is not known. However, doctors have recognized certain factors that can increase the risk of getting it. These include
- Inherited genetic syndromes: These syndromes run in families and include
- Paget disease of bone: Paget disease is a chronic condition that results in deformed and brittle bones. It is most commonly found in adults older than 50 years of age.
- Radiation therapy for cancer: Previous radiation therapy increases the risk of bone cancer in the future.
How do doctors diagnose bone cancer?
Doctors generally rule out other conditions associated with bone pain before they reach the diagnosis of bone cancer. They will use many tests to reach the final diagnosis of bone cancer. Not all the tests used for diagnosing bone cancer may be used. The type of tests ordered will depend on factors, such as signs and symptoms, patient’s age and general health and the result of earlier tests. These tests include
- Blood tests (serum alkaline phosphatase and lactate dehydrogenase level)
- Bone scan
- Computerized tomography (CT)
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
- Bone biopsy
Of all these tests, a bone biopsy is the most reliable test to confirm bone cancer. It also helps the doctor know the type and aggressiveness of bone cancer. A biopsy is a procedure of removing pieces of bone tissue from the suspected bone and examining it under a microscope. This can be done via a needle inserted into the skin to reach the bone or via surgery that involves making an incision through the skin to remove the tissue sample from the bone.
How is bone cancer treated?
The treatment of bone cancer differs amongst patients. Doctors need to consider certain factors before deciding on a treatment plan. These include
- The type of cancer
- The stage of the cancer
- The overall health of the patient
- The patient’s preferences
The treatment of bone cancer involves surgery, radiation therapy and chemotherapy. Depending on the factors mentioned above, doctors may plan surgery and administer chemotherapy or radiation therapy after the surgery. Sometimes, only surgery or surgery along with chemotherapy may also be planned.
Surgery in bone cancer involves removing the cancerous portion from the bone and a small amount of adjacent healthy bone tissue. If the tumor is in the legs, doctors will always use techniques to preserve the legs whenever possible. This is sometimes referred to as "limb salvage" or "limb-sparing." Nine out of 10 patients can be treated with limb-sparing surgery rather than amputation. Artificial implants or prostheses, such as metal plates and soft tissues (for example, muscles) from other parts of the body are often used to restore the functioning of the operated limb. This is known as reconstructive surgery.
Sometimes, amputation may be the only option left in cases where there is extensive involvement of the leg and its reconstruction is not possible.
Radiation therapy involves passing a beam of high-energy waves through the cancerous area of the bone. This therapy destroys the tumor and shrinks it.
Chemotherapy uses strong anticancer drugs, delivered intravenously or in the form of pills to kill cancer cells. It may only work for certain types of bone cancer and not for others.
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American Society of Clinical Oncology. Bone Cancer (Sarcoma of Bone): Symptoms and Signs. https://www.cancer.net/cancer-types/bone-cancer-sarcoma-bone/symptoms-and-signs