The term bone cancer includes all malignant tumors that can be present in bone tissue. The most common bone cancer is called osteosarcoma and occurs in both adults and adolescents. Bone cancer – if detected early – can be cured.
What is bone cancer?
Bone cancer is the term used to describe any malignant (malignant) tumor that is located in bone tissue. A distinction is made between primary and secondary tumors. The occurrence of primary bone cancer is very rare. Secondary bone cancer is a consequence of another cancer. This tumor occurs when another malignant tumor, such as breast cancer or lung cancer, spreads and forms metastases (daughter tumors) in the bones. Secondary bone cancer may already be present even if the initiating cancer does not yet cause symptoms or causes only minor symptoms. Furthermore, there are also benign (benign) bone tumors. It must be emphasized that these are not cancer. In addition, there are tumors that cannot be assigned to either group (malignant or benign). These tumors are called semimalignant because bone cancer can develop from the tumor tissue. Chondroma is the most common semimalignant bone tumor. Bone cancer or tumors are further subdivided according to the tissue from which they arise: Bone cells, cartilage cells, and bone marrow. Benign (benign) tumors:
Osteochondroma arises in cartilage tissue, while osteoma arises in bone tissue. Eosinophilic granuloma arises in the bone marrow. Malignant (malignant) tumors:
Osteosarcoma arises from degenerated bone cells. Chondrosarcoma arises from degenerate cartilage cells, and Ewing’s sarcoma originates in the bone marrow. Another malignant bone cancer is giant cell tumor, but its parent tissue (site of origin) is unknown.
Causes
The causes of bone cancer are largely unknown. A genetic predisposition is suspected, particularly in osteosarcoma and Ewing sarcoma cancers. Osteosarcoma is most common in people who have osteodystrophia deformans, a skeletal disease with a genetic background. Other causes of bone cancer are radiation and/or chemotherapy. In particular, people who had cancer as children, which was treated with radiation and chemotherapy, have a significantly increased risk of developing bone cancer. Another cause is other cancers. Bone cancer often occurs as a result of breast and lung cancers.
Symptoms, complaints, and signs
In bone cancer, the type and severity of symptoms are based on the type, size, and location of the tumor. In most cases, pain at the affected site indicates cancer. Accompanying swelling of the skin and tissue near the bone tumor occurs. The pain and swelling often result in limited range of motion in the affected area of the body. Symptoms of osteosarcoma occur predominantly in the bones of the arm or leg. In the affected areas, the bone loses strength, so even normal weight-bearing or mild external impact can cause fractures. Certain forms of bone cancer can cause further discomfort. In Ewing’s sarcoma, pain, swelling and fever occur, usually accompanied by an increasing feeling of illness. In advanced stages, affected individuals lose weight and are tired or fatigued. Ewing’s sarcoma shows up preferentially in the leg, in the area of the shaft on the long tubular bones. The form of cancer can also occur in the pelvic bones. Symptoms of bone cancer increase as the disease progresses and can cause permanent bone damage. If the tumors spread, other symptoms of the entire body occur. Osteosarcoma that goes untreated is fatal to the patient.
Diagnosis and progression
Bone cancer is diagnosed by an oncologist. After taking a medical history and performing an initial physical examination, additional radiodiagnostic procedures are used if bone cancer is suspected, such as X-rays, ultrasound, CT, MRI, and skeletal scintigraphy. Blood tests also provide information on whether certain enzymes, the so-called “cancer parameters”, are elevated. The following values, among others, are examined: alkaline phosphatase, lactate dehydrogenase (LDH) and neuron-specific enolase (NSE).Only a histological examination can reveal whether it is ultimately bone cancer. This involves a biopsy in which a tissue sample of the tumor is taken and examined for malignancy in the pathology department. The course of bone cancer depends on several factors: Type of tumor, malignancy, size of tumor, and metastases. If the bone cancer is detected early, is small in size, and has not yet metastasized, there is a good chance of cure for osteosarcoma. After five years, about 70 to 80 percent of those affected are still alive. Ewing’s sarcoma also has a good chance of being cured. If this bone cancer is detected early, about 50 to 60 percent of those affected are still alive after five years.
Complications
Bone cancer is a very serious disease. As with any other tumor disease, bone cancer can lead to a reduced life expectancy if the tumor spreads to other areas of the body and affects healthy tissue there as well. In the worst case, this can lead to premature death of the patient. In most cases, those affected suffer first and foremost from severe bone pain. This can also occur in the form of pain at rest and lead to sleep disturbances, especially at night, and thus not infrequently to depression. The quality of life is significantly reduced by bone cancer. Likewise, the affected areas can swell and there are severe restrictions on the patient’s movement. The joints may also become stiff. During the treatment itself, there are usually no particular complications. The bone cancer can be removed with the help of radiation. Whether this results in further symptoms depends to a large extent on the spread and extent of the cancer. Not sail is also a psychological treatment of the affected person necessary.
When should one go to the doctor?
With persistent bone pain or swelling, a doctor should be consulted. If other symptoms such as fever or malaise develop, it is best to consult the family doctor immediately. Bone cancer can manifest itself through a wide variety of symptoms that are often only noticed when the disease has already progressed. This makes immediate clarification of unusual symptoms all the more important. Bone cancer patients should consult closely with the responsible physician. If it is suspected that the cancer has recurred or possibly even spread, the physician must be informed. Nonspecific symptoms or suddenly occurring complaints also require clarification. Often it is sufficient to change the medication, but occasionally there is an underlying complication that requires treatment. Individuals who have undergone radiation or chemotherapy are particularly susceptible to developing bone cancer. There is also an increased risk of cancer associated with osteodystrophia deformans or multiple osteochondroma. People in these risk groups should consult their family doctor or an internist immediately if they experience any of the symptoms mentioned above. Children and adolescents should be taken to a pediatrician.
Treatment and therapy
Therapy for bone cancer depends on the type of tumor and whether it has already metastasized. Both osteosarcoma and Ewing’s sarcoma combine radiation therapy and chemotherapy. As a rule, treatment of osteosarcoma begins with chemotherapy. This is intended to shrink the tumor, which is then removed during surgery. Radiation therapy is usually not performed for osteosarcoma, since this tumor does not react or reacts only slightly to radiation. Following surgical removal of the tumor, further chemotherapy is administered. If metastases were also found at the time of diagnosis, chemotherapy is used to treat them initially. Only if this is unsuccessful are the metastases surgically removed. Furthermore, additional chemotherapeutic agents are used during the second chemotherapy (after surgery). Ewing’s sarcoma is a tumor that responds well to radiation therapy. The course of treatment is identical to that for osteosarcoma. After chemotherapy, the tumor is surgically removed. This is followed by radiotherapy. However, it should be noted here that this bone cancer forms metastases very early, preferably in the lungs.
Outlook and prognosis
The prognosis for bone cancer depends on the progress of the disease at the time of diagnosis, as well as treatment. Without seeking medical care, the premature demise of the affected person is the consequence. The cancer cells spread unhindered in the organism and lead to the progress of the disease. Infestation of other physical regions and destruction of healthy tissue occurs. Eventually, the death of the patient is determined. If bone cancer is diagnosed in the early stages, there is a good chance of cure if appropriate therapy is initiated. The progression of the disease is contained or completely prevented by medical options. By removing the affected areas of the body, bone cancer can ultimately be cured. If surgical intervention takes place, the associated risks and side effects must be taken into account when determining the prognosis. Patients in whom the bone cancer has been completely cured must nevertheless expect restrictions in their further lifestyle. The physical resilience decreases and everyday behaviors must be changed and adapted to the physical possibilities. Due to the psychological stress, secondary diseases may occur. These must also be taken into account in the prognosis. Recurrence of bone cancer is possible during the course of life.
Prevention
There are no preventive measures that can be taken for bone cancer. However, one can do some things to reduce the general risk of cancer. A healthy diet, abstaining from alcohol, drugs and nicotine as well as sufficient physical activity form a good basis to stay healthy for a long time. Furthermore, one should regularly attend cancer screening appointments. In case of repeated complaints, such as pain and swelling in the arms and legs, one should consult a doctor. Because the earlier one discovers the bone cancer, the better are the chances of healing or one can at least counteract a severe course of bone cancer.
Aftercare
Tumors are among the diseases that entail the need for intensive, regular medical follow-up. This is primarily because of the life-threatening dimension of the symptoms. In addition, early diagnosis of a recurrence promises the best treatment success. Metastases can also be detected most quickly in this way. In general, the highest probability of recurrence exists in the immediate period after an initial intervention. For this reason, follow-up examinations initially take place on a quarterly basis. Subsequently, if there are no complaints, the intervals are extended to a semi-annual or annual rhythm. Above all, imaging procedures such as X-rays, magnetic resonance tomographies and computer tomographies can be used to make clear statements about a return of bone cancer. In addition, a blood test and a tissue biopsy can also play a significant role. Follow-up care usually takes place in the clinic where the initial procedure was performed. In addition to diagnosing recurrence, follow-up has another function: initial treatment of bone cancer can lead to functional limitations that require treatment. These must be treated during follow-up care to ensure a final recovery. If symptoms even remain permanently, sufficient aids must be provided. The patient should be able to manage his or her daily life as independently as possible.
What you can do yourself
Malignant cancer spreads rapidly in many patients. In order for the organism to have as many defenses available as possible within the cancer therapy, a healthy and stable immune system is very important. Patients can eat balanced meals rich in vitamins to improve their own well-being. Harmful substances such as nicotine or alcohol must be avoided. In addition, food intake of unhealthy or hard-to-digest foods, such as fats or high protein products, should be avoided. The fluid balance must be controlled and should be based on the recommendations of the doctors. The cancer is emotionally very stressful for the patient. It is therefore important for him to have mental strength and daily motivation in everyday life. In dealing with the disease, it is helpful to promote experiences that are perceived as relaxing and life-affirming.Joy and humor should be an integral part despite all adversities. With a positive attitude and the setting of achievable goals, self-confidence can be supported and new courage to face life can be built up. Relaxation methods have proven themselves many times over to reduce stress. The patient can apply these together in training or alone on his own. Sufficient exercise is important despite bone cancer and should be adapted to the available possibilities.
