Causes
The cause of the development of bone cancer is still largely unexplained today. Nevertheless, a large number of cases show that certain forms of bone tumors occur primarily in individual groups of people. The so-called Ewing sarcoma, like osteosarcoma, occurs preferentially in children and adolescents.
It is now assumed that the cause of these two forms of bone cancer can be traced back to genetic factors. In addition, it can be stated that osteosarcoma is often associated with other diseases. A classic example of such a disease is osteodystrophia deformans (synonyms: Paget’s disease; Paget’s disease).
It is a focal disease of bone tissue characterized by a pathologically increased bone remodeling. The affected patients show a phased increase in the activity of individual cell types (bone-building and degrading cell populations). As a consequence, bone formation is disturbed and the associated reduction in resilience.
Patients suffering from Paget’s disease usually have a large number of benign tumors of cartilage and bone tissue. Typical localizations of Paget’s disease are the thigh bone, the pelvic bone, the spinal column and the skull bones. Previous radiotherapy and/or chemotherapy may also be associated with the development of bone cancer. According to extensive studies, children who have already had cancer at a young age are particularly at increased risk of developing bone cancer.
Symptoms
The symptoms that occur in the course of bone cancer are usually quite similar, but the symptoms can take on different forms depending on the exact location of the bone cancer.In the case of bone cancer, the symptoms that occur also depend primarily on the type of tumor and its size. Above all, pain in the skin and subcutaneous tissue in the area of the affected bone are among the typical symptoms associated with bone cancer. In addition, the affected patients usually experience significant swelling in the immediate vicinity of the tumor.
Both the pain that occurs and the enormous swelling can lead to the normal range of motion being significantly restricted. Other symptoms vary depending on the type of bone cancer present. In the case of osteosarcoma, which occurs mainly in the bones of the arms and legs, the complaints perceived by the patient are mainly in the extremities.
Osteosarcoma is the most common form of bone cancer. Both severe pain and swelling are among the typical symptoms of this bone tumor. In addition, the mobility of the affected extremity is limited.
Due to the tumor-related changes in the bone architecture, the bone often loses stability. As a result, even normal loads or light external violent influences can cause the affected bone to break. In such cases, this is referred to as a pathological bone fracture (technical term: fracture).
Ewing sarcoma is a comparatively rare form of bone cancer in adults. In children and adolescents, however, Ewing’s sarcoma is the second most common tumor in the area of the bony skeleton. In most cases, the bone cancer develops in the shaft of the long tubular bones (for example, the femur or humerus).
Ewing’s sarcoma can also often be observed in the pelvic bones. Patients suffering from this form of bone cancer usually develop pain and swelling associated with fever at a very early stage. Typically, those affected develop a pronounced, general feeling of illness.
Since the symptoms of Ewing’s sarcoma are very similar to the symptoms of a common bone marrow inflammation (see: Osteomyelitis), it often takes a long time before the suspected diagnosis of Ewing’s sarcoma is made, especially in adults. In advanced stages, this form of bone cancer tends to form metastases. The affected patients lose more and more weight and often feel exhausted.
Persons suffering from such symptoms should definitely consult a specialist as soon as possible. The earlier the diagnosis of bone cancer can be made, the better the prognosis. The diagnosis of suspected bone cancer involves several steps.
At the beginning, there is usually a comprehensive doctor-patient consultation (see: medical history). During this discussion, the doctor will ask the patient about the symptoms. Bone pain and swelling in particular play a decisive role in this context.
In addition, the so-called B-symptoms (fever, unexplained weight loss, night sweats) can provide an initial indication of the presence of cancer. In addition, the physician asks questions with regard to possible pre-existing illnesses, allergies and diseases that frequently occur in the patient’s family. Since pain in the bone area can also be caused by a previous accident, the patient should consider whether a strong violent impact on the affected body region has occurred.
Following the doctor-patient consultation, an orienting physical examination is carried out. During this examination, the doctor pays particular attention to abnormalities in the affected body region. In addition, an X-ray must be taken if bone cancer is suspected.
Unevenness or changes in bone density can help to confirm the suspected diagnosis. The diagnosis of suspected bone cancer can also be supplemented by the following procedures:- Ultrasound examination (sonography)- Computed tomography (CT)- Magnetic resonance imaging (MRI)- Skeletal scintigraphy Skeletal scintigraphy is primarily used to visualize bone metastases. In this method, the patient is injected with a radioactively labeled substance that can be absorbed and stored by tumor cells.
These deposits can then be visualized in the image. In addition, a blood test can help to confirm the diagnosis of bone cancer. In certain forms of bone cancer, some blood values are significantly altered.
In the case of osteosarcoma, for example, there is an increase in alkaline phosphatase (an enzyme).However, all these examination methods can only confirm the suspicion of a bone tumor. Ultimately, only the taking of a tissue sample (so-called biopsy) provides certainty. In this procedure, the doctor must use a needle to obtain a sample from the affected bone. This sample can then be examined in the laboratory for changes.
