Bone cancer: osteosarcoma

Medically reviewed: 4, December 2023

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What is a bone cancer?

There are two kinds of bone cancers. The most common kind is cancer that has spread from a cancer in another organ, called secondary bone cancer.

Cancer of the bone itself (primary bone cancer) is extremely rare -it only affects one person in a million, and mainly between the ages of 10 and 20. The main type of primary bone cancer is the osteogenic sarcoma (osteosarcoma).

This usually appears at the lower end of the thigh bone (femur), but it can appear in other long bones.

It destroys bone and spreads rapidly, both into the surrounding tissues and then further away.

Symptoms of osteosarcoma

The first symptom is bone pain, especially at night. This should never be ignored in an otherwise healthy young adult. Unfortunately, it is such an aggressive cancer that the next symptoms are usually those due to it spreading elsewhere, such as cough, fever, chest pain or shortness of breath.

This would happen if the cancer had spread to the lungs.

Causes of osteosarcoma

The cause is unknown, but can be linked to previous injury or damage to bone.

How to diagnose bone cancer

The cancer forms a swelling in the bone that can be felt, and the area may be warm, shiny and painful to touch. The lump feels irregular and has no definite edge. An x-ray often shows radiating spikes of bone in a characteristic sun-ray pattern.

Better views are provided by a computerized tomography scan (CT scan) and magnetic resonance imaging (MRI scan).

A definite diagnosis is important, so a tissue sample (biopsy) of the lump would be needed if the x-rays and scans suggested osteosarcoma.

Treatment of osteosarcoma

Modern advances in treatment mean that survival rates have dramatically improved. Because this is such an aggressive cancer, full treatment with cancer-killing drugs (chemotherapy), deep X-ray treatment to kill the cancer cells (radiotherapy) and amputation of the affected limb is necessary.

There is hope that new treatments involving special natural immune system substances (antibodies) will improve the situation further still.

Occasionally it is possible to save the leg by removing the affected bone with the cancer, replacing it with a donated bone graft.

Complications

Spread of the cancer to other parts of the body, which makes it very difficult to treat. Survival rate at second and third stages are only 20%.

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