Bone cancer is a rare but potentially severe disease that involves the growth of cancer cells within the bone tissue. According to the American Cancer Society (ACS), primary bone cancer (which starts in the bone), accounts for less than 1% of all types of cancer.
Despite its rarity, it remains an important health concern due to its potential severity and impact. Understanding rare conditions also contributes to advancements in medical research and knowledge, ultimately benefiting overall healthcare outcomes.
In 2023, the ACS estimates that around 3,970 people across all age groups in the United States will receive a diagnosis of bone cancer. Primary bone cancer is slightly more common in males (2,160) than for females (1,810). Furthermore, the ACA expects that bone cancer will claim the lives of 2,130 people by the end of 2023.
To put those numbers into perspective, we’ll cover the types of bone cancer you should know about and provide an overview of bone cancer symptoms to aid in early detection, which can significantly impact survival rates.
Indeed, recognizing the symptoms of bone cancer may be the first step in prompt diagnosis and treatment. You’ll also learn about risk factors, screening, diagnosis, and treatment options.
There are several types of primary bone cancer. The type of cancer may determine where the cancer shows up. Osteosarcoma and Ewing sarcoma are the most common types of bone cancer in adults, with Ewing and osteosarcoma being the most common types in children and in teens.
Primary bone cancer always starts in the bone. It can occur in any bone but usually impacts the long bones of the arms and legs. According to a report published in Stat Pearls, secondary bone cancer occurs when cancer begins elsewhere and spreads (metastasized) to the bone. Any cancer could spread to the bone but certain types are more likely than others to do so. These include the following:
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The most common bone cancer symptom is pain. Bone pain tends to start as a subtle ache that might be mistaken for arthritis or injury. Over time, bone pain may intensify and become more persistent, especially at night or during physical activity. The pain also tends to occur around the affected bone.
In some cases, patients may notice swelling in the area of the pain and there may be a lump or mass. Bone tumors can weaken the bone structure and this may lead to unexpected fractures when the patient has only had a minor injury or stress.
There could be unexplained systemic changes like weight loss, fatigue, and fever. Medical consultation is critical if any of these symptoms persist. But it’s crucial to remember that because bone cancer symptoms are vague, minor, or non-existent, they might be missed.
Once bone cancer is suspected, a healthcare provider may recommend some testing. X-rays often provide the first indication of a problem in the bone. However, while an X-ray can show the location, size, and shape of the tumor, it cannot definitively diagnose bone cancer.
For a more accurate diagnosis, a biopsy is needed. This is where a sample of the tumor is removed for examination under a microscope. A computed tomography scan (CT scan) and magnetic resonance imaging (MRI) can provide more detailed images that help determine the size and exact location of the cancer and other information like whether it has spread to other areas of the body.
You may wonder whether bone cancer can show up in blood work. Blood tests do not help diagnose bone cancer. However, once a diagnosis of bone cancer is made, blood tests may be helpful, according to the ACS. For instance, alkaline phosphatase and lactate dehydrogenase (LDH) levels in the blood may indicate advanced cancer.
In addition, blood cell counts and blood chemistry tests are routinely performed as part of a patient's health assessment before surgery. These tests can also help monitor your health while undergoing cancer treatments like chemotherapy.
The Full Body and Full Body Plus from Ezra uses MRI technology and can serve as a comprehensive screening method for various types of cancers, While MRIs may not be able to definitively diagnose bone cancer, they can detect changes or abnormalities that warrant further examination.Currently, the Ezra Full Body and Full Body Plus image the following bones: spine, pelvis, and upper thigh.
Once cancer has been diagnosed, staging is the process of detailing your cancer. It notes details like tumor size and if it has spread. Staging helps guide treatment decisions. The Musculoskeletal Tumor Society staging system is commonly used to stage bone cancer. It bases staging on three data points: grade, primary tumor extent (intracompartmental vs. extracompartmental), and metastasis (whether it has spread to other areas).
Stage IA is the first stage of bone cancer. Early stage cancer is still contained in the bone and has not spread to other areas of surrounding tissue, joints, or other parts of the body. Under a microscope, stage IA bone cancer has many features of normal bone tissue but is undergoing changes.
Stage IB is the next stage. Here, bone cancer has begun to change more rapidly and looks less like normal bone tissue under the microscope. At this stage, lesions are considered “high-grade” but the cancer is still localized. Lesions may be found in one area or several areas within the same bone.
Specific staging can vary based on the different types of cancer but in stages IA and IB, the cancer hasn’t yet spread beyond the bone or compartment into other structures or lymph nodes.
It’s important to note that patients may not experience bone cancer symptoms at the early stages. This emphasizes the need for regular checkups and screenings as early detection can improve treatability and prognosis.
While the exact causes of bone cancer are unknown, there are several known risk factors. Let’s take a closer look.
Radiation therapy uses intense beams of radiation to destroy cancer cells and shrink tumors. A side effect of radiation is that it can harm healthy tissues near the treated area. Therefore, this risk factor generally applies to those who have had radiation to treat cancer in the past.
According to the National Institute of Arthritis Musculoskeletal and Skin Diseases, Paget’s disease is a chronic disease that disrupts the normal cycle of bone repair and growth. Usually, our bodies do a great job of breaking down old tissue and replacing it with new bone cells. Paget’s disease disrupts this process by causing accelerated and irregular bone remodeling that may result in bones becoming weaker. Paget’s doesn’t always cause bone cancer but if you have the disorder, you’ll have a slightly increased risk for developing osteosarcoma.
According to the National Institutes of Health, Li-Fraumeni Syndrome (LFS) is a rare inherited disorder that increases the risk of developing several cancers, especially in young adults and children. Types of cancer most associated with the syndrome includes breast cancer, bone cancer (osteosarcoma), soft tissue sarcomas, brain tumors, leukemia, and adrenocortical carcinoma. Patients with LFS are more likely to have multiple types and multiple instances of primary cancers in their lifetimes.
Management of Li-Fraumeni Syndrome involves regular and comprehensive cancer screening to detect tumors as early as possible. Because of the high risk of developing cancer, some individuals with LFS may choose to undergo preventive (prophylactic) surgeries or take other measures to reduce their cancer risk. Discussions about the risks and benefits of these approaches should take place with a healthcare provider experienced in caring for patients with hereditary cancer syndromes.
If bone cancer is confirmed, treatment options can include surgery to remove all of the cancer. In some cases, this might include amputation. However, efforts are made to avoid limb removal if possible.
Other treatments include radiation therapy, chemotherapy, and targeted therapy. An oncologist will recommend a treatment plan based on the type and stage of cancer, and the person’s overall health and preferences.
Understanding the signs of bone cancer can promote early intervention, which is key to better outcomes. While bone cancer symptoms are often subtle and mimic other conditions, persistent bone pain, swelling, fractures from minor injuries, or systemic symptoms like unexplained weight loss should not be ignored.
However, symptoms alone are not enough to diagnose bone cancer early. Various imaging tests and biopsies are needed to confirm the presence of cancer cells.
Although MRI scans might not be the primary tool for detecting bone cancer, they can identify cancer warnings in the body that may require further examination. As such, screening with an MRI is a great first step.
Ezra’s Full Body MRI scan offers a comprehensive screening for various cancers and health conditions, which could potentially include bone cancer. The state-of-the-art MRI technology captures detailed images of up to 13 specific organs.
Catching potential issues early can make a significant difference in your treatment options and prognosis. Don't wait for bone cancer symptoms to dictate your health journey. Take charge of your health and give yourself the peace of mind you deserve.
Remember, early detection can save lives. Don’t wait to schedule your Full Body MRI today.
