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A snap of the thigh bone could be the first sign of a cancer that is rarely talked about–bone cancer, or sarcoma. Bone cancer is an aggressive type of cancer that begins in the bone or surrounding tissue and typically affects adolescents and young adults under the age of 35. It’s far less common than other types of cancer, like breast, lung, or colon cancer, but it can be life-threatening. Here’s what you need to know about the disease.
What is bone cancer?
When people hear “bone cancer”, they typically think of one of two things:
- Cancer that begins in the bone (called sarcoma)
- Cancer that started somewhere else in the bone and spread to the bones (e.g. metastatic lung, brain, or breast cancer)
When cancer begins to develop in any part of the bone, it’s a type of sarcoma. If breast, lung, or brain cancer metastasized (spread) to the bone, it is still named breast, lung, or brain cancer. This is an important distinction because the source of cancer changes how we approach treatment for that type of cancer. Bone cancer is also different from leukemia, which is a type of blood cancer that starts in the bone marrow.
Like other cancers, bone cancer develops when cells begin to grow out of control. Bone cancer is rare, affecting only 3,000 people every year. When it is discovered, it often can spread rapidly, so prompt treatment is important.
Types of bone cancer.
There are many different types of bone cancer, with certain kinds primarily affecting adolescents and young adults. Other types of bone cancer occur mostly in adults over 45.
Bone cancer is very uncommon, but the types that we see the most include:
- Osteosarcoma often develops in pre-teens and teenagers near the knee where growth is rapid
- Chondrosarcoma begins in the connective tissue in joints, generally affecting adults over 50
- Ewing sarcoma occurs in the bone or connective tissue most commonly in children and adolescents
All three types can be fatal, with survival rates between 50 to 85 percent. Survival rates are highest when cancer is detected early, so if you feel pain in the bone or suspect bone cancer, you shouldn’t delay care.
Signs, symptoms, and risk factors of bone cancer.
Sarcomas that begin in the soft tissue around and between bones are often painless. Many people with these types of sarcomas don’t realize they have it. That’s because even when a bump or lump appears under the skin, it doesn’t necessarily cause discomfort.
Sarcomas that begin in the bone can cause a dull, throbbing pain. Many patients with bone cancer report that activity makes the pain worse, while the aching pain subsides if they lay down. Some people can pinpoint the pain source to the bone, but others feel a more general pain that could be confused with muscle pain.
While there aren’t a lot of known risk factors for bone cancer, we do know that some hereditary conditions can make someone predisposed to developing the disease, including:
- Li-Fraumeni syndrome
- Lynch syndrome
As a doctor, I encourage my patients to live healthy lifestyles because of the overall health benefits associated with eating well and exercising. But unlike other cancers, a healthy lifestyle won’t decrease your risk of developing bone cancer. Bone cancer can affect anyone, and the most publicly-known cases of the disease happen to be in collegiate or professional athletes.
Diagnosing and treating bone cancer.
Bone cancer is often detected unintentionally on an X-ray or other imaging exam for an unrelated injury. In other instances, someone goes to an orthopedic expert with concerns about pain and imaging reveals something abnormal. As one of few cancer centers in the country experienced in treating sarcomas, patients often contact me for a second opinion after receiving a diagnosis somewhere else. Sometimes, this gives them an opportunity to learn about new or better treatment options than what they’ve been told.
The first time I meet with someone who is diagnosed with bone cancer, I take time to understand their personality and how they’ll want to receive information about their diagnosis and treatment options. Some patients appreciate a direct approach with just the facts, while others want the information delivered at a slower pace. In either case, I will always tell the truth about what I know and what I don’t know.
The truth is that bone cancer can be much more challenging to treat than some other types of cancer. There is hope, however, and our goal is always to treat cancer using the most effective approach and also protect your quality of life. At MedStar Health, we take a personalized approach to treating bone cancer based on:
- The size of the tumor
- The location of the tumor
- Whether or not the tumor can completely be surgically removed
- The patient’s age, health, and personal goals
- If the cancer is new or a recurring tumor
Surgery typically plays a role in bone cancer treatment, and advances in surgery have changed how we approach the disease. In the past, bone cancers often required amputation. As one of the few centers in the world treating sarcomas, now we have options for limb-sparing surgeries, and nearly 98 percent of our patients won’t need an amputation. These complex procedures use pieces of bone or tissue from other parts of your body or artificial materials, like metal, to reconstruct the portions of bone that need to be removed.
Chemotherapy is also a common treatment for some types of bone cancers and can be used before surgery to shrink the tumor or after surgery to prevent the tumor from returning. Radiation therapy and targeted therapy may play a role in treatment as well, although bone cancer isn’t always as responsive to those types of treatment as other cancer types, like breast or lung cancer. Early detection is critical for improving treatment options, so if you have a new unexplained lump or bump, seek care regardless of whether you have pain or not.
Bone cancer care from the experts.
Because bone cancer is a rare type of cancer, it can be hard to find oncologists specializing in the diagnosis and treatment of the disease. Our team of orthopedic cancer experts has the training, experience, and state-of-the-art technology to care for patients with bone cancer, and we make it easy for patients from all over to get the compassionate and comprehensive cancer care they need.
If you’ve been diagnosed with bone cancer, or you have concerns that you may have bone cancer, don’t wait to seek care–or a second opinion. A second opinion may reveal additional information about your cancer or treatment options that may not be available elsewhere.
We offer appointments via video or in-person within 48 hours so you can get answers and peace of mind quickly.