Bone cancer is a rare but treacherous disease because the symptoms are often difficult to interpret. Find out what signs indicate an illness, whether bone tumors are curable and what the life expectancy is.
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Quick overview
To form: The most common types are osteosarcoma, chondrosarcoma and Ewing’s sarcoma.
Symptoms: There are no clear signs that appear at the beginning of bone cancer, also because the symptoms vary depending on the type and location of the tumor. Pain and swelling often occur in the affected area.
Diagnosis: If bone cancer is suspected, various imaging procedures such as an X-ray, an MRI or a computer tomography (CT) are used.
Treatment: Therapy depends on the type of bone cancer. A combination of surgery, radiation therapy and chemotherapy is usually carried out.
Article content at a glance:
Bone cancer: These 8 symptoms can be warning signs!
What is bone cancer?
Bone cancer is a malignant tumor that can occur anywhere in the human skeleton. Medically, a distinction is made between primary and secondary bone tumors.
Primary bone cancer, also called bone sarcoma, arises from bone tissue that degenerates and proliferates uncontrollably. Bone sarcomas can generally occur in any bone in the skeleton. The long bones of the legs and upper arms, the pelvis or the shoulder girdle are most commonly affected.
Secondary bone tumors On the other hand, they are metastases that form in the bones from other cancers such as breast cancer or lung cancer. Metastases (secondary tumors) arise when cancer cells from the original tumor reach other organs or tissues and cancer spreads there.
The causes of bone cancer are still not exactly known. However, if bone cancer is detected early, it can often be treated well.
How common is bone cancer and who is affected?
Primary bone cancer is a rare cancer. Around 800 people in Germany develop it every year, men slightly more often than women. Children and adolescents can also be affected by bone cancer. Osteosarcoma and Ewing’s sarcoma are the two most common forms of this disease in this age group.
Bone metastases are much more common than primary bone cancer. In particular, tumors of the lungs, breasts, prostate, kidneys and thyroid have a tendency to spread to the bones.
What types of bone cancer are there?
Bone cancer occurs when the cells in the bone, cartilage or bone marrow tissue degenerate and multiply uncontrollably. Depending on the type of cell from which the sarcoma arises, there are different types. The most common are:
Osteosarcoma: Osteosarcoma is the most common bone tumor. Its cells form directly in the bone or in the osteoid – the soft, not yet mineralized basic substance of the bone tissue. Osteosarcomas usually arise near the joints in the long bones of the thighs, shins or upper arms. This cancer can occur at any age. As a rule, osteosarcoma occurs in the pubertal growth phase between 10 and 15 years. Male children and adolescents may be affected slightly more often.
Ewing sarcoma: Ewing sarcomas tend to develop in bone tissue, but can also spread beyond the bone. They most commonly occur in the pelvis and long bones of the thighs, shins or upper arms. Ewing sarcomas can also occur in any other bone. Male children and adolescents between the ages of 10 and 15 are predominantly affected.
Chondrosarcoma: Chondrosarcoma forms in the cartilage tissue of the skeleton, preferably in the pelvis, trunk, shoulder girdle and in the upper areas of the thigh and upper arm. This cancer mostly occurs between the ages of 40 and 60.
Causes of bone cancer
The causes of primary bone cancer are still largely unknown. Since bone sarcomas often develop during childhood and puberty, growth-related and hormonal factors are suspected. In addition, there are various risk factors that can promote the development of bone tumors. These include:
- Chronic pre-existing conditions such as Paget’s disease
- Genetic predisposition to tumor-forming diseases such as Li-Fraumeni syndrome or retinoblastoma
- Previous radiation or chemotherapy
- Benign tissue changes that become malignant
Changes in chromosome 22 were also found in around 80 percent of patients with Ewing sarcoma.
Bone cancer: recognizing symptoms
Pain is usually the first symptom of bone cancer. However, depending on the type of tumor, the symptoms can vary. The following complaints can provide information:
Osteosarcoma: Bone pain, swelling and redness often above and below the knee joint or at the top of the humerus. The pain may initially only occur with exertion, but increases over time and is also present at rest and at night. Occasionally the pain does not occur directly at the tumor, but at another location in the same bone area. Restricted movement of neighboring joints or sudden bone fractures are also possible symptoms. Osteosarcoma in the jaw can cause loose teeth and swelling in the mouth area.
Ewing sarcoma: Pain and swelling in the area affected by the tumor are the main symptoms. Around a third of those affected experience general symptoms such as fever, feeling ill, weight loss and increased fatigue.
Chondrosarcoma: Pain and increasing swelling are the main symptoms, predominantly in the pelvis, femur and shoulder girdle.
The signs of bone cancer are very non-specific and are often misinterpreted as an injury, bone inflammation or growing pains in children and adolescents. These non-specific symptoms often make it difficult to recognize the disease early.
Diagnosis of bone cancer
If bone cancer is suspected, comprehensive examinations are necessary to determine whether a malignant bone tumor is actually present. In addition to a detailed anamnesis, this also includes a physical examination. The following are used, among others:
Therapy: This is how bone cancer is treated
The treatment of bone cancer depends on the type of cancer and should be carried out in specialized therapy centers.
At a Osteosarcoma Treatment usually begins with chemotherapy to shrink the tumor and destroy possible cancer cells in other organs. The tumor is then surgically removed. In specialized bone tumor centers, it is often possible to preserve the affected leg or arm, even if parts of the bone have to be removed. This can be achieved through the use of tumor endoprostheses or, in some cases, through the use of the body’s own bone tissue. After the operation, another phase of chemotherapy follows.
The Ewing sarcoma tends to metastasize quickly to other organs, especially the lungs and other bones. Therefore, treatment begins with chemotherapy. Surgery, radiation therapy, or a combination of both procedures can be used to treat the tumor. After completion of local treatment, chemotherapy continues.
Chondrosarcomas are usually treated exclusively with surgery because this type of cancer responds poorly to chemotherapy or radiation therapy.
Once all treatments have been completed, follow-up care follows. At the beginning, frequent check-ups are necessary in order to detect and treat possible relapses at an early stage. It is important that those affected take any symptoms, especially bone pain, seriously and seek medical attention immediately.
Bone cancer: course and prognosis
The extent to which bone cancer is curable and how the disease progresses depends on the type of tumor as well as the size and spread of the sarcoma at the time of diagnosis. Basically, the earlier a bone sarcoma is detected and treated, the better the prognosis.
Osteosarcoma: The overall survival rate for children and adolescents is now around 70 percent. A favorable prognosis exists if the tumor is localized, can be completely removed, responds well to chemotherapy and has not yet formed metastases. For patients who suffer a relapse, the prognosis is usually poor. However, there are still chances of recovery as long as the tumor can still be completely removed.
Ewing sarcoma: With Ewing sarcoma without visible metastases, more than 80 percent of patients can be cured in the long term. Especially if the tumor can be completely removed and responds well to chemotherapy. If metastases have already formed, the prognosis is worse. There is a 5-year survival rate of around 20 to 25 percent.
Chondrosarcoma: If the tumor can be completely removed and no metastases have yet formed, the chances of recovery are 40 to 60 percent.
The most common types of cancer in Germany
