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 Bone cancer is a condition in which abnormal cancer cells grow in bone tissues. Depending upon the evolution of cancerous cells, bone cancer can be primary or secondary. In primary bone cancer, the cancerous cells grow in the bone tissues right from the start. In the secondary type, the cancerous cells migrate to the bone tissue from the other parts of the body. Secondary bone cancer is also known as metastatic bone cancer. The sooner the bone cancer is detected, the better are the chances of getting a positive result.

Depending upon the specific region in which the cancer cells grow, bone cancer can further be classified into six types:

• Osteosarcoma: This is the most common primary bone cancer, usually affecting the arms, legs and pelvis. The cancer develops in the osteoblast cells that constitute the outer covering of the bones.
• Ewing's sarcoma: In this type, the cancerous tissues develop in the cavity of the arm and the leg bones. As per the American Cancer Society, Ewing’s sarcoma accounts for 16 percent of the total bone cancer cases.
• Chondrosarcoma: This holds the second position after osteosarcoma among the most common primary types of bone cancer. This cancer develops in the cartilage, which is the connective tissue present in adults. Most bone cancer cases develop from here. The cancer affects the thigh bone, pelvis, spine, arm and knee.
• Chordoma: This is a primary bone cancer that develops in the skull and the spine.
• Fibrosarcoma: In this condition, the cancer cells develop in the soft tissues of the bones such as the tendons and ligaments. This may also develop in the fat and the muscle tissues.
• Giant Cell Tumor: This is a type of bone tumor that holds a 10 percent chance of turning cancerous. This commonly occurs in the arm and the leg bones.
  

The causes of osteosarcoma in adults are not clearly understood. However, genetic factors are believed to be an important factor for this condition. Children and adults having any type of hereditary abnormalities such as exostoses, Ollier’s disease, and Paget’s disease, among others, are at a higher risk of developing osteosarcoma. The major cause behind Ewing’s sarcoma is the rearrangement between the chromosomes 11 and 22. This rearrangement causes fusion transcript, resulting in a change in the function and position of the genes. This, in turn, leads to Ewing’s sarcoma. Chondrosarcoma is also considered to be associated with the genetic factors.

The symptoms of the bone cancer vary, depending upon the size and location of the cancerous tissue. The common symptoms may include:

• Deep pain in the bone, usually severe at night
• Increase in pain during activities
• Abnormal mass on the affected bone
• Unexplained weight loss
• Decrease in appetite
• Fever and night sweats
• Paralysis

Typically, there are three stages of bone cancer, namely localized, metastatic, and recurrent. In the localized stage, the cancerous cells grow in the bone tissues and do not spread beyond the bones. In the metastatic stage, the cancerous cells of the bone spread to other parts of the body. The cancer commonly spreads to the lungs and to the other bones. Recurrent bone cancer means that the cancer has resurfaced after treatment. In such a scenario the cancer may recur at the location where it occurred for the first time or at any other location.

The treatment of bone cancer depends on factors like the type, location, and stage of the cancer. The specialist will establish the treatment plan only after checking all of the above aspects of the cancer. The treatment strategies practiced include radiation therapy, chemotherapy, surgery, and myeloablative therapy with stem cell support.

The prognosis for bone cancer depends on the type of cancer and the extent to which the cancerous tissues have spread. Bone metastases can be managed by treatment options like radiation, chemotherapy, surgical fixation, pain management, and hormonal therapy, among others, and this significantly increases the quality of life for patients.

References

1. http://www.urmc.rochester.edu/childrens-hospital/hemonc/bone-stages.aspx
2. http://www.cancer.med.umich.edu/cancertreat/tissue_bone/frequentquestions.shtml
3. http://www.med.nyu.edu/content?ChunkIID=12008
4. http://www.fccc.edu/cancer/types/sarcoma/index.html

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