What are bones for?
Your body has 206 bones. These bones serve multiple different functions. First, your bones provide structure to your body and help provide its shape. Muscles attach to the bones and allow you to move. Without the bones, your body would become a pile of soft tissues without structure, and you would be unable to stand, walk, or move. Second, the bones help to protect the more fragile organs of the body. For example, the bones of the skull protect the brain, the vertebrae of the spine protect the spinal cord, and the ribs protect the heart and lungs. Third, the bones contain bone marrow, which makes and stores new blood cells. Finally, the bones help control your body's collection of various proteins and nutrients including calcium and phosphorus.
What is bone cancer?
Bone cancer is caused by a problem with the cells that make bone. More than 2,000 people are diagnosed in the United States each year with a bone tumor. Bone tumors occur most commonly in children and adolescents and are less common in older adults. Cancer involving the bone in older adults is most commonly the result of metastatic spread from another tumor.
Cancer that starts in a bone is rare. Cancer that has spread to the bone from another part of the body is more common.
There are three types of bone cancer : -
- Osteosarcoma - develops in growing bones, usually between ages 10 and 25
- Chondrosarcoma - starts in cartilage, usually after age 50
- Ewing's sarcoma - begins in nerve tissue in bone marrow of young people, often after treatment of another condition with radiation or chemotherapy
Symptoms of Bone CancerPatients may present with persistent pain, swelling, or tenderness of a bone. They may have unexplained fracture of one or more bones, sometimes without noticeable trauma.
Diagnosis of Bone CancerThe presenting symptom is usually pain. Pathologic fracture may be present and is more common in the lower than the upper extremity.
The presenting radiologic finding on X-ray is often destruction of bone. In a patient with a known primary malignant tumor presenting with a painful, destructive lesion of bone, a diagnosis of metastatic cancer can be made with some assurance. However, there are individuals in whom the primary cancer is not yet recognized at the time when the early metastatic lesion in bone becomes painful.
A CAT scan, MRI, radionuclide bone scan or a skeletal survey may be done to pinpoint which bones have been affected.
Treatment of Bone CancerThe treatment of cancer of the bone, especially metastatic cancer, has two goals: management of the neoplasm and management of the symptoms produced by the local lesion. Prognosis is affected by a patient's age, the size of the primary tumor, grade and stage, degree of lymphatic and blood vessel invasion, the duration of symptoms and the location of the tumor on the arm, leg or trunk.
There are two ways bone metastasis is treated. Systemic therapy, aimed at cancer cells that have spread throughout the body, includes chemotherapy, hormone therapy, and immunotherapy. Local therapy, aimed at killing cancer cells in one specific part of the body, includes radiation therapy and surgery.
Surgeryoften has to be extensive, with a wide margin of tissue around the tumor being removed. Sarcomas involving muscles require removal of the entire affected muscle group.
Radiation therapy : - Radiation therapy uses high-powered beams of energy, such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table while a special machine moves around you and aims the energy beams at precise points on your body.
Radiation therapy may be used to shrink a bone cancer to increase the likelihood that a surgeon can remove the entire cancer with surgery. In this situation, radiation therapy may be combined with chemotherapy.
Radiation therapy may also be used in people with bone cancer that can't be removed with surgery. Radiation therapy may also be used after surgery to kill any cancer cells that may be left behind. For people with advanced bone cancer, radiation therapy may help control signs and symptoms, such as pain.
Chemotherapy : - Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy is most often given through a vein (intravenously). The chemotherapy medications travel throughout your body.
Hormone therapy : - is either the removal of the organs which produce hormones which can promote the growth of certain types of cancer (such as testosterone in males and estrogen in females), or drug therapy to keep the hormones from promoting cancer growth.
Biphosphonates : - are drugs that can be used to reduce bone pain and slow down bone damage in people who have cancer that has spread to their bones.
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