“Primary bone cancers can be of various types.”
New Delhi , July 21,2018 :
can rarely occur in the bones. It accounts for less than 1% of all cancers but occur more commonly in children and adolescents. They can originate primarily from various cells present in the bones and are called as bone sarcomas. Cancer can originate from other organs such as breast, kidney, prostate etc and spread to the bones and are called metastatic carcinoma of the original cancer.
Primary bone cancers can be of various types, but the most common type is Osteosarcoma. Other types of bone cancers are Ewing sarcoma and Chondrosarcoma. Bone cancers can occur anywhere in the bones, but commonly present in the arms and legs.
The exact cause of bone cancer is unknown, but there are various risk factors that may predispose an individual to a higher risk of developing bone cancers. Various genetic defects such as Li-Fraumeni syndrome, Rothmund-Thompson syndrome, retinoblastoma and Multiple exostoses syndrome may increase ones chances of developing bone cancers. Exposure to radiation, a history of having undergone a bone marrow transplantation or having Paget’s disease of the bone also increases the risk of developing bone cancer.
Bone cancers generally present with pain or swelling of the affected bone. These symptoms can be persistent and may get worse on activity and may be more pronounced at night. Occasionally fractures can also be a presenting complaint.
If these symptoms are present, one should always seek help from their doctor. The commonest initial investigations done are X-Ray of the affected bone. If there is a suspicion of bone cancer then the individual may need further testing such as MRI of the bone or PET CT scan. A biopsy of the affected bone is also required confirm and clarify the type of bone cancer.
Different types of bone cancers have different treatment options. A multidisciplinary approach to treatment is required to treat bone cancers. The treatment usually involves a combination of Surgery, chemotherapy, targeted therapy and radiation therapy. The type of treatment depends upon the type of bone cancer, its location, aggressiveness and whether it has spread to other organs or not. Given the advances in surgical techniques, limb preservation surgeries and reconstructions are generally attempted whenever possible as they result in excellent functional outcomes.
When bone cancers are diagnosed in early stages the treatment aim is to try to achieve a cure. However, in advanced stages, cure is seldom possible. Hence early diagnosis is the key to improving outcomes in bone cancers.
The author of this article is Dr Vijay Agarwal, Lead & Senior Consultant, Medical Oncology & Haematology, Aster CMI Hospital,Bangalore.