Osteosarcoma is the most common primary malignant bone cancer. It most commonly affects younger males between 10 and 25 years old, but can less commonly affect older adults. It often occurs in the long bones of the arms and legs at areas of rapid growth around the knees and shoulders of children. This type of cancer is often very aggressive with risk of spread to the lungs. The five-year survival rate is about 65%. It starts in immature bone cells that normally form new bone tissue.

 

Osteosarcoma is the most common primary malignant bone cancer. It most commonly affects younger males between 10 and 25 years old, but can less commonly affect older adults. It often occurs in the long bones of the arms and legs at areas of rapid growth around the knees and shoulders of children. This type of cancer is often very aggressive with risk of spread to the lungs. The five-year survival rate is about 65%. It starts in immature bone cells that normally form new bone tissue. Osteosarcoma usually arises in a bone and destroys local tissue and weakens the bone. It can occur, very rarely, as a tumor of the soft tissues of the body, outside the bone itself. There is a preference for the metaphyseal region of tubular long bones. 50% of cases occur around the knee. It is a malignant connective (soft) tissue tumor whose neoplastic cells present osteoblastic differentiation and form tumoral bone.

Types of Bone Cancer

There are several types of bone cancer but the commonest among them is Osteosarcoma. Other bone tumors include –

 

• Ewing’s sarcoma is the most aggressive bone tumor and affects younger people between 4-15 years of age. It is more common in males and is very rare in people over 30 years old. It most commonly occurs in the middle of the long bones of the arms and legs. The three-year survival rate is less than 70% but this rate is much lower if there has been spread to the lungs or other tissues of the body.

• Chondrosracoma is the second most common bone tumor and accounts for about 25% of all malignant bone tumors. These tumors arise from the cartilage cells and can either be very aggressive or relatively slow-growing. Unlike many other bone tumors, Chondrosracoma is most common in older people. It is slightly more common in males and can potentially spread to the lungs and lymph nodes. Chondrosracoma most commonly affects the bones of the pelvis and hips.

• Malignant fibrous histiocytoma affects the soft tissues including muscle, ligaments, tendons, and fat. It is the most common soft-tissue malignancy in later adult life, usually occurring in people 50-60 years of age. It most commonly affects the extremities and is more common in males as females.

• Fibrosarcoma is much rarer than the other bone tumors. It is most common in people 35-55 years of age. It most commonly affects the soft tissues of the leg behind the knee. It is slightly more common in males than females.

• Chordoma is a very rare tumor with an average survival of about six years after diagnosis. It occurs in adults over 30 years of age and is about twice as common in males as females. It most commonly affects either the lower or upper end of the spinal column.

Symptoms of Bone Cancer

• Fatigue
• Fever
• Weight loss
• Anemia
• Swelling and tenderness in joints
• Pathologic fractures due to weakening of bones
• Stiffness or swelling of joints
• There may be back pain or loss of bowel or bladder control
• Lymphadenopathy
• Decreased range of motion

Diagnosis and Investigations

• Various investigations can be performed depending on case to case basis to confirm the diagnosis made on symptoms. These include –
• X-rays
• Magnetic resonance imaging (MRI)
• Computerized tomography (CT) scans
• Bone scan
• Needle biopsy
• Surgical biopsy

Treatment and Medications

Depending upon the severity and grading and spread of the disease in the body various types of therapy can be given for Bone Cancers. These include –

• Chemotherapy
• Radiation Therapy
• Surgery

These treatment modalities can be used either alone or in conjunction with other modalities depending on the clinical condition and the type of Bone Cancer.