Every cell in the body is born knowing how fast it is supposed to grow and how often it is supposed to divide. When this programming breaks down and cells start to divide and grow wildly, cancer occurs. Cancer cells form tumors and rapidly crowd out normal tissues.
Malignant (cancerous) tumors differ from benign (noncancerous) tumors in their speed of growth and their fatality rates. Benign tumors are rarely fatal; malignancies are almost always fatal when untreated. Treatment for bone cancer depends on the size and location of the tumor and whether it has spread to other areas of the body.
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Types of bone cancer
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An osteosarcoma looks almost cloud-like in this X-ray.
Osteosarcoma is the most common bone cancer. It rarely occurs in adults older than 25 years old. Osteosarcoma is usually found in the bones of the arms, legs and pelvis, and in bones that grow rapidly, such as the shoulders and knees.
Ewing's sarcoma is commonly found in children ages 4 to 15, and is rare in adults older than 30. It is an aggressive cancer typically found in the center of the long bones of the arms and legs.
Chondrosarcoma is found in cartilage cells and accounts for about 25 percent of bone tumors, making it the second most common type. Unlike most other bone cancers, it is most common in people older than 40. It is typically found in the large bones of the hips and pelvis.
Fibrosarcoma is a rare bone tumor occurring in people 35 to 55 years old. It is usually found in the soft tissues behind the knee, but can occasionally grow in bone.
Malignant fibrous histiocytoma is usually found in connective tissues such as ligaments, tendons, fat and muscle, but does occur occasionally in bone. It is found in adults 35 to 55 years old and spreads to other parts of the body quickly.
Chordoma is an extremely rare bone cancer that affects the spine and the base of the skull. It is found in adults older than 30, usually males.
Lymphoma and multiple myeloma are sometimes classed as bone cancers. Lymphoma is a cancer of the lymphatic system that sometimes starts in bone. Multiple myeloma is a cancer of the bone marrow.
Symptoms of bone cancer
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"Malignant osteoid" in osteosarcoma
Symptoms of bone cancer include pain that doesn't go away with over-the-counter pain relievers. It usually starts mildly, but progresses in severity and duration. There also may be swelling, lumps, fatigue and unexplained fractures. Diagnosis of bone cancer can be done with imaging studies, such as X-rays, CT scans, MRIs and needle biopsies.
Surgery
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Osteosarcoma has replaced medullary bone and penetrated cortex
How bone cancer is treated depends on the type of tumor, how aggressive it is, the location of the tumor and whether or not the cancer has spread to other areas of the body. Options include surgery, radiation and chemotherapy, or a combination of the three.
Before advances in the field were made, amputation was the most common way to remove bone cancer. Today, the tumor is removed without necessitating amputation. Bone cement and grafts fill in for small areas of removed bone; larger areas are reinforced with metal or donor bone, either from other parts of the patient's body or cadaver bone. Amputation is used as a last resort in most cases. After the tumor is removed, it is examined by a pathologist to make sure the surgery removed the entire tumor and some of the surrounding healthy tissue. Risks include infection, damage to surrounding muscles, nerves and blood vessels, and recurrence of the cancer. Patients are often prescribed a course of physical therapy after surgery to help them regain full use and strength in the limb where the tumor was removed.
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