Bone Cancer: Risk Factors, Causes, Symptoms, Types, Diagnosis and Treatment

It is a malignant tumor that arises from the cells that make up the bones of the body. It is also known as primary bone cancer.

Primary bone tumors are tumors that arise in the bone tissue itself and can be benign or malignant (bone cancer).

Benign (non-cancerous) tumors in the bones are more common than bone cancers. When cancer is found in the bones, it originated in the bones (as in primary bone cancer) or spread to the bone after it originated elsewhere (a metastasis or a secondary cancer that spread to the bones).

In fact, when cancer is detected in the bone, it is often a metastasis that started in another organ or part of the body and then spread to the bones. This cancer that has metastasized to the bone gets its name from the site where the original cancer started (for metastatic prostate cancer that has spread to the bone).

Breast, prostate and lung cancers are among the types of cancer that commonly spread to bone in advanced stages.

Primary primary and metastatic bone cancers are often treated differently and have a different prognosis.

There are other types of cancer that can start in the bone, even if they are not considered true bone cancers. The lymphoma is a cancer of the cells that are responsible for the body ‘s immune response. Lymphoma usually begins in the lymph nodes, but begins in the bone marrow.

Multiple myeloma is another cancer of the immune cells that usually begins in the bone marrow. These tumors are not considered primary bone cancers because they do not arise from the current bone cells.

What are the risk factors for bone cancer?

Approximately 2,300 cases of bone cancer are diagnosed in the US UU Every year. Primary bone cancers are not common and represent much less than 1% of all cancers. Bone cancers are more common in children and young adults than in older people.

The cancer found in the bones of an older adult has generally spread to the bone after it originates in another location in the body. Risk factors for bone cancer include the following:

  • Previous treatment with radiotherapy.
  • Previous chemotherapy with drugs known as alkylating agents.
  • Mutation in a gene known as the retinoblastoma (Rb) gene or other genes.
  • Associated conditions, such as hereditary retinoblastoma, Paget’s disease of the bone, Li-Fraumeni syndrome, Rothmund-Thomson syndrome, tuberous sclerosis,and Diamond-Blackfan anemia.
  • Implantation of metal to repair previous fractures.

What causes bone cancer?

As with other cancers, there is no single cause of bone cancer. In general, cancers arise when normal cell growth and proliferation are interrupted, allowing abnormal cells (cancer cells) to divide and grow out of control.

It is likely that several hereditary and environmental factors participate in the development of bone cancers.

What are the symptoms and signs of bone cancer?

Pain is the most common symptom of bone cancer. Bone pain may develop initially at certain times of the day, often at night or with physical activity. The pain tends to progress and get worse over time. Sometimes, the pain may be present years before the affected person seeks treatment.

Sometimes, bone cancer is detected accidentally when x-rays or imaging studies are done for another reason.

Occasionally, a mass, swelling, or lump is felt around the area of ​​a bone cancer. Bone fractures can also occur at the site of bone cancer because the underlying bone structure has been weakened.

The most common symptoms are caused by compression or disruption of the nerves and blood vessels in the affected area.

These symptoms can be:

  • Numbness.
  • Tingle.
  • Sensitivity.
  • Decreased blood flow. Beyond the site of the tumor, causing a cold hand or foot with weak or absent pulses.

What are the different types of bone cancer?

There are several different types of bone cancer, and they are often treated differently. Knowing the exact type of bone cancer is essential to develop an optimal treatment plan.

Some of the most common types of bone cancer are the following:


It is the most common bone cancer. Osteosarcoma occurs more frequently in older children, adolescents, and young adults (10-19 years of age), and is more common in men.

Cancer tissue in osteosarcoma in young people tends to develop at the ends of long bones in areas of active bone growth, often around the knee, either at the end of the thigh bone (femur) or the tibia near the knee. knee.

The next most common location for bone cancer is in the arm bone (humerus). However, it is possible that an osteosarcoma develops in any bone. Depending on the appearance of the tumor cells under the microscope, there are also several different subtypes of osteosarcoma.


Chondrosarcoma is the second most common bone cancer. It arises from the cartilage cells that are attached to the covering bone. It is more common in people over 40 years of age, and less than 5% of these cancers occur in people under 20 years of age.

It can grow quickly and aggressively or grow slowly. Chondrosarcoma is most commonly found in the bones of the hips and pelvis.

Sarcoma de Ewing

Ewing’s sarcoma, sometimes called the Ewing’s sarcoma tumor family (ESFT), is an aggressive form of bone cancer that is most common in children 4 to 15 years of age.

It can occur in the bones or soft tissues and is believed to originate in primitive nervous tissue. ESFTs are more common in men than in women. The most common location for this type of cancer is the middle portion of the long bones of the arms and legs.

Pleomorphic bone sarcoma

Pleomorphic sarcoma is a cancer previously known as malignant fibrous histiocytoma or HFM. This term is still used frequently. Pleomorphic sarcomas are not usually bone cancers, but soft tissue cancers. However, they can arise in the bone in up to 5% of cases.

Pleomorphic sarcomas typically occur in adults and can be found anywhere in the body.


Fibrosarcoma is an uncommon type of bone cancer. It usually occurs behind the knee in adults.


Chordoma is a very rare type of cancer that is usually seen in people older than 30 years. It is located more frequently at the lower or upper ends of the spine.

What types of bone cancer occur in children?

Osteosarcoma, the most common type of bone cancer, is most common in older children, adolescents, and young adults. Ewing sarcoma and ESFT are bone cancers that usually affect children.

What tests are used to diagnose bone cancer?

Various imaging tests can be used to detect bone tumors, including bone cancers. Very early bone cancers may or may not be apparent on simple X-rays. Computed tomography and magnetic resonance imaging are more accurate in defining the location of bone cancers.

A bone scan is a test that uses radioactive material to produce images of the entire skeleton. This can allow the localization of bone cancer in any part of the body.

This test is not specific for bone cancers and can also reveal areas of inflammation such as those found with arthritis , fractures and infections.

While many bone cancers have a characteristic appearance in imaging studies, a biopsy (tissue sample) must be taken to determine precisely what type of cancer is present and confirm the diagnosis.

A biopsy is a procedure to acquire a sample of a portion of the tumor that is examined under a microscope. The tissue sample can be obtained with a needle inserted through the skin into the tumor or with a surgical operation.

Currently, there are no screening tests available to detect early bone cancers.

What is the treatment for bone cancer?

An operation to eliminate cancer is the basis of treatment for bone cancers. Surgical techniques can remove most bone cancers without requiring amputation of the affected limb.

In some cases, amputation can be avoided with conservative limb surgery. Sometimes, the muscles and other tissues surrounding the cancer must also be removed. Reconstructive surgery, in addition to resection of the cancer, may be needed to help maximize limb function.

Ewing’s sarcoma, osteosarcoma and other bone cancers may require chemotherapy in addition to surgery.

Radiotherapy is the typical treatment for chondrosarcoma.

Ewing’s sarcomas that do not respond well to high-dose chemotherapy may require radiation therapy and even a stem cell transplant.

In this procedure, the patient’s stem cells (blood cells that have the potential to develop into all different types of blood cells) are removed from the bloodstream.

After high doses of chemotherapy to destroy the bone marrow, the harvested stem cells are then returned to the body, as with a blood transfusion. Over the next few weeks, stem cells produce new blood cells from the bone marrow.

Targeted therapies are specially designed treatments that target treatment specifically on cancer cells. For example, denosumab (Xgeva) is a monoclonal antibody that acts to block the activity of specialized bone cells called osteoclasts.

This medication has been used in the treatment of tumors of giant cell bones that have reappeared after surgery or can not be removed by surgery. Imatinib (Gleevec) is a targeted therapy drug that can block the signals of certain mutated genes that cause the growth of tumor cells.

Imatinib has been used to treat some chordomas that have spread or recurred after treatment. Clinical trials are another type of treatment for bone cancers. In clinical trials, doctors try promising new drugs, combinations of medications or procedures.

Clinical trials are carefully controlled research studies. Talk to your doctor if you think you may be interested in participating in a clinical trial.

What specialists treat bone cancer?

Bone cancer is usually managed by surgical oncologists or orthopedic oncologists (for the surgical removal of the tumor) and medical oncologists (for administration or chemotherapy).

Radiation oncologists participate in the treatment team if radiation therapy is planned. Palliative care doctors may be involved in controlling pain and symptoms.

Is there any treatment or medication that relieves the pain of bone cancer?

Analgesics treat the pain of bone cancer. These can be medicines without a prescription. Mild to moderate pain is treated with medications such as acetaminophen (Tylenol).

Also nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen (Advil, Motrin) and naproxen (Naprelan, Aleve, Naprosyn, Anaprox). However, people who take anti-cancer chemotherapy drugs should sometimes avoid NSAIDs because of the increased risk of bleeding.

Prescription medications are used for the pain of moderate to severe cancer. Opioids, stronger narcotic pain medications, such as hydromorphone, morphine, codeine, oxycodone, and fentanyl may be needed to control severe pain.

Sometimes a combination of medications is used to treat the pain caused by cancer. Opioid medications may be associated with side effects such as drowsiness, constipation and nausea.

What is the prognosis for bone cancer?

The prognosis for the survival of patients with bone cancer depends on the particular type of cancer and the degree to which it has spread.

What is the five-year survival rate for bone cancer?

The overall five-year survival rate for all bone cancers in adults and children is approximately 70%. Chondrosarcomas in adults have a five-year survival rate of around 80%.

The five-year survival rate specifically for localized osteosarcomas is approximately 60% -80%.

If the cancer has spread beyond the bone, the survival rate is about 15% -30%. Osteosarcomas tend to have a more favorable prognosis if they are located in an arm or a leg, respond well to chemotherapy, and are usually completely eliminated in surgery.

Younger women and women in general also tend to have a more favorable prognosis than men or older patients.

Ewing sarcomas have a five-year survival rate of approximately 70% when they are in a localized stage. If they have spread outside the bone, the survival rate drops to 15% -30%.

Factors that are associated with a more favorable prognosis for Ewing sarcomas include a smaller tumor size, less than 10 years, cancer in an arm or leg (rather than in the pelvis or chest wall) and a good response to chemotherapy drugs.

Is it possible to prevent bone cancer?

Since the exact cause of bone cancer is poorly understood, there are no changes in lifestyle or habits that can prevent these rare cancers.