21/8-2017 
 
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Bone tissue diseases

Bone Tumors (including cancer of the bone, Bone Cancer)

Definition and cause of Bone cancer

Bone Cancer is a malignant tumor of the bone tissue. 99 out of 100 times, it is so called metastasis from a cancer somewhere else in the body. The spreading of a cancer (metastasis) to the bones are predominantly seen from cancers in the chest, prostate, lungs and kidneys. It is not rare that the primary cancer is discovered in the light of the findings of metastasis in the bone.

Very rarely development of a primary tumor in the bone tissue is seen, and in principle, cancer of the bones may arise from any cell type in the bone. These tumors are most common in the long bones. Malignant tumors in the bones are often discovered late and have a poor prognosis.

Benign tumors of the bone are seen more frequently than malignant, but they are still rare. They do not grow as aggressively as the malignant, and often require little or no treatment.
 

Symptoms of bone cancer

Early these cancers provide little or no symptoms. Often a bone tumor is found because the patient has an X-ray taken for another reason. A frequent symptom onset is a bone fracture. Some tumors destroys bone tissue, the bone is weakened, until the sudden emergence of a fracture.

Tumors of a certain size cause symptoms in the form of tenderness, and subsequent pain and swelling, even at rest.

There might be diffuse symptoms from the primary cancer.
 

Precautions and diagnosis

You should always consult a doctor if feel the development of a tumor in your body. Additional signals to be taken seriously are rapid growth, pain and swelling. Cancer often causes non-specific general symptoms such as fatigue and loss of appetite, which are important signals to ignore.

The first thing your doctor will do is take an X-ray of the affected area. Here it will be possible to see the tumor, and get an idea of the size and whether it is of benign or malignant origin. A blood test may give an idea of where the tumor is derived from, and whether it is malignant.

The next step will be a so-called bone scintigrafy of the entire skeleton. It shows in which parts of the skeleton, there is a high bone activity, which will can be associated with cancer. This examination will be complemented with a CT or MRI scanning of the suspect areas.

At the specialized ward the patient will undergo a tissue biopsy of the tumor. This may show whether the tumor is primary (includes typical bone cells) or whether it is secondary (the typical cells derived from other tissue), a metastasis. As mentioned above in most cases the tumor is a metastasis, and it is therefore important to identify the primary tumor and any metastases to other organs.
 

Treatment of bone cancer

If a malignant bone cancer is not treated, it is in all cases deadly. Treatment depends on the size, number of metastases and type of tumor. The goal is the complete removal of the malignant tissue, but it is not always possible because the tumor may have spread too much.

The primary tumor (depending on type) will often be treated with chemotherapy (cell poison) and, possibly radiation therapy to reduce tumor size. Following this the surgeon will remove the remaining tumor mass.

Some metastases can be removed by surgery. Others are treated with chemotherapy and / or radiation to slow down tumor growth. In cases where the tumor destroys the bone causing fractures it may be necessary to support the bone with splints etc. It may be necessary to replace a joint if the tumor is involving a joint.

The treatment is carried out in consultation with specialist doctors from several areas (for exampleoncologist, lung specialists, orthopaedic surgeons etc)

Prognosis and complications

Prognosis depends entirely on:
  • Type of tumor.
  • Whether it is primary or secondary (metastasis).
  • Tumor size.
  • Number of metastases
  • Dissemination of the primary tumor.
Overall the prognosis is in general poor as there is a tendency for the tumor to be detected relatively late with increased risk of growth and metastases. The prognosis is good if the tumor is detected early and if it is operationally possible to remove all tumor tissue, the patient is basically cured.

The benign tumors have a good prognosis. Some are removed surgically as they may cause pain and problems of the bone.

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