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Bone cancers are malignant tumors that arise in the bone due to the abnormal growth of bone cells in the body.
Bone cancers are malignant tumors that arise in the bone due to the abnormal growth of bone cells in the body. The most common symptom of bone cancer in the hip is hip pain, which can be severe enough to disrupt sleep and daily activities. The bones involved can weaken, resulting in fractures caused by trivial trauma. Sometimes, swelling or a mass may be felt in the hip in absence of any history of trauma to the body pain.
Cancers that originate in the hip bones are primary bone cancers. In general, the primary bone tumors of the hip are rare. Chondrosarcoma (cancer originating in the cartilage at the edges of the hip bone) is the most common primary tumor of the bone. Most tumors seen in the hip bone are secondary tumors. This means cancer from other body parts has spread to the bones.
A type of cancer can also originate in the spongy part of the hip bone (bone marrow). These are blood cancers (leukemia and multiple myeloma), which manifest as throbbing hip pains, hip fractures, fevers, night chills, kidney failure, bleeding, etc. Other cancers that may develop in the hip include osteosarcoma, chondrosarcoma, Ewing sarcoma and soft tissue sarcomas.
What causes bone cancer?
The cause of most bone cancers is unknown. A few bone cancers have been linked to hereditary factors, whereas others are related to previous radiation exposure.
Risk factors for bone cancer
The following factors increase the risk of developing bone cancer:
- Family history of cancer/bone cancer
- Exposure to radiation
- Stem cell transplant
- Previous chemotherapy with alkylating agents
- Paget disease of the bone
- Inherited genetic conditions, such as Li-Fraumeni syndrome, hereditary retinoblastoma, Rothmund-Thomson syndrome, tuberous sclerosis and Diamond-Blackfan anemia
- Multiple tumors in the cartilage
What are the signs and symptoms of primary bone cancer?
The symptoms of bone cancer include
- Bone pain and tenderness
- Swelling or palpable hard mass in the long bones of the limbs
- Weakened bone, leading to fracture
- Weight loss
- Fatigue
Less common symptoms caused by compression of nerves and blood vessels by the tumor are
- Numbness or tingling sensation in arms or legs
- Cold hand or foot with weak or absent pulse
What are the types of bone cancer?
The two main types of bone cancers are:
- Primary bone cancers: These develop primarily in the cells of the bone tissue. They can arise from any bone in the body but most commonly arise in the pelvis or long bones in the arms and legs. Primary bone cancers are rare accounting for less than 1 percent of all cancers.
- Secondary bone cancers: These occur when cancer from other parts of the body spreads to the bones. Secondary bone cancers are more common than primary bone cancer.
Staging and grading of bone cancer
Staging and grading bone cancer helps doctors in deciding the best treatment options.
Grading involves assessing the difference between tumor cells and healthy bone tissue. Grade I tumor has cells that resemble bone tissue whereas grade III tumor has more abnormal cells and suggests aggressive cancer.
Primary bone cancer is staged as follows based on the size of cancer and its spread:
- Stage I: Tumor has not spread from the original bone.
- Stage II: Tumor has not spread, but it may be aggressive and of a higher grade. It could be a threat to other tissues.
- Stage III: Tumor has spread to one or more areas of the same bone and is aggressive.
- Stage IV: Metastasis of bone cancer. The tumor has spread to the tissues surrounding the bone and to other organs, such as the lungs or brain.
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How is bone cancer treated?
Treatment options for bone cancer depend on
- Type, size, location and stage of bone cancer
- Age and overall health of the patient
Treatment options include
- Surgery: The tumor and surrounding bone tissues are removed surgically. The surgery options are:
- Limb salvage surgery: To stop cancers that spread quickly, the damaged bone is replaced with healthy bone from another part of the body or artificial bone.
- Amputation: For extensive bone damage in the arms or legs, amputation followed by the use of prosthetics may be required.
- Radiation therapy: High-energy X-rays are used to destroy cancer cells.
- Cryosurgery: Cancer cells are targeted using liquid nitrogen to freeze and destroy them.
- Chemotherapy: Anti-cancer drugs are used to destroy cancer cells.
- Targeted therapy: This treatment prevents cancer cells from growing by using a drug that specifically attacks the molecule that causes cancer cells to grow.
- Other Medications:
- Pain medications relieve inflammation and discomfort
- Bisphosphonates protect the bone structure and prevent bone loss
- Cytotoxic drugs halt the growth of cancerous cells
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What is the prognosis of bone cancer?
The five-year survival rate for bone cancer depends on the location and the stage of cancer when it was first diagnosed. About 75 percent of people live at least five years after diagnosis.
The prognosis may differ based on
- Whether it is primary bone cancer or secondary.
- Whether it has originated in bone or the marrow.
- Time elapsed since the first symptom.