Recent Advancements in Bone Cancer Treatment

Bone cancer is a rare disease that arises from the cells within or around a bone. In bone cancer, the cancer cells arise de novo (start from the beginning) and then tend to multiply aggressively, destroying the bone in the process. Cancer may also spread through the body via the blood. It can spread to multiple systems like the lung, other bones, and tissues. The tumours in bone cancer can grow to large sizes, impairing the function of the body and can even lead to death.

Types of Bone Cancers

Based on the cell of origin, bone cancers can be of different types, the most common of which are:

• Osteosarcoma: In this type of bone cancer, the cancerous cells produce bone.
• Ewing’s Sarcoma: In this type of cancer, tumours arise most commonly in the arms, legs, or pelvis

Both osteosarcoma and Ewing’s sarcoma are more common in children between the ages of 5 and 20 years.

Other types of cancers like multiple myeloma and chondrosarcoma are more common in late adult and old age. Then there are the cancers that arise from other parts of the body, like the breast, thyroid, lung, etc., which may spread to the bone. These cancers are known as secondary (metastatic) bone cancers.

Most Common Symptoms of Bone Cancer

Patients who suffer from bone cancer generally show the following symptoms:

• Persistent bone pain that is not relieved by rest or pain medication
• Progressive swelling and tenderness near the affected part
• Weakened bone(s) that may lead to a fracture
• Unintended weight loss
• Fatigue

In addition, tumours that arise from the spine may result in symptoms like weakness in the hand, foot, or even paralysis.

Diagnosing Bone Cancer

Bone cancers are not easy to detect and generally, the diagnosis of the same is delayed. As bone cancers are quite rare, awareness about them is also poor among the public as well as among doctors. Early detection is one of the most essential aspects of managing bone cancer, which is why it is important that people consult the concerned doctor at the earliest. For proper diagnosis, thorough examination and appropriate investigations are very important. A patient may have to undergo investigations like X-ray, CT scan, MRI scan, bone scan, and PET scan. A biopsy is also a very important investigative procedure that is performed by the treating surgeon to confirm the diagnosis of bone cancer.

Treatment of Bone Cancer

In earlier times, the cancer of the bone was considered to be an incurable disease. To relieve patients from pain, procedures like amputation surgery were generally performed. Today, numerous advances have been made in cancer management which has really helped a lot with the treatment of bone cancer. While high-end investigation modalities like PET scans and MRIs have made it easier to diagnose bone cancer, various limb salvage procedures help treat upper or lower limb cancers and pelvic cancer. On the other hand, reconstruction techniques like megaprosthetic replacement, allo bone graft, vascularized fibula, and rotationplasty are increasingly popular options today. For children who suffer from bone cancer, special implants are available like expandable megaprosthesis. Patients with metastatic bone cancer have the option to undergo palliative surgeries for relief from cancer pain and to improve the quality of their life and function.

In many cases, a multimodality approach is recommended, which may include procedures like surgery, chemotherapy, and radiotherapy. While chemotherapy is a technique that helps prevent cancer from spreading and can even help save lives, radiotherapy is mostly used as an adjuvant to surgery.

The advent of new technologies and skills for cancer management and treatment has made early detection and cure of primary bone cancers possible. The rate of curing bone cancer has improved from 25% to 70%. In cases where the patients are diagnosed late and are suffering from large local disease and metastasis (spread), where a cure may not be possible, care is taken to relieve them from pain and to help improve their function so that the quality of their life may be improved.