What is bone cancer?
Bone cancer is one of the most challenging cancers that we encounter during our practice so most of the bone cancers occur in the growing bones in children and adolescents and not all bone cancer is the same.
Many times, it is detected by an accident feeling of pain or an extra hardness or growth of the bone felt by sometimes the child's mother and brought to the doctor for further evaluation. Rarely a large growth of the bone which gives a bumpy appearance on the bone brings the patient to the doctor. So basically, just like we have several parts of every organ there are several parts to a bone so if you see the long bone okay for example the bone of our thigh which is otherwise called as the femur it has three components it's got the diaphysis or the middle of the bone
it has got the epiphysis or the tip of the bone and then you have the bridging part of the epiphysis and the diaphysis called as a metaphysis. Metaphysis is the area where most of the growing bone tissue is located for example, once a person achieves his or her maximum height in adolescence the metaphysis would be fused so there are no more growing cells in the metaphysis but in a child which is growing, metaphysis is composed of several actively growing bone forming cells known as osteoid which help in the growth of the bone length as well as breath wise, so that is a normal
Bone inside the bone in the hollow of the bone as you would like to call, it is the bone marrow and bone marrow is usually located in the hollow bones which are the hip bones of the thigh also called as the femur. The bones of the arm also called as the humerus and the bone marrow is also located in certain backbones also so like I told you that initially the child or the adult or even the adult is brought to the doctor for a swelling of the bone abnormal pain in the bone, a boring kind of regular increasing intensity pain, and sometimes deformity of the bone also can bring the patient to the oncologist, so how do we proceed when the patient comes to us with these varied presentations? x-ray of the bone is the first test that we usually ask for and believe it or not in the era and pet, even today x-ray gives us a lot of information with respect to the diagnosis of the tumor and also strategies for management of the bone tumor.
What Are The 7 common Types Of Bone Cancer ?
- Osteosarcoma
- Chondrosarcoma
- Ewing tumor
- Fibrosarcoma and malignant fibrous histiocytoma
- Giant cell tumor of bone
- Chordoma
- Metastatic bone cancer
After the x-ray we want to know what kind of bone cancer it is, it is important to tell you that even today most of the bone tumors are benign most of the bone deformities are also benign bone cancers are the malignancy of the cancer wherein the bone is destroyed and also the tumor cells spread to other parts of the body are a minority of bone tumors. not all bone spellings or bone tumors are malignant so then we proceed to do a biopsy: biopsy is nothing but you put a thick board needle into the tumor core get the tissue there and study it under microscope.
So most pathologists who are well oriented with cancer diagnosis can easily differentiate between whether this is a bone tumor which is benign or a bone tumor that is malignant. However, please note that not everybody can do a bone biopsy if it's actually a malignant bone tumor and the biopsy is not done in the right technique you may end up spreading the cancer outside the bone house that is why a highly qualified orthopedician, a surgical oncologist are qualified to take the bone biopsy in an adequate and optimal way so that the diagnosis is also established and there is no seeding of the bone tumor outside the bone.
6 Different most experience Symptoms Of Bone Cancer
- Bone pain
- Swelling
- Fractures
- Decreased mobility
- weight loss
- fatigue
If the biopsy report turns out to be cancerous or malignant, in that instant we then proceed to a staging evaluation, so for bone tumors usually nowadays we do a whole body contrast enhanced ct scan or a pet scan; sometimes we also do a bone scan which is a nuclear medicine test with these tests we then establish whether the bone tumor that we diagnosed
is located only to that particular bone or has it spread elsewhere. If the imaging test shows that the bone is localized to the site of the symptom then we proceed to think of a curative management and if it has spread then treatment intention is only to control the disease and to palliate the symptoms. So,
the most definitive modality for treatment and you know the cure of bone tumors is surgery. Time and again, I find that many children
and adolescents who grow with a bone tumor they tend to lose their limb, basically an amputation is done after which the limb is removed and the patient is given prosthesis so that then the patient can perform whatever activities that it is possible to do with limb processes, also I want to enlighten all of you that many a times we can do what are called as limb salvage surgeries by which the same lymph can be salvaged by these advanced surgical techniques called as limb salvage surgeries limb.
Salvage surgery basically utilizes special processes or metallic
processes which can be inserted end to end to the either side of the
resected bone and this helps the individual perform as close to normal before the patient was diagnosed with bone tumor.
This is not done by everybody the reason is it requires great skills and also requires you know down staging of the tumor by a chemotherapy by which a tumor which could start out to be around eight or nine centimeters can be shrunk to as less as three centimeters and then lymph solid surgery is made possible.
So remember that for anybody who have bone tumor, it does not mean that the patient has to lose their limb. Limb salvage surgery is certainly possible, in fact many of our patients who come to us with bone tumors we make sure that until otherwise if it's not possible we always try and insist on a limb salvage surgery protocol so that patients do not have to live a life forced bone tumor treatment being severely handicapped.
Conclusion
I'll summarize with just two points, which are; one make sure that earliest treatment is started when bone tumor is diagnosed it could not be malignant but make sure the diagnosis is done and two make sure that treatment is taken from a center which has multi-disciplinary oncology management possible so that these advanced techniques such as limb salute surgery can be made possible and in many cases the limbs of the child or the adolescent can be preserved using this latest strategies.