Bone cancer: what is it and how can you combat it?
Receiving a cancer diagnosis, of any kind, is life changing and forces us to make decisions that matter to the patient as well as their loved ones. Bone cancer is more common among children and young people, but it can also affect adults.
Keep reading to find out more about bone cancer, including what it is, its symptoms, diagnosis, treatments and alternative therapies.
What is bone cancer?
Bone cancer refers to cancer that originates in the bones in any part of the body and starts to destroy the bone tissue. Usually, it affects large bones such as the arms, legs, or pelvis.
Cancer that originates in the bones (primary cancer) is not a common type of cancer, since most bone tumors are benign. More often than not, cancer forms in another part of the body and metastasizes (spreads) to the bones (secondary bone tumor), which is not bone cancer.
There are three types of bone cancer, which have different names depending on the tissue where it originates:
- Osteosarcoma: forms in new, growing bone tissue (hence why it is most common in children)
- Chondrosarcoma: starts in the cartilage, which is the tissue that protects the joints
- Ewing’s Sarcoma: starts in the bone marrow or the immature neural tissue
Symptoms
If you have not yet been diagnosed but you suspect that you or someone close to you is not well, it is important to identify any symptoms as soon as they appear. Here are the most common symptoms of bone cancer:
- Pain: in the affected bone (initially not consistent, but worsens with time)
- Inflammation: evident in the painful area
- Growths or lumps
- Weakness in the bones that can cause fractures
- Fatigue
- Unexplained weight loss
- Fever
- Loss of mobility
If you or someone close to you is experiencing one or more of these symptoms it is important that you get them checked out by a doctor as soon as possible to receive an accurate and timely diagnosis.
Causes
As is the case for other types of cancer, the specific causes of bone cancer are difficult to determine. What is certain, is that there are several risk factors that increase your chances of suffering from this type of cancer.
Risk factors
Some of the factors that increase the risk of suffering from bone cancer are:
- Genetic disorders: some bone cancers have been proven to be hereditary and caused by genetic alterations, as is the case for osteosarcoma or retinoblastoma. Although the latter is not treated as a bone cancer, it can increase one’s chances of suffering from tumors in the ocular socket.
- Chondrosarcomas: a hereditary disease that produces tumors, which starts in the cartilage and then spreads to the bone tissue. Can cause pain, deformities or fractures in the bones.
- Radiation: being exposed to ionizing radiation, or high amounts of energy, can increase the chances of developing bone cancer. Here, we are talking specifically about constant exposure to a high dosage of radiation.
- Paget’s Disease: this condition causes bones to become more fragile and develop abnormally, which makes them fracture more easily. 1 % of patients with this disease develop bone cancer (American Cancer Society).
Diagnosis and exams
Although there is no one way to prevent bone cancer, many studies suggest that someone with bone cancer who receives an early diagnosis and begins treatment during the initial stage, can significantly increase their chances of winning their battle against cancer.
- Physical exam: the doctor does a full examination to detect any abnormal lumps or growths and to see if the patient feels pain upon touching them or moving. They will also ask about the medical history of the patient and their family.
- X Rays: x-rays show where there are abnormalities in the bones, such as orifices, deformities or decolorations.
- Computerized tomography (CT) scan: a more advanced exam that allows the stage of the bone cancer to be determined and whether it has spread to other organs and tissues such as the lungs or the liver.
- Magnetic resonance imaging (MRI): allows the tumor in the bone to be determined, which provides a reference as to the scope or contraction of the bone in treatment.
- Bone scintigraphy with radionuclides: more precise than x-rays, since it can capture smaller areas of metastasis and show the scale of damage caused by bone cancer.
However, a diagnosis must be confirmed by means of a biopsy, which consists of taking samples of tissue and analyzing them under a microscope. There are two types of biopsies:
- Needle biopsy: a syringe is used to extract liquid and some cancer cells from the tumor to analyze it and determine whether or not it should be treated as cancer.
- Surgical bone biopsy: an incision is made through the skin to the tumor and a tissue sample is taken.
Treatments
Treatment for bone cancer depends on various factors, such as its size, location, degree of development and the general health of the patient. The treatment for this type of cancer may include:
Surgery
Consists of the complete surgical removal of cancerous cells. Usually, a small amount of normal tissue surrounding the tumor is also removed to ensure that the cancer is removed in its entirety.
Occasionally, a limb must be amputated to eliminate the cancer, but mostly it is possible to remove the entire malign tumor without requiring amputation, this is called limb-sparing surgery.
Cryosurgery
Occasionally, instead of surgery, cryosurgery is used to treat bone cancer. It consists of the application of liquid nitrogen, to freeze and destroy the abnormal tissue or cancerous cells.
This treatment might be an option if bone cancer has returned after radiotherapy.
Radiotherapy
Radiotherapy can be used as a treatment prior to surgery or in combination with chemotherapy. It consists of using high-energy X-rays or particles to destroy cancer cells. This type of radiation is applied outside the body and targets the cancer.
Most bone cancers are not easily destroyed by radiation, which is why it’s not usually used as the main treatment. One the most significant side effects is the impact that high levels of radiation can have on healthy tissues.
Chemotherapy
Consists of medication administered orally or intravenously to destroy any remaining cancer cells after surgery or radiotherapy. It is used to treat Ewing’s sarcoma (a malignant bone tumor that is most common in children and young people) and osteosarcoma (a cancer that generally affects larger bones).
“Anti-cancer” medication or drugs that are most commonly used in this type of therapy are:
- Doxorubicin (Adriamycin®)
- Cisplatine
- Etoposide (VP-16)
- Iphosphamide (Ifex®)
- Cyclophosphamide (Cytoxan®)
- Metotrexate
- Vincristine (Oncovin®)
These are just some of the most common drugs, but there are actually 100 more types of medication used for this therapy. Chemotherapy often causes one or more side effects such as nausea and vomiting, loss of appetite, hair loss, mouth ulcers, among others.
Targeted therapy
Recent advances in cancer research have given way to the creation of a new type of drug that focuses on the molecular and genetic changes that cause cancer. This type of treatment does not damage the healthy cells in the body.
It is different to chemotherapy, which also uses medication to destroy cancer cells, and is also known as “molecular targeted therapy” or “precision medicine”. The drugs used for this type of therapy are:
- Imatinib (Gleevec®)
- denosumab (Xgeva®)
- Interferon
Results for targeted therapy medication have been very promising, and recent research suggests it may be even more effective than chemotherapy in treating bone cancer. For this reason, many researchers are currently evaluating how these drugs can be used to treat primary bone cancers.
Complementary treatments
There are also other complementary therapies available that adopt a more integrated approach to cancer treatment, which can complement conventional therapies used to treat bone cancer and relieve some of the symptoms these treatments can cause.
Many of these complementary treatments help to strengthen the immune system, regulate sleep cycles, and reduce pain and inflammation, among others.
Healthy diet
Eat a balanced diet, with at least 2 ½ cups of fruit and vegetables a day, as well as several portions of whole grains, such as whole wheat bread, cereals, grains, rice, pasta or beans.
Limit the consumption of red and processed meat (e.g. sausages); the fresher and more colorful the food, the better. Smoothies can be a good way for bone cancer patients to get important nutrients:
- 1 cup of of almond milk
- 1 teaspoon of olive oil +
- juice of 1-2 limes
- 1 piece of fruit
A diet rich in antioxidant and anticarcinogenic foods such as fruits, vegetables, olive oil, such as the mediterranean diet, is recommended. Additionally, avocado, wheatgrass and mushrooms provide a good source of vitamin D, whilst sesame, almonds, berries, kale and spinach are loaded with calcium, which helps strengthen bones.
Exercise
Physical activity is recommended for general wellbeing, but it is even more important if you are dealing with bone cancer. Doing regular exercise will help improve blood flow and boost your metabolism.
According to the World Health Organization (WHO), staying active can help patients overcome the effects of cancer and cancer treatment, such a fatigue, weight loss, depression and anxiety.
Mind-body medicine
Meditate, reflect, understand that no one else knows you or your body better than yourself. Feel every part of your body and learn to understand it; a bit of self-reflection may help you understand what is happening in your body and how best to combat your disease.
Yoga is an excellent way to form a mind-body connection, especially hatha yoga, which uses postures and breathing techniques to increase strength and flexibility and improve wellbeing.
Yoga is recommended for cancer patients, as it helps to:
- improve physical functioning
- reduce fatigue
- reduce stress
- improve sleep
- improve quality of life
Cannabis*
Cannabinoids, the main component in the Cannabis plant, have various medicinal benefits that help reduce general discomfort, which contributes to reducing nausea and vomiting, stimulating appetite and relieving pain that may be caused by chemotherapy or radiotherapy treatments. CBD can promote the death of cancer cells, reducing the potential for tumors to spread and metastasize.
A recent study, which is still underway, has found that CBD can strengthen bones during the healing process, as it improves the maturation of the collagenous matrix that forms the basis for the mineralization of new bone tissue.
*Always check to see if it is legal in your jurisdiction before obtaining any cannabis-based product.
Coping and support strategies
We know that a cancer diagnosis can pose a huge emotional challenge. But it is important to keep friends and family close and to share your thoughts and feelings with your loved ones. Feeling heard and supported will help you feel stronger.
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