Bone cancer treatment

We found 38 clinics & 51 doctors for Bone cancer Worldwide. AiroMedical ranks among 437 hospitals based on qualification, experience, success rate, and awards.

Bone cancer is a rare malignant disease that most often occurs due to the metastasis of сancerous cells from other organs. However, there is also primary cancer, which firstly appears in the skeleton. Treatments for cancer in the bone include surgery (limb amputation or limb-salvage surgery), chemo- (neoadjuvant and adjuvant), immuno-, target and radiation therapies. Sometimes operation can be combined with joint replacement.

Bone cancer occurs anywhere in the human skeleton. There are primary malignant bone tumours directly from the bone tissue. Secondary malignant tumours arise as metastases from malignant cells in another organ. Lung, prostate, breast, kidney and thyroid cancer, in particular, can spread to the bones.

Oncologists divide cancer in the bones into different types - depending on which cells or tissues it originates from:

  • Osteosarcoma originates in the cells where new bone tissue forms. It is the most common type of bone cancer. Children and teenagers are at the most risk.
  • Ewing sarcoma forms in the soft bone tissues: the connective, fat, muscle and the tissue of the peripheral nerves.
  • Chondrosarcoma originates in the cartilage of the bone and accounts for about 20% of all bone malignancies. Most people with chondrosarcoma are between 40 and 60.
  • Chordoma is a sporadic type which begins in the bones of the spine.

In general, primary bone cancer is rare. Osteosarcoma is the most common tumour, with nearly 40% of all bone malignancy cases, followed by chondrosarcoma with about 20%. Ewing's sarcoma is rare, with 0.6 new cases per million people yearly.

Bone cancer usually originates from a part of the bone called the metaphyseal. It is located in the area of ​​the transition of the heads into the central tubular section (where active growth and division of bone cells occur). The growth zone functions for up to 25 years. Therefore, osteosarcoma mainly affects children and adolescents (8 out of 10 cases). Sometimes it occurs in 20-40-year-old people. For the elderly, the disease is sporadic. Boys and men get sick more often.

The region of the knee, thigh and upper part of the shoulder is commonly affected (80% of cases), and the tumour occurs six times more often in the lower extremities. Flat bones are much less prone to be involved in the disease. It can be the jaw or frontal bone.

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Causes for cancer in the bones

Doctors suspect that genetic and growth-related reasons play a role in bone cancer. It is known that it more often occurs during the period of the most intensive division of skeleton cells. In addition, certain hereditary diseases (progeria, osteochondroma) and syndromes (Bloom, Li-Fraumeni) increase susceptibility to the condition. Osteomyelitis without treatment can also become a trigger.

One of the provoking reasons is radiation therapy. Therefore, children who had cancer and underwent radiotherapy have an increased risk of developing osteogenic sarcoma in the future.

Statistics show that the tumour develops near the joints exposed to trauma. Therefore, it should not be a one-time fracture but multiple frequent injuries. It often happens to athletes.

Lifestyle, nutrition, weight, and contact with carcinogens do not play a role in bone malignancy.

What are the symptoms of bone cancer?

The tumour is characterised by active growth and rapid spread throughout the body. The disease process proceeds quickly, even at the initial stage, when only a slight dull pain in the joint area is present among the symptoms. It is usually taken as a result of a past injury or arthritis, so patients do not immediately consult a doctor. In the future, the picture will become more pronounced.

  • The main symptoms of bone trouble are pain and swelling;
  • If the cancer is on the legs or arms, patients usually feel dull but intense pain - especially when they move and put stress;
  • In the legs, bone neoplasm symptoms often manifest as knee pain;
  • Cancer in the skeleton that grows in the hip area or regions near the spine on the spinal cord can also be excruciating;
  • Often the areas where the tumour has formed swell. Its mobility is usually restricted if the site is near a joint;
  • The malignant bone disease can damage and weaken bones to the point where they break more easily;
  • General signs such as tiredness, exhaustion, reduced performance, weight loss or fever can occur when the cancer is more advanced.

Osteosarcoma actively grows, both inwardly and outwardly. It captures the bone marrow and muscle tissues and spreads metastases through the blood. Malignant cells from bones are most often can be found in the lungs and brain.

How is the bone tumour diagnosed?

Usually, patients consult a doctor after impaired mobility and the appearance of severe pain. Orthopaedic doctors examine the joint or the bone to check for protruding bumps and other noticeable changes at the first stage.

The main diagnostic tests are imaging scans. For instance, the X-ray examination in 2 planes is still the first and most crucial test. It shows a tumour in bone and can also reveal metastases, for example, in the lungs. Magnetic resonance imaging works with powerful magnetic fields and dissects the body into "slices". MRI shows the precise localisation of malignant neoplasm and possible metastases. Computed tomography is an X-ray method that takes a picture of the body in layers. CT makes a clear image of the patient's skeleton, which is essential in bone cancer diagnosis.

In addition to standard scans, bone scintigraphy can provide information about the extent of the disease, especially if bone metastases are suspected. First, doctors inject a slightly radioactive substance into the blood. Then, it accumulates in those parts of the bones where the metabolism is particularly active, for example, cancer cells.

A biopsy confirms the diagnosis of cancer in the skeleton. Doctors take samples from the suspicious tissue, and then the pathologist examines them under a microscope. He can say what type of tumour it is, how aggressive the cancer cells are and how far the tumour has progressed.

Cancer in bones is classified by stages:

  • Stage I: The tumour is low-grade, localised and does not spread from the origination place.
  • Stage II: The cancerous cells still do not spread, but the tumour is already high-grade.
  • Stage III: The high-grade tumour which extends within the same bone.
  • Stage IV: Cancer metastases to other body areas, such as the lungs or liver.

This category is enough to determine further treatment tactics. But unfortunately, in 80% of cases, an already advanced metastasising bone tumour is detected.

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Treatment options for bone cancer

Treatment of osteosarcoma is always complex. It starts with chemotherapy, which combines several drugs. During chemotherapy, the bone cancer patient receives certain drugs, so-called cytostatics. These inhibit the division and growth of fast-growing cells, including bone cancer. In addition, there is neoadjuvant (given before surgery) chemotherapy to shrink the tumour so that the subsequent operation can be gentler and safer. In addition, the options can be adjuvant chemotherapy for one cancer (after the primary treatment) or transarterial chemoperfusion (local chemotherapy through the arteries). Finally, bone cancer therapy involves immunotherapy and target treatment (a modern molecular-biological approach).

Surgery remains the best treatment for bone cancer. Unfortunately, the entire limb sometimes must be amputated (limb amputation) if there is a vast bone tumour in an arm or leg. In most cases, however, a "limb-preserving" operation can be offered. Limb-salvage surgery means removing the part of the bone affected by the bone tumour and some surrounding tissues.

Radiation therapy uses high-energy rays from outside through the skin onto the cancer region. Proton treatment can be modern and effective radiotherapy for bone cancer. It is an option for bone cancer if:

  • The tumour is difficult to reach, and the surgeon can not do the operation.
  • Bone cancer responded poorly to chemotherapy.

Often, bone cancers give a one-time relapse after two or three years of remission. The new tumour is usually associated with micrometastases in the lung area. The principle of repeated treatment is similar, but the percentage of those who survive is less.

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What is the prognosis for bone malignancy?

The forecast depends on the type of tumour, its aggressiveness and size. Some numbers on survival rates:

  • The five-year survival rate for osteosarcoma is around 70%.
  • About 60% of patients with Ewing's sarcoma are still alive after five years.
  • Life expectancy has increased, primarily since doctors have also used chemotherapy to treat bone cancer. Previously, the five-year survival rate for osteosarcoma and Ewing's sarcoma was less than 15%.

In the case of metastatic forms, everything depends on where the metastases are and whether onco surgeons can remove them. On average, five-year survival is 30-40%.

FAQ

Is there treatment for bone cancer?

Surgery, chemo-, immuno-, target and radiation therapy are bone cancer treatment methods. Usually, oncologists use chemotherapy combinations (before and after the operation) and surgery to treat the primary bone tumour. 

Why do patients choose treatment abroad for bone tumours?

Your local hospital may be suitable for more common cancers. But if you have rare cancer, such as bone cancer, the best option is to choose a foreign clinic that specialises in this. After all, such centres are equipped with all the necessary devices, have the latest generation of drugs in their arsenal, and experienced doctors guarantee the success of the therapy.

What surgery is the best for the bone tumour?

Surgery is the best option for bone cancer treatment. The oncosurgeon removes the entire tumour with negative margins (no malignant cells are found at the edge of the removed tissue). They may also use special salvage techniques to minimise the amount of healthy tissue removed and the cancerous ones.

Does bone cancer spread fast?

The spreading and susceptibility to metastasis directly depend on the type of bone cancer. It can grow fast and aggressively or grow slowly without spreading for months.

Can we save a limb after bone tumour surgery?

Limb salvage surgery helps save the limb by removing some of the bone associated with the tumour and some of the surrounding tissue. The bone is replaced by an implant, either a bone graft or a metal prosthesis.

Where can I get Bone cancer treatment?

Germany, Israel, Poland, Czech Republic, Turkey are among the best for Bone cancer treatment.

7 countries and 25 cities for Bone cancer