Bone Sarcomas (Cancers)
Bone sarcomas are a group of cancers that originate from the living cells of the bones. Roughly 2,000 new cases are diagnosed each year in the United States. Bone sarcomas are more common in children and young adults. Any bone in the body may be affected; however, long bones are more prone to this illness.
Cause
The actual cause of this illness is unknown; however, some environmental factors play a role in development of this cancer. Exposure to radiation, chemotherapy and certain chemicals may increase the risk of developing this cancer.
Signs and symptoms
Signs and symptoms depend on the origin and location of the cancer. In tumors of the arms or legs, patients may notice a swelling and a lump, along with pain. Some may present with fever, fatigue and weakness.
Diagnosis
These cancers can be detected upon physical examination of the involved area. Any suspicious lump should be biopsied. X-rays, CT scan, Bone scan, MRI or other studies might be necessary to locate the cancer. There are two important types of bone cancers:
- Osteosarcoma , which is the more common type
- Ewing's Sarcoma, more prevalent in children
Treatment
Surgery: Management of this disease relies on surgery in an attempt to remove most or all of the tumor. Surgery on the limb cancers should be performed by an experienced surgeon specializing in this type of cancer. Attempts are made to preserve the functionality of the limb.
Certain patients may benefit from removal of tumor metastasis from the lungs , especially when the primary site of cancer is managed aggressively and is under control.
Chemotherapy: Is appropriate for patients in whom the disease may not be cured with surgery. Adriamycin, Ifosphamide, high dose Methotrexate, Cytoxan, DTIC, VP-16, Cisplatinum, Actinomycin D are among the most commonly used drugs. These drugs are used in combination and can have moderate to severe toxic effects. More recently, chemotherapy has been used as Neo-Adjuvant treatment with some success. The goal is to shrink the tumor prior to surgery and increase the chance for cure. This approach can use concomitant radiation therapy, as well.
Radiation: For the most part, radiation is used in combination with surgery and chemotherapy. Radiation at the time of surgery, referred to as Intra-Operative Radiation, has not proven to be more effective than external radiation.
Pattern of Spread
If left untreated, or if it fails to respond to treatment, this cancer can spread to the liver, lungs, brain or other bones and almost anywhere else.
Prognosis
This type of cancer carries a poor prognosis if not detected in its early stages and treated very aggressively.
