Bone cancer pain is the most important symptom of bone cancer. In the following article, you will learn about this condition.
Bone cancer is one of the rarest forms of cancer, making up 1% of all cancer cases. In the United States, there are 3 thousand new cases of bone cancer each year. It usually affects children and teenagers. Then, it affects adults around 60 years of age. Most of the time, it has a good prognosis (or possible outcomes).
If you want to learn more about the bone disease, keep reading this article. Here, you will find the answer to frequently asked questions about this topic. Everything from what cancer is to what does bone cancer pain feels like and a bone cancer diagnosis. All of this, simply put, directly from a doctor. So, keep reading, and you will find yourself with more knowledge about this disease.
What is cancer?
Cancer is not a singular condition. In fact, it is a collection of diseases that are related. What all types of cancer have in common is what happens with your cells. Every tissue in your body is made up of cells that perform specific functions. Normally, they divide and grow as needed and die when damaged or old.
In cancer, this latter process gets disrupted. Your body starts to create more cells even if it doesn’t need them. These extra cells can form what we know as tumors. Also, old and damaged cells remain functioning even if they should die.
There are two basic types of tumors: benign or malignant. Benign tumors have a better prognosis since they don’t invade or spread into other tissues. They can be removed through surgery and usually don’t grow back. On the other side, malignant tumors are dangerous because they spread and invade other tissues in the body. This happens because cancer cells can travel through the blood or lymph system and form new tumors. This is called metastasis.
Another important characteristic of tumor cells is that they are not as mature as healthy cells. This makes them unable to perform the functions of a healthy cell. Also, cancer cells are very good at preventing the immune system from destroying them.
What is bone cancer?
Bone cancer is a condition in which bone cells begin to grow out of control. These cells can form bone tumors, which are primary cancer (tumors that start in the bone itself). These cancer types receive the name sarcoma, like other cancers of muscle, fat tissue, and blood vessels.
This cancer includes malignant bone tumors that can invade other tissues in your body. It also includes secondary bone cancer. The latter is a tumor that is in the bone but comes from another primary tumor in another tissue. In fact, most of the time, this cancer arises because of bone metastasis when a patient has another cancer. It commonly happens in many types of cancer, like breast cancer and prostate cancer.
The most common types of primary bone cancer are chondrosarcoma and osteosarcoma. Another common type of bone cancer is Ewing sarcoma. We’ll talk about this in-depth later.
There can also be benign bone tumors. They are not cancer since they can’t spread or invade other tissues. This is why they are not life-threatening and can be removed with surgery. The most common type of benign bone tumors includes osteoid osteoma and osteoblastoma.
How common is bone cancer?
Bone cancer is one of the rarest cancers there is. In fact, it makes up around 1% of all the cancer cases there are. However, it affects around 3 thousand people every year in the US, and it is slightly more common in men than women. Also, this cancer is very rare in children under five years old, affecting less than one child in every million inhabitants. Nevertheless, the probabilities increase with age, as it corresponds with a teenage growth spurt. It can reach around 8 million cases every year in the age group from 15-19 years old. Remember, there is a second peak, with increased chances of developing this condition at around 60 years of age.
What are the risk factors for bone cancer?
Some factors can increase your risk of developing bone cancer. These may vary in the various types of bone cancer that exist. However, amongst the most common, we find:
- Age: Bone cancer is more common in people around the ages of 10 and 30 years old. Especially during a teenage growth spurt, teens are likely to develop bone tumors. Doctors think this is linked to the quick growth of bone tissue during this period. The risk also increases in people over 60 years.
- Height: Children who are tall for their age appear to be more likely to develop bone cancer. The explanation is also the quick growth of bones in these children.
- Radiation exposure: Radiation is a common risk factor for developing several types of cancer. However, it is also a pretty useful cancer treatment as well. Cancer patients who were treated with radiation therapy for another cancer have a higher risk of bone cancer. Imaging studies that use radiation like X-rays and CT scans can increase the risk of bone cancer too. This is why doctors try to limit the use of these tools.
- Bone diseases: There are bone diseases that are not cancer but are related to a higher risk of bone cancer. One common example is Paget’s disease, in which abnormal bone tissue forms in one or more bones. These bones are thicker but somehow are weaker and easier to break.
- Cancer syndromes: Certain types of cancer affect several genes in your body, causing mutations. This can cause one type of cancer to increase your risk of developing bone cancer.
- Genetics: You are more likely to develop bone cancer if you have a family history of this condition. This happens in almost every disease, and bone cancer is no exception.
What does bone cancer feel like?
Sometimes, people find it hard to identify bone cancer symptoms. This can cause a delay in diagnosis. In fact, symptoms can start weeks or even months before the diagnosis. The most common symptoms include:
- Bone pain: This is the most important symptom of this condition. It can start with a feeling of tenderness in the affected bone. In fact, the pain can be mistaken for growing pains in children and arthritis in older adults. Then, as the tumor grows, it can progress to more intense pain. Often, patients describe it as severe pain that can be persistent or come and go. If the tumor happens to be close to a joint, there can be pain during activity.
- Mass: Depending on the tumor’s size, a palpable mass may or may not be present. This mass can be tender and warm.
- Decreased range of motion: If the tumor is close to a joint, it can difficult movement.
- Other symptoms: Fever and weight loss are typical of cancer but may be rare in bone cancer.
Metastatic bone pain also has the same characteristic as primary bone cancer pain.
Where do you feel bone cancer?
The most common thing is to “feel” bone cancer in the affected bone or joint. You can start by feeling a dull pain or tenderness in the area of the affected bone. Then, while the tumor continues to grow, the pain can become much more intense. Also, when the tumor reaches a certain size, it can be felt as a palpable mass. This mass can get swollen and red, but this is rare in bone cancer.
Why is bone cancer so painful?
Bone cancer is painful because of its nature. Remember that the continuous growth of the tumor damages the bone tissue. This is because cancer disrupts the normal functioning of bone cells. Also, other forms of cancer can invade the bones and cause skeletal metastasis. These metastases are responsible for the erosion of the healthy bone tissue that surrounds them.
Another way bone cancer causes pain is because of nerve compression or spinal cord compression. Depending on the location, a bone tumor that grows uncontrollably can compress near nerves. This causes a special kind of pain that doctors call neuropathic pain. This can also happen with the spinal cord, a structure in your spine that originates from peripheral nerves. Spinal cord compression is also a very dangerous and painful phenomenon. The bad thing is that this pain will only get better when the mass causing the compression is gone.
Where does bone cancer usually start?
It depends on the type of bone cancer. However, the most common is that cancer starts in your body’s long bones or your pelvis. Most of the time, bone cancer will start in the metaphysis of the bones. This is the part of the bone where the growth nuclei are. In these nuclei, bone cells divide faster and are accountable for the growth of the bone. Here, cells can lose control of their division and make more cells than needed. This is when cancer starts.
In the case of other bone cancers, like chondrosarcoma, cancer starts in the cartilage. This happens because, in this type of cancer, the cells that start dividing uncontrollably are cartilage cells.
Does bone cancer pain start suddenly?
Actually, no. The thing with bone cancer pain is that, at first, it can be mistaken for other causes of bone pain. At first, the pain is mild and appears on only certain occasions, like during physical activity. In the case of young children or teenagers, it can be mistaken for growing pains. As the tumor grows bigger, the pain will become more intense. This is when patients will start to notice the pain as an issue in their lives. Also, when the tumor grows, it can limit the functionality of the limb or the affected bone or joint.
What could cause bone pain?
Many conditions can cause bone pain. This makes the diagnosis of bone cancer a little difficult. Thinking of more common reasons for bone pain can delay the diagnosis of bone cancer. Of course, the delay in the diagnosis will delay the treatment. Among the causes of bone pain, we will find:
- Injury: In the event of a trauma, an injury can cause bone pain or even bone fractures.
- Deficiency of certain minerals: Like calcium and vitamin D, which are key in the formation of healthy bone.
- Metastatic cancer: Cancer that affects a different organ, can spread into and invade other tissues. When advanced cancer affects the bones, it can cause intense bone pain.
- Diseases that cut blood flow to bones: Like any other tissue, bones need blood to nurture them. Once the blood flow is cut, the bone tissue will start to die. This results in necrosis and severe pain. This happens in conditions like sickle cell anemia.
- Bone infections: Also known as osteomyelitis. Bone infections are damaging to the bone tissue, resulting in swelling and bone pain.
- Leukemia: It is another type of cancer that starts in the bone marrow. Since this cancer starts in the bone marrow, it can affect many bones of your body and cause pain.
As you can see, there are many causes of bone pain. However, bone pain is not normal, and you should go to the doctor if you are experiencing it.
How is this cancer diagnosed?
A doctor can only make the diagnosis of bone cancer. If you think you have symptoms similar to bone cancer, then you should get an appointment. Your doctor first will ask about what symptoms you have experienced so far. They may also ask questions about your medical history or family history in order to know your risk factors. Then, they will perform a physical examination, looking for findings that can help them establish a diagnosis.
However, clinical findings are not enough to make a diagnosis. This is why your doctor will probably indicate some laboratory and imaging studies. The best way to make a diagnosis is through imaging studies. Even a simple x-ray can be enough to visualize a bone tumor. There are also other studies like CT scans or MRIs that are also helpful to find bone tumors. They are also important to find probable metastasis of cancer. There is another study call bone scan, which base is the bone tissue. With a bone scan, doctors can visualize the presence of metastasis or multifocal cancer.
How is bone cancer staged?
All cancers need to be staged in order to stratify risk groups and establish treatment. However, bone cancer is staged differently than other tumors. This is because it rarely affects lymph nodes and rarely causes metastasis. The staging for bone cancer is based on histologic grade (grade of malignancy of cells), the location, and if there’s metastasis. All musculoskeletal tumors, including soft tissue ones, are staged this way. The bone cancer staging system (Enneking staging system) is as follows:
- Low-grade tumor, intracompartmental – IA
- Low-grade tumor, extracompartmental – IB
- High-grade tumor, intracompartmental – IIA
- High-grade tumor, extracompartmental – IIB
- Any tumor with evidence of metastasis – III
In this system, a compartment is a bone itself and the intraarticular space (space between the two bones of a joint). By definition, the extracompartmental areas are the inguinal region, the popliteal space (behind your knee), and the spinal area.
Also, the location of the tumor is often associated with different prognoses. According to this, distal extremity tumors have the best prognosis. Tumors in the axial skeleton, on the other side, have the worst prognosis.
What’s the treatment for bone cancer?
Cancer treatment can be very difficult and is different for every type of cancer. The targeted therapy for bone sarcoma can include both medical and surgical approaches. In the case of medical treatment, patients with bone cancer can benefit from chemotherapy. This because chemotherapy can help slow down the growth of the tumor or even shrink it.
Also, the tumor’s response to chemotherapy can act as a sign of a better prognosis. There is a group of drugs called bisphosphonates. They help preserve the density of the bone, preventing bone fractures and further bone damage.
On the other side, surgical treatment includes the resection of the tumor. This procedure is called a wide resection since doctors take away both the tumor and healthy edges. This, in order to make sure that they removed all the tumor and avoid relapses.
Sometimes, the tumor would be so big that the only way to remove it is through an amputation. This is terrible, yes, but keep in mind that doctors would rather save your life.
Is osteoporosis a sign of bone cancer?
No. Osteoporosis is another bone condition, and it has no link to this cancer. What happens in osteoporosis is that the speed of bone reabsorption is higher than the speed of bone formation. This results in a reduction of bone density, making it more prone to fractures. This condition is more common in women and people older than 60 years old. Even though it’s a bone condition, it has no relation whatsoever to bone cancer. Plus, it isn’t a risk factor for developing this cancer. This means that it doesn’t increase your chances of developing a bone sarcoma.
Can you die from bone cancer?
Even if the prognosis of bone cancer is really good, you can still die from it. The patient’s prognosis will depend on several factors like the tumor’s location, the type of cancer, and its response to chemotherapy. It also depends on the extension of cancer and if it has spread or not.
Overall, the five-year survival rate of all patients is around 70%. In the specific case of osteosarcoma, the five-year survival rate is around 60% to 80%. However, if cancer has spread beyond bone, the survival rate drops to 15% to 30%. Osteosarcomas will have a better prognosis if they are located in the legs/arms, respond to chemotherapy, and get removed with surgery.
Do you have these symptoms or risk factors?
This tool is a Bone Cancer Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for the disease. Therefore, the tool will tell anybody who uses it the likelihood of their symptoms because of bone cancer. Using the tool is free and would only take a few minutes.