Bone cancer is one of the less common types of cancer, although it is unusually common in children and is often difficult to detect before it endangers a person’s life.
Primary bone cancer, that is, cancer that develops in the bones without taking into account those that do so in other organs but later metastasize to the bones, are not one of the most common types of malignant tumors.
In fact, “only” they represent about 0.2% of all cancer cases diagnosed each year in the world . Some 3,600 cases of bone cancer are detected annually in the world, a very small figure compared to the two million lung cancer or 1.8 million colorectal cancer.
The problem, then, is not so much its incidence, which obviously is also, but that of these 3,600 cases, more than 1,700 end with the death of the person. Therefore, we are facing a type of cancer with a high mortality rate even applying treatments. Also, unlike what happens with other cancers, it is more common in young people than in adults.
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And is that bone cancer, due to its location and other factors that we will see below, it is very difficult both to control its progression and to cure it. However, its severity will largely depend on the type of tumor you have. Therefore, in today’s article we will see the causes of bone cancer, the different types that exist, the symptoms and the treatments available today.
What is bone cancer?
Bone cancer is one that develops in bone cells, which are cells specialized in synthesizing the bone matrix, which makes up 98% of bones and gives them the robustness and rigidity of these tissues.
We have said that, in general figures, bone cancer is rare. And so it is. The problem is that it is unusually frequent in children and adolescents, who very rarely suffer from other types of cancer, as it is a disease typical of aging. In this most infantile age group, bone cancer is the fourth most common cancer.
Like any type of cancer, bone cancer consists of an abnormal growth of cells that, due to mutations in their genetic material, lose the ability to correctly regulate their division cycles, which is why they grow uncontrollably, giving rise to a tumor that, in case it endangers the health of the person, it receives the category of cancer.
In this case, bone cancer can develop in any set of cells in any bone in our body , although it is more common in the longer bones (those of the legs and arms) and the hips. Beyond this, its causes remain unclear, much less the reason why it has this unusually high incidence among the very young.
One of the first problems both in detecting and treating bone cancer is that, unlike others such as liver cancer in which the tumor is clearly located in an organ, bone cancer can develop in any bone in our body.
Therefore, depending on the location and nature of the tumor itself, there are different types of malignant bone tumors . We present them below.
Between 35% and 50% of bone cancers diagnosed each year are osteosarcomas, which consist of malignant tumors that develop in bone cells. In addition, it is the one that has a higher incidence in young people. In fact, almost 90% of cases are diagnosed in those under the age of 30, something unheard of for other types of cancers that are not bone. They mainly affect the bones of the legs, arms and pelvis.
It represents approximately 10% of all diagnosed bone cancers. It originates in cartilage cells and is especially common in middle-aged people, as there are generally no cases before the age of 20. Cancer begins in any cartilage in the body, including not only those near the bones, but also those in the trachea, larynx, and chest.
3. Ewing’s sarcoma
It makes up about 15% of diagnosed bone cancers and is again more common in the young population. Ewing’s sarcoma develops in the bone cells of the pelvis, ribs, shoulder blades, arms, and legs. It is very rare to find this type of cancer in those over 30 years of age.
4. Malignant fibrohistiocytoma
This type of cancer is more common in adults and is not usually diagnosed in children. It is not one of the most common since malignant fibrohistiocytoma usually develops in soft tissue cells, such as tendons and ligaments, although it can sometimes also develop in bones. In this case, it usually affects the legs, especially the area near the knee, and the arms.
5. Giant cell bone tumor
This type of cancer is more common in young adults and children. It tends to develop in the bones of the legs, especially near the knee, and the arms. One of its main characteristics is that it has a tendency to recur, that is, even if it is removed with surgery, it is common for a malignant tumor to reappear in that same region. Each time it reappears, it is more likely to metastasize to other organs, such as the lungs.
Similar to malignant fibrohistiocytoma, it is more common to develop in soft tissues and does not usually affect children. However, the nature of this cancer is different and it is common for it to appear in the bones of the jaw, something rare in other types of bone cancer.
It is perhaps the least common type of bone cancer but one of the most dangerous. And it is that chordoma is that malignant tumor that develops in the bones of the skull and spinal column. In this case, it is more common in those over 30 years of age.
Bone cancer is one of the types of malignant tumors for which we have the least information regarding its causes and risk factors. The reasons why some people develop these tumors and others do not are unknown . And it is even less clear why, unlike almost all other cancers, many of the bone cancers, as we have seen, are more common among children.
It is believed that, as happens with all, its appearance is due to a complex interaction between genetics and the environment, although in this case there do not seem to be clear and obvious risk factors as there is, for example, with lung cancer ( tobacco) or cervical cancer ( HPV infection ). What we do know is that the hereditary factor plays a role that, although small, seems to exist.
Having Paget’s disease of bone and having undergone radiotherapy treatment to cure another cancer in the past appear to slightly increase the risk of bone cancer, although this is not entirely proven.
Another major obstacle that doctors and those affected face is that bone cancer does not usually give noticeable symptoms until the tumor is in advanced stages. And even then, it is no guarantee that it will give clear signals of its presence. Symptoms depend on the affected bone and the size of the tumor. The type of cancer influences, but the clinical signs are usually common to all, regardless of the differences in terms of affected region.
The most common symptoms are bone pain, pain and inflammation in the region where the tumor is present, weakness and fatigue, weakness in the bones that can often be responsible for fractures, weight loss and general malaise. In any case, all these symptoms do not always manifest themselves and, in fact, there are times when they do so so mildly that it is confused with other health problems and even with trauma or problems of aging.
This, along with the fact that no parent expects their child to have cancer when they complain of bone pain, makes early diagnosis difficult to achieve.
Once diagnosed through MRIs, physical examination, X-rays and, if necessary, a bone tissue biopsy, treatment should begin as soon as possible. And it is that when they are diagnosed and treated quickly before they have metastasized, the most common types of bone cancer have a survival that ranges between 80% and 90%.
The problem is that many times it does not show signs of its presence until it has metastasized to other vital organs, in which case survival can be reduced to 30-50%. Therefore, it is vitally important to be aware of the symptoms.
In case it has been detected quickly, a removal surgery may be enough to treat the cancer, although there is always a risk that it will recur. For more serious cases and whenever the doctor deems it necessary, it will be necessary to go through chemotherapy or radiotherapy sessions , which, in case the tumor is localized, are usually effective.