Bone cancer : Causes, Symptoms, and Treatment

Bone cancer is a type of cancer that attacks the bones. This disease can be suffered by children to adults.
Bone cancer is divided into two, namely primary and secondary bone cancer. Named primary bone cancer when the cancer appears and develops directly in the bone. Whereas secondary bone cancer is a cancer that originates from other parts of the body that spread to the bones.
All bones in the body can be attacked by this disease, but most occur in the bones of the legs and arms.

The following are the three main signs and symptoms of bone cancer, namely:

Pain. Someone who has bone cancer will feel pain in the area of the bone that is attacked, and pain will increase when moving. Pain will usually be felt continuously until night.
Swelling. The area around the bone affected by cancer will experience swelling and redness. If the swelling occurs in the bones that are close to the joints, the movement will be difficult and limited.
Brittle bones Bone cancer causes bones to become weak or brittle. Even if it is severe, a slight fall or a small injury can make the bone break.

In addition, there are also several other symptoms, such as numbness and numbness when cancer in the spine suppresses innervation, a lump in the bone appears, the body feels tired, weight loss, fever above 38 ° C, and sweating especially at night .

Also Read : Throat cancer : Causes, Symptoms, and Treatments

In adults, symptoms of bone pain are sometimes misinterpreted as arthritis . In children and adolescents, it is sometimes misinterpreted as a side effect of bone growth. We recommend that you see a doctor if you or your child constantly feels pain in the bones or the pain gradually worsens.

Causes of bone cancer

The exact cause of bone cancer is unknown, but this condition is thought to be caused by changes or mutations in the DNA structure controlling cell growth so that it continues to grow out of control. The buildup of these cells then forms tumors that can attack nearby bone structures or even spread to other parts of the body.
Here are some factors that are thought to increase a person's risk of bone cancer.

Exposure to high radiation from a treatment that has been experienced by patients, for example radiotherapy.
Have had a history of a type of eye cancer called retinoblastoma as a child.
Suffering from Li-Fraumeni syndrome, a rare genetic condition.
Suffering from Paget's disease, which is a condition that can cause bone weakness.
Suffering from umbilithic hernia from birth.

Types of bone cancer

Based on where cancer cells begin, bone cancer is divided into:

Osteosarcoma. This bone cancer develops at the end of a long bone in the bone that is actively growing. This type usually attacks the shin, thighs, and arms. Osteosarcoma can be found by anyone, but the most common are young men and young people who are just growing up, which is the range of 10-19 years.
Chondrosarcoma. This bone cancer develops in cartilage cells which usually attacks the femur, pelvis, ribs, shoulder blades, or upper arm bones. Chondrosarcoma is commonly suffered by people over the age of 40.
Ewing's Sarcoma . This bone cancer develops in immature nerve tissue in the bone marrow. This type usually attacks the femur, shin, and pelvic bones. Ewing's sarcoma is more common among adolescent boys than adults, namely at the age of 4-15 years.
Giant Cell Tumors in Bones. Although most of these tumors are benign, some of them can be malignant and generally attack the bones in the legs (near the knees). These tumors rarely metastasize to other distant parts of the body, but often reappear even after surgery.
Chordoma. This bone cancer often appears at the base of the skull or in the spine. Usually attacks people over the age of 30 years, and men are twice as susceptible to attack than women.

Stages of development of bone cancer

There are four stages that determine the severity of a bone cancer, including:

Stage 1. At this stage, the new cancer affects one part of the bone and has not spread to other parts. Stage 1 is divided into two:

Stage 1A: tumor measuring ≤ 8 cm
Stage 1B: tumor measuring> 8 cm, or if there are more than one tumor in the same bone.

Stage 2. Almost the same as stage 1, but at this stage, the cancer is still in one part of the bone and has not spread. At this stage too, cancer aggressiveness has begun to appear. Stage 2 is divided into two:

Stage 2A: tumor measuring ≤ 8 cm
Stage 2B: tumor measuring> 8 cm.

Stage 3. At this stage the cancer has begun to spread to more than one area of the same bone.
Stage 4. At this stage, cancer that gnaws at the bone has spread to other parts of the body, such as the lungs, liver, or brain. Stage 4 is also divided into two:

Stage 4A: The tumor has spread to the lungs
Stage 4B: The tumor has spread to the lymph nodes around and or spread to other organs other than the lungs.

Determination of the severity of bone cancer can be done through a diagnosis enforcement process. This is useful in helping doctors to provide appropriate treatment.

Diagnosis of bone cancer

To find out if a patient has bone cancer, in addition to asking about the symptoms that are felt, the doctor needs to do several tests. These types of tests include:

Biopsy. In addition to detecting the type of bone cancer suffered, this test can also determine the severity and spread of the disease if present. Biopsy is carried out by taking a small sample of bone to be examined in a laboratory. This test is considered the most accurate way to diagnose bone cancer.
X-ray. Through this test can be known whether bone damage experienced by patients is caused by cancer or other conditions (such as fractures). In addition to bone damage, abnormal bone growth due to cancer can also be detected via X-ray .
Bone scan. This test is done by injecting a number of radioactive substances into the veins. The material will later be absorbed by the bone. Usually a problematic or abnormal bone will more quickly absorb radioactive substances than normal bones. Information about bone problems obtained through bone scanning is usually more detailed than those obtained through X-rays.
MRI scan. Through this method, the severity of the spread of cancer in the bone can be known. With the help of radio waves and magnetic fields, MRI scans can produce images of bones and soft tissue in more detail.
CT scan . This examination is done to find out whether bone cancer has spread, for example to the lungs. Scans that use X-ray circuits and computer aids can produce detailed body parts in three dimensions.

Treatment of bone cancer

Treatment options for bone cancer depend on the severity of the cancer, the location of the cancer, and even the type of cancer itself. The main treatment for bone cancer is usually done through surgery combined with other treatments, such as chemotherapy and radiotherapy.
Several types of surgery can be done to treat bone cancer, including:

Bone removal surgery. This procedure is usually done if the cancer has not spread out of the bone. Parts of bones or joints that are infected with cancer can generally be reconstructed or replaced with artificial bones or joints, although not infrequently amputation steps must be carried out. This surgical removal can also be applied if a new cancer spreads to the tissues around the bone, for example in the knee joint.
Amputation. Amputation is usually done if the cancer is not successfully treated with bone removal surgery or if bone cancer has spread, for example to the nerves, blood vessels, and skin. Amputation may also be needed if there is a postoperative infection of bone removal. Patients who have to go through an amputation procedure will use artificial limbs to replace the raised leg. Patients will go through the rehabilitation stage to restore the function of organs to the limbs that are lifted through various types of therapy, one of which is physiotherapy.

Chemotherapy

Chemotherapy is a cancer treatment method that involves administering a number of drugs. In bone cancer, these drugs are infused into the blood vessels through an IV.
In the case of bone cancer, chemotherapy is usually done before surgery with the aim of shrinking the cancer so as not to need amputation. Generally, this procedure is performed after surgery so that the cancer does not reappear. In addition, chemotherapy can also be combined with radiotherapy to be given to Ewing sarcoma patients before undergoing surgery. This method is called chemo radiation . If patients with bone cancer cannot be treated again in any way, chemotherapy is usually given with the aim of slowing down the symptoms.

The time for chemotherapy is usually divided into several cycles, each of which consists of several days. The number of cycles needed by patients with bone cancer varies depending on the type and severity of the disease they have. Each cycle of chemotherapy is usually separated by a delay of several weeks. The purpose of giving this time lag is so that patients can recover from the effects of chemotherapy.

Some of the side effects of chemotherapy are hair loss, fatigue, mouth sores, diarrhea, nausea and vomiting, and weakening of the immune system. Usually these side effects will disappear after chemotherapy treatment ends. Another side effect that needs to be considered is the effect of chemotherapy on the level of fertility of the patient.

Mifamurtide

Mifamurtide is an immune system stimulating drug, especially white cells called macrophages which are responsible for killing cancer cells. This drug is given by injection into a vein for a treatment period of 12-24 weeks, depending on the patient's condition.

The use of mifamurtide in female patients who are pregnant and breastfeeding should be monitored by a doctor. Sexually active patients should be accompanied by the use of contraceptives, discuss each method of treatment with a doctor before deciding to do so.

Mifamurtide is an osteosarcoma type of bone cancer treatment method that can be combined with the treatments mentioned here, namely chemotherapy. In addition to patients with bone cancer who have high osteosarcoma, mifamurtide is usually given after surgery.
Some side effects of mifamurtide are dizziness, nausea, nausea, diarrhea, loss of appetite, and feeling tired.

Radiotherapy

The radiotherapy method is carried out using radiation to destroy cancer cells. In the case of bone cancer, radiotherapy can be used before or after surgery. This method can also be done to slow down the symptoms of bone cancer in patients who can no longer be treated in any way. Radiotherapy is usually done in five sessions a week. Each session usually takes several minutes.

Just like chemotherapy, radiotherapy also has side effects. Some of them are fatigue, hair loss, joint pain , nausea, irritation and redness of the skin. Generally these side effects will disappear after radiotherapy treatment ends.

Recovery opportunities for bone cancer sufferers

Bone cancer that has not spread to other organs or is still localized, is easier to handle than bone cancer that has spread or metastasizes. This factor will later affect the chance of the patient to recover.
According to research in the UK, someone diagnosed with localized osteosarcoma is estimated to still have a life chance of 60 percent for at least the next 5 years, compared to those diagnosed with metastatic osteosarcoma who only have a 25 percent chance.

While for cases of Ewing's sarcoma bone cancer that have been diagnosed, patients with their localized conditions are estimated to still have a life chance of 70 percent for at least the next five years compared with patients with metastatic conditions who only have a 30 percent chance. As with localized osteosarcoma , most people with localized Ewing's sarcoma also recover from their illness.

In addition to the rate of spread, how severe cell tissue affected by cancer can also have an impact on the chance of the patient to recover. According to the study, the ratio of the chance of survival of patients with low-grade chondrosarcoma bone cancer with high-stage sufferers for at least the next 5 years is 80 percent versus 30 percent.