What is a bone tumor and what are the causes for bone tumors?
Definition – It is an uncontrolled multiplication of bone cells, which cannot be regulated by the body defense mechanism. These cancer cells are non-functional; feed on normal cell’s oxygen and nutrition. Bone tumors are very rare, accounting for 0.5% of all malignancies.
Causes for Bone tumor – Exact reason for bone cancer is not known. A lot of research is going on in this field. A very small number of bone cancers can be secondary to high dose radiation exposure and hereditary.
What are the types of bone tumors?
Types of Bone tumors
- Benign bone tumors – are non-cancerous tumors, which lacks the ability to invade the surrounding tissue and doesn’t spread to other parts of the body, however, if not treated early they can fracture the bone and compression the surrounding tissues.
- Malignant Bone tumors – Are cancerous tumors, which invades surrounds tissue and can spread to other parts of the body. If not treated early they cause a threat to life.
| Tissue of Origin | Benign | Malignant |
| Cartilage | Osteochondroma, Chondroblastoma, Chondroma, Chondromyxoid Fibroma | Chondrosarcoma |
| Osteiod | Osteoblastoma, Osteoid Osteoma, | Osteosarcoma |
| Fibroblastic | Fibroma, Desmoplastic Fibroma | Fibrosarcoma |
| Unknow | Giant Cell Tumor, Aneurysmal bone cyst | Ewings sarcoma, Synovial sarcoma, Adamatinoma, Malignant Fibrous Histiocytoma |
| Hematopoietic | Myeloma, Lymphoma | |
| Notochord | Chordoma | |
| Tumor like conditions | Simple Bone cyst |
When should I consult a Musculo-Skeletal Onco-Surgeon?
Symptoms –
- Bone Swelling
- Persistent bone pain
- Fracture following trivial trauma
- Know case of cancer ( Breast, Prostate, Lung, Thyroid …) with bone pains
What are the Investigations required before treatment?
- Plain X-ray – Helps in diagnosis and surgical planning
- MRI (Magnetic Resonance imaging) – Helps in diagnosis and surgical Planning
- Biopsy – Trucut biopsy is the most valuable tool to establish the diagnosis. In Biopsy, a small needle is introduced into the tumor through a 1-2 mm skin incision and tumor sample is sent for microscopic examination. It helps in accurate diagnosis of cancer, subtype, and grade of the tumor. It is very important to know the above details because treatment of each tumor is different.
A biopsy is done as a day care procedure under local anesthesia or rarely under general anesthesia. Usually, a biopsy procedure takes 10-15 mins.
Tumor does not spread with biopsy and biopsy is not a big surgical procedure.
Can we save limb in bone cancer?
A few decades backbone tumors were treated with amputation, today with improved imaging techniques, chemotherapy, radiotherapy, and trained surgeons, we are able to save limb in more than 90-95% of the patients.
Each bone cancer treatment is different. They require multimodality treatment like surgery, chemotherapy, and radiotherapy
Bone cancer can be completely cured in 60-80% of the patients depending upon the stage and grade of the tumor.
Is there any screening test to detect bone cancers?
No screening tests are available for bone and soft tissue cancers. Early diagnosis is critical, any bone swelling, Persistent bone pain, fractures following trivial injury are the indications of bone tumors. Biopsy to diagnose the type of tumor is strongly recommended before any surgical procedure in suspected bone cancer. It has to be done by the trained person and at the cancer center, where a patient is going to receive the complete cancer treatment.
Early detection and multimodality treatment at a specialized bone cancer center is the key to a high success rate.