Bone tumors develop when cells in the bone divide without control, forming a mass of tissue. Most bone tumors are benign, which means they are not cancer and cannot spread. However, they may still weaken bone and lead to fractures or cause other problems. Bone cancer destroys normal bone tissue and may spread to other parts of the body (called metastasis).
Benign Bone Tumors
Benign tumors are more common than malignant tumors of the bones. These are a few common types of benign bone tumors:
- Osteochondroma is the most common benign bone tumor. It is more common in people under age 20.
- Giant cell tumor is a benign tumor, typically affecting the leg (malignant types of this tumor are uncommon).
- Osteoid osteoma is a bone tumor, often occurring in long bones, that occurs commonly in the early 20s.
- Osteoblastoma is a single tumor that occurs in the spine and long bones, mostly in young adults.
- Enchondroma usually appears in bones of the hand and feet. It often has no symptoms. It is the most common type of hand tumor.
When people have cancer in bones, often it is cancer that has spread there from elsewhere in the body. This is metastatic cancer. Even though it spreads to bone, it is not considered bone cancer because the tumor cells are from the primary cancer. For example, a person with lung cancer that has spread to the bone is considered to have lung cancer with metastasis to the bone -- not lung cancer and bone cancer.
Cancers that commonly spread to bone include:
Primary Bone Sarcoma
Primary bone sarcoma is a tumor that forms first in bone. It is less common than metastatic cancer. The cause of bone sarcoma is not certain, but heredity may play a role. High-dose radiation therapy or cancer drugs may increase the risk of this type of cancer. These are some of the most common types of bone cancer:
- Osteosarcoma begins in bone cells and is most common around the knee and upper arm. Most of the time, it is found in teens and young adults. There is an adult form of this tumor that is usually seen in persons with pre-existing Paget’s disease of bone.
- Ewing's sarcoma also is seen in younger people between the ages of 5 and 20. The ribs, pelvis, leg, and upper arm are the most common sites. It usually shows up in bone, but it can also start in soft tissue around bones.
- Chondrosarcoma occurs most often in people between 40 and 70. The hip, pelvis, leg, arm, and shoulder are common sites of this cancer, which begins in cartilage cells.
Although almost always found in bone, multiple myeloma is not a primary bone cancer. It is a bone marrow cancer. Bone marrow is the soft tissue inside bones.
Symptoms of Bone Tumors
You may have no symptoms of a bone tumor. This is common. Your doctor may find a tumor when looking at an X-ray of another problem, such as a sprain. But symptoms of a bone tumor may include pain that:
- Is in the area of the tumor
- Is often felt as dull or achy
- May get worse with activity
- Often awakens people at night
Trauma does not cause a bone tumor, but a bone that is weakened by a tumor may be more easily broken. This may then cause severe pain.
Other symptoms related to bone tumors may include:
If you think you might have a bone tumor, see your doctor right way. Your doctor will ask you questions about your symptoms and medical history and conduct a physical exam. You may need blood and imaging tests. To confirm a diagnosis, your doctor may remove tissue through a needle or incision and have it examined under a microscope for signs of cancer. This is called a biopsy.
Treatment of Bone Tumors
Cancerous bone tumors require more aggressive treatment to enhance survival.
Benign tumors are watched or may be treated with medication. Your doctor may remove benign tumors that are more likely to spread or become cancer. In some cases, tumors come back, even after treatment.
Malignant tumors may require the attention of several cancer specialists. Treatment depends on the stage of cancer -- how far it has spread. Cancer cells confined to the bone tumor and surrounding area are at a localized stage. Bone cancers that spread to other areas of the body are at a metastatic stage. These are more serious and a cure is more difficult. Cancers of the bone are most often removed with surgery.
These are common types of treatment for bone cancer:
- Limb salvage surgery removes the part of the bone with cancer. Nearby muscles, tendons, and other tissues are not removed. A metallic implant (prosthesis) replaces the portion of bone that was removed.
- Amputation may be needed if a tumor is large or extends to nerves and blood vessels. A prosthetic limb can aid function after amputation.
- Radiation therapy kills cancer cells and shrinks tumors with high-dose X-rays. It is often used in combination with surgery and may be used before or after surgery.
- Systemic chemotherapy kills tumor cells that have spread through the bloodstream with cancer drugs. Chemotherapy may be given before surgery, after surgery, or for metastatic disease.
Your doctor may recommend that you participate in a clinical trial, which tests new therapies. Regardless of your type of treatment, you will need regular follow-up with your doctor.