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Orthopaedic Cancers

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Orthopaedic cancers are associated with bones, and most often are metastatic cancers, meaning that the cancer spreads from other parts of the body, such as breast, colon, lung, and prostate. Sarcoma is the most common cancer type that begins in bone. Bone sarcomas are known as osteosarcomas. Other forms of malignant (cancerous) bone tumors include chondrosarcoma, Ewing tumor, malignant fibrous histiocytoma (MFH), fibrosarcoma, and chordoma.

Statistics 

  • In 2012, approximately 2,890 new cases of bone cancer will be diagnosed in the U.S.
  • Of the 2,890 new cases, approximately 1,410 deaths are expected.
  • Cancers of the bone make up less than 0.2 percent of all cancers.

Risk Factors 

There are certain factors that increase the risk of developing bone cancers. Not all factors put a person at risk for every form of bone cancer. Some of these risk factors include:

  • Previous radiation therapy treatment.
  • Previous treatment with anticancer drugs.
  • Certain conditions such as hereditary retinoblastoma, Li-Fraumeni syndrome, Bloom syndrome, and Werner syndrome.

Signs and Symptoms 

The first symptom of bone cancer is usually pain or tenderness near the cancer. Bone pain is caused by stretching of the periosteum (thick membrane that covers the bone) by the cancer, or by stimulation of nerves within the bone. Bone pain may be difficult to differentiate from regular pain or arthritis. Usually the pain is fairly constant, even at night. It can be worse in different positions, such as standing up, which may compress the cancer in a weight bearing bone. If pain lasts for more than a week or two, doesn’t seem to be going away, and is unlike other pain, it should be evaluated by a physician with experience in orthopaedic cancers.

A patient may also experience a pathological fracture as the first sign of bone cancer. A pathological fracture is a break in a bone due to problems within the bone itself rather than by external factors, such as force. Pathological fractures are caused when the cancer destroys enough bone that the skeleton can no longer support normal body functions adequately.

Prevention 

It is difficult to pinpoint how to prevent bone cancer from forming. There is no scientific evidence linking a bone break or fracture to the development of bone cancer.

Treatment Options 

Treatment options depend on the stage of the cancer, as well as whether the cancer started in the bone or spread from another area of the body. In rare cases, if a tumor developed in the bone, chemotherapy and surgery are options for removing the tumor, as well as radiation therapy before or after surgery. In the more common instance of the cancer spreading to the bone, treatment depends on where the cancer originated. “Limb salvage” surgery may be needed to reconstruct the skeleton to preserve function of the limb and control pain. Radiation therapy is also an option for targeting the affected area and relieving pain.

Sources: American Cancer Society, National Cancer Institute, U.S. National Library of Medicine