Bone Cancer – Diagnosis and Treatment
Diagnosis
Scans and Imaging for Bone Tumors
Doctors use imaging tests as a first step to check for bone cancer. These tests show the bones and highlight any unusual areas.
The main types of imaging include:
| Type of Imaging | What It Shows | Common Use |
|---|---|---|
| X-Ray | Bone structure and fractures | First test for bone pain |
| MRI (Magnetic Resonance Imaging) | Detail of bone and nearby tissue | Shows tumor size and spread |
| CT (Computerized Tomography) scan | Cross-section of bone and organs | Spot size and shape changes |
| PET (Positron Emission Tomography) scan | Activity of cells | Finds cancer spread |
| Bone Scan | Areas of unusual bone activity | Finds spots cancer may have reached |
Doctors use these tests to locate the tumor, measure its size, check for fractures, and see if the cancer has spread.
Tissue Testing to Check for Cancer
Doctors use a biopsy to remove a small piece of bone or tissue to check for cancer cells under a microscope. The two main types are:
- Needle Biopsy: Doctors insert a thin needle through the skin to the affected bone and collect small tissue samples.
- Surgical Biopsy: A surgeon makes a cut to remove a larger piece of bone or tumor if more tissue is needed.
Doctors choose the biopsy type carefully to avoid making future surgery more difficult. Biopsies confirm if a tumor is cancerous, identify the type of bone cancer, and help plan treatment.
Categories and Spread of Bone Cancer
After confirming bone cancer, doctors determine how advanced it is. This process is called “staging.” The stage describes how much the cancer has grown and if it has spread.
Doctors look at several factors:
- Tumor location
- Tumor size
- Growth speed
- Number of bones involved
- Whether the cancer has spread to lymph nodes or other body parts
There are four main stages. Stage 1 means the cancer is small and slow-growing. At Stage 4, the cancer has spread to other body parts. The stage of the condition directs the treatment choices.
Doctors use imaging and biopsy results to diagnose and stage bone cancer before starting treatment.
Therapies for Managing Bone Cancer
Surgical Approaches
Surgeons often remove bone tumors and some nearby healthy tissue to ensure all malignant cells are taken out. They may use bone from another part of the body or materials like metal or plastic to repair the area.
Sometimes, surgeons need to remove an entire limb if the tumor is large or in a hard-to-reach spot. Most of the time, limb-sparing surgery is possible.
People who need an arm or leg removed can use artificial limbs to regain independence with therapy.
Key goals of surgery:
- Remove the tumor and affected tissue.
- Preserve as much healthy bone and function as possible.
- Reconstruct the bone or limb if needed.
Common surgeries:
| Type of Surgery | Used For | Notes |
|---|---|---|
| Limb-sparing surgery | Osteosarcoma, Ewing sarcoma | Most common approach |
| Amputation | Large or hard-to-reach tumors | Less common, only when needed |
| Bone grafts or implants | After tumor removal | Helps repair and strengthen |
Medicine to Target Cancer Cells
Doctors use chemotherapy to destroy cancer cells with strong medicine. These drugs are usually given through a vein, but sometimes as pills.
Chemotherapy can shrink bone tumors before surgery or destroy any remaining cancer cells after surgery. It is often used for osteosarcoma and Ewing sarcoma, but not as much for chondrosarcoma.
Chemotherapy may help treat bone metastasis in some cases.
Side effects might include:
- Hair loss
- Tiredness
- Nausea
Powerful Energy Treatments
Doctors use radiation therapy to fight bone cancer with strong energy beams like X-rays or protons. A machine directs these beams to the tumor while the patient stays still.
Radiation can target cancer cells that surgery could not remove or shrink tumors if surgery is not possible. Doctors often use radiation for Ewing sarcoma or for tumors in hard-to-reach places.
Possible short-term side effects:
- Skin changes at the treated spot
- Fatigue
Managing and Finding Help
Dealing with a bone cancer diagnosis can be difficult. Many people experience symptoms like swelling, fatigue, and fever, which can affect daily life.
Building a strong support system can improve quality of life.
Ways to Manage and Seek Support:
- Gain Knowledge: Learning about bone cancer, treatment options, and what to expect can help people feel more in control. Talking with the healthcare team or using resources from organizations like the American Cancer Society can provide guidance.
- Connect with Loved Ones: Staying close to friends and family can ease emotional stress and help with daily needs. Simple acts like having someone run errands or just spending time together can make a difference.
- Talk to Others: Speaking with a counselor or joining a cancer support group gives a chance to share feelings and experiences. This can help with feelings of uncertainty or sadness.
| Common Challenges | Ways Support Can Help |
|---|---|
| Swelling | Physical comfort, advice |
| Fatigue | Rest breaks, daily assistance |
| Fever | Medical guidance, monitoring |
Taking small steps to cope and seek help can reduce stress and make daily life easier.
Getting Ready for Your Visit
Tips for Getting Set Before Your Appointment
Appointments with a healthcare professional can feel stressful. Being prepared can help you get the most out of your time.
Here are some steps to make your visit smoother:
- Check for Pre-Visit Rules: Call ahead to ask about any restrictions, such as eating, drinking, or taking medicine before the appointment.
- Write Down Your Symptoms: List all symptoms, even those that don’t seem related to bone cancer.
- Note Your Health History: Include recent illnesses, surgeries, or major life changes.
- List Your Medications: Write down all prescriptions, over-the-counter drugs, vitamins, and supplements you use.
- Bring a Support Person: Having a family member or friend can help you remember details and offer support.
- Gather Medical Records: Bring copies of recent scans, X-rays, test results, and any written reports about your condition.
These steps can help you feel more organized and less rushed during your appointment.
Key Things to Ask During the Visit
Having questions ready for your healthcare provider is important. Write your questions before the visit and place the most urgent ones at the top.
Common questions to ask include:
| Possible Questions to Ask |
|---|
| What kind of bone cancer do I have? |
| What stage is my cancer, and is it growing quickly? |
| Will more tests be needed? |
| What are my treatment choices? |
| What are the chances that these treatments will work? |
| What side effects or risks should I be aware of? |
| Will treatment affect my ability to have children? |
| How will these treatments interact with my other health conditions? |
| Is there a treatment you strongly recommend? Why? |
| Would you recommend this treatment to a family member in my position? |
| Should I see a specialist, and will insurance cover the cost? |
| Can you suggest where to get a second opinion? |
Bringing these questions in writing helps you cover what matters most. Add more questions as you think of them.
What Your Healthcare Provider Might Ask You
The doctor or specialist usually asks questions to learn more about your situation.
If you prepare for these questions, your visit may go faster, and you can give clearer answers.
Expect questions like:
When did your symptoms begin?
Are your symptoms steady or do they come and go?
How would you describe the level of pain or discomfort?
Does anything you do lessen your symptoms?
Is there anything that makes the symptoms worse?
When you answer honestly and simply, the care team can figure out the next steps. They may also talk with you about which specialists might join your care, such as orthopedic oncologists, medical oncologists, or rehabilitation experts.
