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When cancer cuts to the bone

We visualize our bones as strong and solid. Yet they are actually organs with layers of cells and tissue that are constantly regenerating—and susceptible to a rare form of cancer.

How rare? According to the American Cancer Society, only 2,380 new cases of bone cancer will be reported this year [2008], and 1,470 patients will die from it. It’s also a highly mysterious disease, one that doctors are only beginning to understand.

Various forms

Most bone cancers afflict children and young adults. Osteosarcoma, the most common type, usually develops in males between 10 and 30 years old. Osteosarcoma tumors start on the surfaces of bones in the arms, legs and pelvis.

Another type, Ewing’s tumor, attacks the bone marrow and soft tissue inside the long leg and arm bones. It almost always strikes Caucasian children and adults under age 30.

Chondrosarcoma is cancer of the cartilage, the soft tissue at the end of bones that helps cushion joints. It develops in the limbs, pelvis and ribs, striking equally at men and women older than 20. Osteochondromas—benign bone tumors that turn cancerous—may cause some chondrosarcoma, doctors say.

Your attention, please

There are no tests to screen for bone cancer, so staying alert for symptoms is the only way to detect it early. Watch for:

  • pain in the bone that becomes constant and is worsened by activity.
  • swelling that follows the onset of pain. A lump may also appear.
  • fractures that can occur as the disease weakens the bone. Normally, a patient has long-term pain in the bone before the fracture.
  • declining health, including fatigue and weight loss.

Should you have any of these signs, see your doctor. Bone cancer can be diagnosed with X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) or radionuclide bone scans that show cancerous cells in bones throughout the body. If cancer is suspected, it’s best to have a biopsy performed by a bone cancer specialist with experience in such procedures.

Better treatment

Surgery is still the most common therapy for bone cancer. Fortunately, the days when bone cancer automatically meant amputation are past. Now seldom used, it’s been superseded by surgical methods that can replace lost bone and surrounding tissue with grafts or metal plates.

Some patients seem to have a hereditary predisposition to the disease, but so far, no risk factors have been identified. Bone cancer remains one of our least understood illnesses, and because it preys on children and young adults, it will always be one of the cruelest.