OSTEOSARCOMA Definition

Bone cancer is an uncommon cancer that begins in a bone. Bone cancer can begin in any bone in the body, but it most commonly affects the long bones that make up the arms and legs. Several types of bone cancer exist. Some types of bone cancer occur primarily in children, while others affect mostly adults. The term "bone cancer" doesn't include cancers that begin elsewhere in the body and spread (metastasize) to the bone. Instead, those cancers are named for where they began, such as breast cancer that has metastasized to the bone. Bone cancer also doesn't include blood cell cancers, such as multiple myeloma and leukemia, that begin in the bone marrow — the jelly-like material inside the bone where blood cells are made.

Symptoms
Signs and symptoms of bone cancer include:

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Bone pain Swelling and tenderness near the affected area Weakened bones, sometimes leading to fractures Fatigue Unintended weight loss

When to see a doctor Make an appointment with your doctor if you or your child develops signs and symptoms that worry you.

Causes
It's not clear what causes most bone cancers. Doctors know bone cancer begins as an error in a cell's DNA. The error tells the cell to grow and divide in an uncontrolled way. These cells go on living, rather than dying at a set time. The accumulating mutated cells form a mass (tumor) that can invade nearby structures or spread to other areas of the body.

Osteosarcoma occurs most often in children and young adults. Your doctor may recommend one or more imaging tests to evaluate the area of concern. It's not clear where in bone Ewing's sarcoma begins. This precancerous condition that affects older adults increases the risk of bone cancer. Bone cancer types include:    Osteosarcoma. Ewing's sarcoma. such as those given during radiation therapy for cancer. It's not known what causes bone cancer. increases the risk of bone cancer in the future. Chondrosarcoma begins in cartilage cells that are commonly found on the ends of bones. Radiation therapy for cancer. including:      Bone scan Computerized tomography (CT) Magnetic resonance imaging (MRI) Positron emission tomography (PET) X-ray Removing a sample of tissue for laboratory testing Your doctor may recommend a procedure to remove (biopsy) a sample of tissue from the tumor for laboratory testing. hereditary retinoblastoma and multiple exostoses.   Tests and diagnosis Imaging tests What imaging tests you undergo depends on your situation. Chondrosarcoma. what type of . Paget's disease of bone. Exposure to large doses of radiation. if so. Scientists believe Ewing's sarcoma may begin in nerve tissue within the bone. Ewing's sarcoma occurs most often in children and young adults. Rothmund-Thomson syndrome. but factors that increase the risk of bone cancer include:  Inherited genetic syndromes. Osteosarcoma begins in the bone cells. Risk factors Most bone cancers occur in people who have identifiable risk factors. including Li-Fraumeni syndrome. Certain rare genetic syndromes passed through families increase the risk of bone cancer. Chondrosarcoma most commonly affects older adults. Testing can tell your doctor whether the tissue is cancerous and.Types of bone cancer Bone cancers are broken down into separate types based on the type of cell where the cancer began.

After biopsy testing. Doctors need to perform the biopsy in a way that won't interfere with future surgery to remove bone cancer. Tests to determine the extent (stage) of the bone cancer Once your doctor diagnoses your bone cancer. At this stage. At this stage. doctors remove the tumor and a small portion of healthy tissue that surrounds it. Stage II. chemotherapy. The cancer's stage guides your treatment options. radiation or a combination of treatments. which helps doctors understand how aggressive the cancer may be. Types of biopsy procedures used to diagnose bone cancer include:  Inserting a needle through your skin and into a tumor. liver or lungs. Stages of bone cancer include:  Stage I. he or she works to determine the extent (stage) of your cancer. your doctor makes an incision through your skin and removes either the entire tumor (excisional biopsy) or a portion of the tumor (incisional biopsy). Surgery to remove a tissue sample for testing.During a needle biopsy. ask your doctor for a referral to an appropriate surgeon before your biopsy. The needle is used to remove small pieces of tissue from the tumor. your overall health and your preferences. But biopsy testing reveals the bone cancer is high grade and is considered aggressive. bone cancer is limited to the bone and hasn't spread to other areas of the body. During a surgical biopsy. cancer at this stage is considered low grade and is not considered aggressive. Surgery The goal of surgery is to remove the entire bone cancer. Bone cancer treatment typically involves surgery. bone cancer occurs in two or more places on the same bone. For this reason. This stage of bone cancer indicates that cancer has spread beyond the bone to other areas of the body. Types of surgery used to treat bone cancer include: . This stage of bone cancer is limited to the bone and hasn't spread to other areas of the body. your doctor inserts a thin needle through your skin and guides it into the tumor. To accomplish this. Stage IV.    Treatments and drugs The treatment options for your bone cancer are based on the type of cancer you have. Testing may also reveal the cancer's grade. the stage of the cancer.cancer you have. Stage III.  Determining the type of biopsy you need and the particulars of how it should be performed requires careful planning by your medical team. such as the brain.

If a bone cancer can be separated from nerves and other tissue. such as pain. radiation therapy may be combined with chemotherapy. this procedure is becoming less common. . the surgeon replaces the lost bone with some bone from another area of your body or with a special metal prosthesis. but spare the limb. For people with advanced bone cancer. Chemotherapy may also be used in people with bone cancer that has spread beyond the bone to other areas of the body. Surgery to remove a limb. As other treatments have been developed. If bone cancer occurs in bones other than those of the arms and legs. Radiation therapy may also be used in people with bone cancer that can't be removed with surgery. radiation therapy may help control signs and symptoms. Surgery to remove the cancer. such as in cancer that affects the spine. Surgery for cancer that doesn't affect the limbs. Chemotherapy is often used before surgery. Intense rehabilitative therapy may be necessary after limb-sparing surgery in order for the affected arm or leg to become fully functional. During radiation therapy. such as in cancer that affects a rib. to kill cancer cells. Since some of the bone is removed with the cancer.   Radiation therapy Radiation therapy uses high-powered beams of energy. surgeons may remove the bone and some surrounding tissue. Bone cancers that are large or located in a complicated point on the bone may require surgery to remove all or part of a limb (amputation). In this situation. such as X-rays. Chemotherapy is most often given through a vein (intravenously). Radiation therapy may also be used after surgery to kill any cancer cells that may be left behind. Chemotherapy Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. usually in combination with radiation therapy. Radiation therapy may be used to shrink a bone cancer to increase the likelihood that a surgeon can remove the entire cancer with surgery. Bone removed during surgery can be replaced with a piece of bone from another area of the body or with a special metal prosthesis. The chemotherapy medications travel throughout your body. to shrink a bone cancer to a more manageable size that allows the surgeon to use a limb-sparing surgery. or may remove the cancer while preserving as much of the bone as possible. you lie on a table while a special machine moves around you and aims the energy beams at precise points on your body. the surgeon may be able to remove the bone cancer and spare the limb. You'll likely be fitted with an artificial limb after surgery and will go through training to learn to do everyday tasks using your new limb.

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