Bone Cancer

Bone Cancer

What is bone cancer?
Bone cancer happens when normal cells in the bone change into abnormal cells and grow out of control. This article discusses cancer that starts in the bone. Cancer can also spread to the bones from other parts of the body.
There are different types of bone cancer, depending on the cells involved. The most common type is osteosarcoma. Other common types of bone cancer are chondrosarcoma and Ewing sarcoma.

What are the symptoms of bone cancer?

Bone cancer usually causes pain and swelling in the area of the cancer. The pain can come and go, but it usually gets worse over weeks to months. The pain is sometimes worse at night and with exercise. Some people with bone cancer might also see or feel a lump on their bone or in the tissues around the bone.
All of these symptoms can also be caused by conditions that are not bone cancer. But if you have these symptoms, tell your doctor or nurse.

Is there a test for bone cancer?

Yes. Your doctor or nurse will first order an X-ray of your bone.
If the X-ray shows that you likely have bone cancer, you will have other tests. These will probably include:

  • Blood tests
  • An imaging test, such as an MRI or CT scan, of the area with the cancer – An imaging test creates pictures of the inside of the body.
  • A full-body bone scan or other imaging test, to check for bone cancer in other parts of your body
  • A biopsy – This is a procedure in which a doctor removes a sample of the cancer. Then another doctor looks at the sample under a microscope.

How is bone cancer treated?

Depending on the type of bone cancer, treatment includes 1 or more of the following:

  • Surgery – In general, surgery is the main treatment for bone cancer. The type of surgery you have depends on which part your cancer is and how big it is. In most cases, surgeons do “limb-sparing” surgery. This is when the surgeon removes the cancer without removing the arm or leg where the cancer is growing. Depending on the type of surgery, the doctor might need to “rebuild” part of a bone after surgery.
    Sometimes, when bone cancer is growing in an arm or leg, surgery involves amputation. This is when the surgeon removes the arm or leg along with the cancer. After an amputation, some people use a prosthesis, which is a man-made arm or leg.
  • Chemotherapy – Chemotherapy is the term doctors use to describe a group of medicines that kill cancer cells. Most people with bone cancer have chemotherapy before and after their surgery.
  • Radiation therapy – Radiation kills cancer cells. Doctors might use radiation when people can’t have surgery or when all of the cancer can’t be removed safely with surgery.

What happens if my bone cancer comes back or spreads?

If your bone cancer comes back or spreads, you might have more surgery, radiation, or chemotherapy.

What is multiple myeloma?

Multiple myeloma is a cancer of one type of white blood cell. White blood cells fight infections in the body. They are made in the bone marrow, which is the middle part of bones. When people have multiple myeloma, the bone marrow makes too many of these white blood cells and not enough of the normal blood cells a person’s body needs. This can cause symptoms.

What are the symptoms of multiple myeloma?

Multiple myeloma can cause many different symptoms. These include:

  • Bone pain or bones that break easily
  • Nausea, vomiting, confusion, or feeling more thirsty than usual
  • Feeling more weak, tired, or short of breath than usual
  • Blurry vision
  • Numbness, tingling, or weakness in the chest, lower back, or legs
  • Getting sick more easily
  • Losing weight without trying to

All of these symptoms can also be caused by conditions that are not multiple myeloma. But if you have these symptoms, let your doctor or nurse know.

  • Severe back pain
  • Weakness, numbness, or tingling in the legs
  • No control over your bladder or bowel (that is a new problem)

Is there a test for multiple myeloma?

Yes. Your doctor/nurse will do examine you and conduct certain tests. Tests can include:

  • Blood or urine tests
  • Bone marrow biopsy – A doctor will take a very small sample of the bone marrow. Another doctor will look at the sample under a microscope to see if cancer cells are present
  • X-ray or other imaging tests – Imaging tests create pictures of the inside of the body

How is multiple myeloma treated?

People with multiple myeloma often have one or more of the following treatments:

  • “Watch and wait” – Some people have a condition called “smoldering myeloma” before they get multiple myeloma. These people do not have any symptoms and might not receive treatment right away. But their doctor does follow them. When they start to have symptoms, they will have active treatment
  • Chemotherapy – Chemotherapy is the term doctors use to describe a group of medicines that kill cancer cells
  • Steroid medicines – These medicines can kill cancer cells and slow cancer growth. (These steroids are not the same steroids that athletes take to build muscle.)
  • Medicines called “immune modulating medicines” – These medicines stop the cancer from growing.
  • Bone marrow transplant – The bone marrow makes blood cells, including white blood cells. During a bone marrow transplant, a doctor removes some bone marrow from the body. Then, the person gets medicines called “chemotherapy.” These medicines are usually used to kill cancer cells, but they also kill bone marrow cells. After chemotherapy, the doctor puts the bone marrow back into the person’s body

People with multiple myeloma also have treatment for any symptoms they have. For example, doctors might treat bone symptoms with pain medicines, medicines to stop bone loss, or radiation therapy. Radiation can kill cancer cells

What happens after treatment?

After treatment, you will be checked every so often to see if the cancer comes back. Treatment does not usually cure the disease, but it can reduce symptoms and help people live longer. Follow-up tests can include blood tests, urine tests, imaging tests, or bone marrow biopsy.

What happens if the multiple myeloma comes back?

If the multiple myeloma comes back, you might get more chemotherapy, immune modulating medicines, steroid medicines, or bone marrow transplant.

What else should I do?

It is important to follow all your doctors’ instructions about visits and tests. It’s also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for multiple myeloma involves making many choices, such as what treatment to have and when. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

  • What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
  • What are the downsides to this treatment?
  • Are there other options besides this treatment?
  • What happens if I do not have this treatment?