Bone Tumor: Types, Symptoms, Treatment, Survival Period

Bone tumors are not a rare disease and can be seen to occur in people of almost all ages. Some bone tumors are harmful and some are not. It depends on the type of the tumor to understand its threats and determine its treatment possibilities. In the year 2011, the Cancer Statistics Review of the National Cancer Institute, came up with an estimation that 1,620 men and 1,190 women would be diagnosed with bone tumor (malignant type) and as per the reports of Surveillance, Epidemiology and End Results (SEER), 1,490 men and women amongst them would die of this disease alone in the United States of America. However, malignant type of bone tumor can well be managed and treated if diagnosed on time.

Abnormal and uncontrollable neoplastic growth of the bones that can form a mass or lump of tissue is known as bone tumor.¹

Bone Tumor can develop as a result of some injury, exposure to radiation or because of some genetic defects that will pass on this disease to you.

The tumors that are formed in the bones can be of two types: –

1. Benign Bone Tumor or Non-Cancerous Bone Tumor: Benign bone tumor does not spread in the other bone tissues, they can still be harmful as they compress the healthy bone tissue and hence, require treatment, yet benign bone tumors are unlikely to cause death.²
2. Malignant Bone Tumor or Cancerous Bone Tumor: Malignant bone tumor or cancerous bone tumors can spread to other parts of the bones and cause death.

• Osteochondromas: As per the reports of American Academy of Orthopaedic Surgeon, Osteochondroma is the most common type of benign bone tumor, occurring in 35 to 40% people with benign bone tumors. It mostly develops in adolescents and teenagers and mostly occurs in the arm or leg bones.
• Enchondroma: This occurs inside the bone marrow and is a cartilage cyst and can be seen in arm, thigh, feet and hands. Usually this kind of benign bone tumor is a syndrome that occurs in Ollier’s and Mafucci’s syndrome.³
• Non-Ossifying Fibroma Unicameral: Occurring mostly in children and adolescents, it is a single and simple bone cyst that is mostly found in the legs.
• Fibrous Dysplasia: Caused by gene mutation, this type of benign bone tumor makes the bones vulnerable to fracture and fibrous.
• Giant Cell Tumors: A rare phenomenon occurring at the rounded end of the bones and not in the flat growth plate surfaces, this type of benign bone tumors can grow rapidly and aggressively.
• Aneurysmal Bone Cyst: This type of benign bone tumor can be destructive as it affects the growth plates, though it starts from the bone marrow and is an abnormality of blood vessels. This type of benign bone cyst or tumor occurs mostly in teenagers, who are below the age of 20 and are found to occur along with other benign bone lesions.
• Osteoid Osteoma: It is a small tumor that usually occurs in the tibia and femur, but is likely to be found anywhere else in the entire body bone structure. However, it is mostly common in teenagers within the age group of 10 to 20 years, and is rare in people above the age of 30.
• Osteoblastoma: Commonly found in the spine and long bones, it behaves aggressively and can occur in people of any age. Although rare, due to its aggressive nature, it is often confused with malignant bone tumors.
• Chondroblastoma: Found mostly in the femur, proximal humerus and proximal tibia of men during their adolescent period. Chondroblastoma is a very rare benign bone tumor.
• Unicameral Bone Cysts: It is a type of benign bone tumor caused by circulation problems of the veins and an abnormality of the growth plate, it occurs in children, mostly in the proximal femur and humerus.
• Eosinophilic Granuloma or Histiocytosis of Bone: It is a condition that occurs mostly in children and young adults and involves two or three bony sites in the patients.

Malignant bone tumors are also of various types and the two broad divisions involve the primary bone cancer and secondary bone cancer. When the bone tumor itself is cancerous, it is called the primary bone tumor and when some other kind of cancer spreads into the bones, causing the development of cancerous tumors, it is called the secondary or metastatic bone cancer. The common primary malignant bone tumor types are:

• Osteosarcoma or Osteogenic Sarcoma: It is a rapid growing bone tumor mostly occurring in children and adolescents around their hips, shoulders or knees. The areas in which the bone grows rapidly are the areas in which this type of bone tumor occurs.
• Ewing Sarcoma Family of Tumors (ESFTs): This is a type of malignant bone tumor occurring mostly in long bones like legs, backbone, pelvis, upper arms, ribs and skull, it is found in children and young adults. However, children as young as 5 years old are also found to have been suffering from this type of cancer.
• Chondrosarcoma: This type of bone tumor or cancer usually occurs in the hips, shoulders, and pelvis of the middle aged people or seniors.

The more common type of bone cancer is the secondary bone cancer in which the cancer spreads from other cancerous cells like – kidney, breast, lung, prostate or thyroid gland than the primary bone cancer.

Symptoms are not common in bone tumors. Usually a doctor finds a bone tumor while diagnosing the X-ray report for some other disease or health problem. However, in many cases there can be a few symptoms such as –

• Symptoms of pain in the area in which the bone tumor has developed
• Sometimes the pain can be consistent and severe, strong enough to wake you up at night
• As bone tumors can significantly weaken the bone, insignificant injuries might break the bone
• A feeling of dullness and aching can be persistent in people suffering from bone tumor
• Night sweats
• Fever
• Tenderness and swelling in joints are also a common symptom of bone tumor.

Unless you have symptoms of bone tumor, you cannot really understand the presence of the bone tumor. However, as you visit the doctor for some other diseases and undergo tests and diagnosis it can also denote the presence of tumor on the bone. But, when you feel swelling, pain, infections and fracture in the bone, the doctor will recommend quite some tests that might include –

• X ray – To check the position and size of the tumor
• CT scan – To take images of the tumor from different angles
• Positron emission tomography or PET scan – A little amount of radioactive sugar is inserted in the vein to determine the position of the tumor. It is helpful as tumors use more glucose than regular and normal cells.
• Biopsy – As the presence of the tumor is assured and its exact position is determined, a small needle is inserted into the tumor to collect a sample of the tissue and it is tested to check if it has malignancy or not.

Depending on the type, size and malignancy or benignity of the bone tumor, the treatment regime is determined.

Treatment for Benign Bone Tumor: Most benign tumors of the bone disappear on their own; without the need for any treatment. In other cases, when the benign bone tumors stay for long, medications are given to reduce them or surgeries are done if they interfere in the normal functioning of the bone.

Treatment for Malignant Bone Tumor: For cancerous bone tumors or malignant bone tumor, the treatment procedures that are followed include –

• Limb Salvage Surgery in which the tissues nearby the area of the bone tumor are removed to prevent the cancer from spreading. Metallic implants are used to replace the removed bone parts. Although the cancer affected limbs are treated by removing the bone tumor, in this process the muscles, tendons, nerves and blood vessels are spared.
• Radiation Therapy is given to kill the cancer cells and also to shrink the tumor. This application of high dose of X-rays is given along with surgeries in which the tumors are removed.
• In case of metastatic cancer that spreads to the bones, chemotherapy drugs are used to kill the cancerous cells in the blood stream and in the bones, in order to stop them from spreading further.
• If the tumor and the cancerous cells spread to the blood vessels and nerves, amputation technique is followed to treat it and in that case, a prosthetic limb is replaced at the site by surgeries by the doctors.
• Sometimes, when general surgeries are ineffective to treat malignant bone tumor, a cryosurgery is done. In this surgery, the doctor inserts a hollow tube to pump liquid nitrogen or argon gas into the tumor. This prevents the cancer from spreading.

With proper treatments, the 5 year survival rate for all types of bone cancer is 70 to 80%. By using the term 5 year survival rate, the doctors denote the number of patients, who have survived at least 5 years after the diagnosis of bone cancer. However, many have survived for many more years and some have been cured forever. Hence early the detection, the better it is for the successful recovery from benign bone tumor or malignant bone tumor.

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