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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Bone Cancer

What is it?

Bone cancer is the growth of malignant cells that gradually replace normal bone cells, leading to weakness and pain in the affected bone. Primary bone cancer, which arises directly in the bone (usually in the leg), is relatively rare and generally strikes people under the age of 20. Much more common is metastatic or secondary bone cancer, which originates in another organ and then spreads to the bone.

Cancer may also develop in associated bone structures, including the marrow and the connective tissues. Some types of bone cancer may spread to other organs. With modern therapies, the outlook for many patients (especially those with primary bone cancer) has improved significantly.

What Causes It?

  • The cause of primary bone cancer is unknown, but hereditary factors, environmental factors, trauma, or excessive radiation therapy (to treat other types of cancer) may be involved.
  • Metastatic bone cancer most often stems from cancer of the breast, lung, prostate, thyroid, or kidney. Multiple myeloma (a cancer of the bone marrow) may also affect the bones.
  • The incidence of bone cancer is higher in patients with Paget's disease, a degenerative bone disease (see Paget's Disease for more information).

Prevention

  • Get routine screenings for breast, colon, and prostate cancer to detect cancer before it has a chance to spread.

Diagnosis

  • X-rays are taken.
  • Diagnostic imaging techniques such as CT (computed tomography) scans or MRI (magneticresonance imaging) are used to detect tumors and metastatic areas.
  • A biopsy of the affected bone may be taken to confirm the presence of cancer (especially in the case of primary tumors, since cancer has usually already been diagnosed in the case of metastatic tumors).
  • Blood tests may be performed.

How to Treat It

  • The bone or bones affected by primary tumors may need to be surgically removed. This may involve amputation, although in some cases only the tumor is removed and the remaining bone is reinforced with a metal prosthesis.
  • Chemotherapy and radiation therapy may be required.
  • Orthopedic surgery may be necessary to repair bone fractures.
  • Underlying causes of bone cancer should be treated.
  • Bisphonates may be used in metastatic bone disease to decrease pain and improve mobility and quality of life.

When to Call a Doctor

  • Call a doctor if you feel persistent pain in one or more bones, if you develop weakness or paralysis in the limbs, or if you begin to limp unexpectedly.