05 Mar, 2025
05 Mar, 2025
This article is medically reviewed by Dr. Sunit Lokwani, Consultant - Medical Oncology and Clinical Hematology, HCG Cancer Centre, Indore.
Bone cancer is cancer that forms in cells of the bone. Bone cancer is rare and includes several types. Some bone cancers, including osteosarcoma and Ewing sarcoma, are seen most often in children and young adults. Primarily, bone cancer is of two types: primary bone cancer and secondary bone cancer.
There are mainly two types of bone cancer: primary and secondary bone cancer.
1. Primary Bone Cancer:Primary bone cancer starts in the bones when the bone cells undergo harmful mutations and begin dividing uncontrollably to form a tumor. Some common types of primary bone cancer are:
2. Secondary Bone Cancer:Secondary bone cancer occurs when cancer from different organs spreads to
bones.
It is also referred to as bone metastasis.
The cancer cells from the primary tumor break away, travel
through
the bloodstream or lymph vessels, and accumulate in the bones to develop a new tumor.
Pain is the most common bone cancer symptom, but not all bone cancer causes pain. Swelling in or near a bone can also be a bone cancer symptom.
Other bone cancer symptoms include:
While we do not know the exact cause of bone cancer, we do know that certain factors increase its risk. Different risk factors identified for bone cancer include previous history of radiation therapy; history of certain bone diseases (fibrous dysplasia, Paget’s disease of the bone, and endochondromas); certain inherited conditions (Li-Fraumeni syndrome, hereditary retinoblastoma, and Rothmund-Thomson syndrome); history of chemotherapy treatments; and a family history of bone cancer.
Diagnosis of bone cancer generally involves a combination of clinical evaluation, imaging tests, and biopsy procedures. Diagnosis of bone cancer may include:
Blood tests: Blood tests determine the levels of two enzymes, alkaline phosphatase and lactate dehydrogenase. However, blood tests are not typically diagnostic for bone cancer, though they may help rule out other conditions.
X-rays: X-ray imaging is an important testing method recommended for the diagnosis of bone cancer. It can show the location, size, and shape of a bone tumor.
Biopsy: A biopsy is done to confirm the presence of bone cancer and determine its type. There are three types of biopsy: needle biopsy, excisional biopsy, or an incisional biopsy.
Other Imaging Tests: Additionally, imaging tests such as CT scan, MRI, PET scan, and bone scan are recommended for diagnosis, disease staging, and treatment planning.
Treatment for bone cancer depends on the type, size, location, and stage of the cancer, as well as the person’s age and general health. Here are some options for treatment for bone cancer:
It is the most usual and effective treatment for bone cancer. During the surgery, the entire tumor with negative margins is removed. The surgeon may also use special surgical techniques to minimize the amount of healthy tissue removed along with the tumor. Other surgical approaches for bone cancer include limb salvage surgery and amputation. Bone cancer surgery can be performed through both open and minimally invasive approaches. Bone cancer surgery may be followed by reconstructive surgery, wherein the implants or bone grafts from other body parts are used to reconstruct the affected bone area and improve its structure and functionality.
Liquid nitrogen is used to freeze and kill cancer cells during cryosurgery. This treatment for bone cancer can sometimes be used instead of conventional surgery to destroy tumors in bone.
Chemotherapy is often used in conjunction with surgery to treat bone cancer, especially for cancers like osteosarcoma and Ewing's sarcoma, which are more likely to spread. It involves using powerful anti-cancer drugs to destroy cancer cells in the body.
Radiation therapy, also known as radiotherapy, is another treatment for bone cancer that uses high-energy X-rays to kill cancer cells. Radiation therapy can help in treating bone tumors that cannot be removed surgically or destroying residual cancer cells after the primary treatment.
These therapies focus on specific molecules and cellular pathways involved in the growth and spread of cancer cells. Targeted therapies can be used for some types of bone cancer, like osteosarcoma. It is often combined with other cancer treatments to improve the overall effectiveness of the treatment.
Immunotherapy is a targeted treatment approach for bone cancer, wherein the immune system is stimulated to identify and attack cancer cells in the body. This approach precisely targets cancer cells and reduces damage to healthy cells in the body.
Bone cancer survival rates depend on the type, stage, and early detection. For osteosarcoma, the 5-year survival rate is 60%-80% for localized cases but drops to 30%-40% for metastatic cases. Ewing's sarcoma has a 70%-80% survival rate for localized cases, while the survival rate for chondrosarcoma ranges from 80%-90% for low-grade tumors to 50%-60% for high-grade tumors. Metastatic bone cancer has a lower survival rate in general.
Bone marrow cancer develops in the blood-forming stem cells of the bone marrow, the soft tissue inside your bones responsible for producing blood cells. The most common types of bone marrow cancer include leukemia and multiple myeloma.
The most common types of bone marrow cancer are:
Bone marrow cancer symptoms include:
The exact cause of bone marrow cancer is often unknown. However, each type of bone marrow cancer has its own risk factors. These factors cause the bone marrow cells to undergo abnormal division and produce cancer cells.
The possible causes of bone marrow cancer include exposure to hazardous chemicals, radiation, and viruses; a compromised immune system; certain genetic conditions and bone marrow failure syndromes; increasing age; smoking; and a history of chemotherapy and/or radiotherapy.
The diagnosis of bone marrow cancer typically involves a combination of clinical evaluation, laboratory tests, imaging studies, and biopsy procedures.
Diagnosis of bone marrow cancer includes:
Blood tests check the levels of white blood cells, red blood cells, and platelets and provide information on bone marrow anomalies, if any.
Blood tests for tumor markers are done to look for specific markers/signals that confirm the presence of bone marrow cancer. Beta 2 microglobulin (B2M) is an example of a bone marrow cancer marker.
A metabolic panel blood test involves examining the functions of the liver and kidneys and fluid levels in the body.
Urine tests help determine the protein level in your urine and examine the kidneys.
A bone marrow biopsy involves collecting a small sample of bone marrow and examining it to look for the presence of cancer cells.
Lymph node biopsy may be recommended for lymphoma diagnosis.
Imaging tests, such as X-rays, CT scans, PET scans, and MRIs, are recommended to determine the extent of the disease’s spread and its stage and plan the treatment strategy.
The treatment for bone marrow cancer, including leukemia, lymphoma, and multiple myeloma, depends on the type of bone marrow cancer, its stage, and individual patient factors like age and overall health.
Some common treatments for bone marrow cancer include:
Chemotherapy: Chemotherapy is the most common treatment for bone marrow. It uses drugs to kill or stop the growth of cancer cells. This treatment is often followed by a stem cell transplant.
Stem Cell Transplant: Stem cell transplant, or bone marrow transplant, is one of the commonly recommended treatment options for bone marrow cancer. This procedure involves replacing cancerous bone marrow cells with healthy ones to restore the production of normal blood cells.
Immunotherapy: Immunotherapy aims to boost or restore the body's immune system so that it can better recognize and fight cancer cells.
Targeted therapy: Targeted therapy uses medicines that attack specific components or cellular pathways associated with the growth of cancer cells and control their growth.
CAR-T cell therapy: A type of immunotherapy, CAR T-cell therapy involves training the immune system to identify and attack cancer cells. CAR T-cell therapy is found to be effective against certain types of bone marrow cancer. This treatment begins with removing some white blood cells, including T cells, from your blood.
Radiation therapy: This treatment for bone marrow cancer involves the use of powerful energy beams to kill cancer cells. Radiation can quickly shrink the growth of myeloma cells.
Bone marrow cancer survival rates depend on cancer type, stage, and patient age. Depending on individual case factors, the 5-year survival rate for leukemia is between 65-70%; for lymphoma, it is around 61-90%; and for multiple myeloma, it is about 40-80%. Bone marrow cancer survival rates have significantly improved in recent times due to the treatment advancements available.
Bone cancer and bone marrow cancer are two different types of cancer, each affecting different parts of the body with different symptoms, treatments, and results. Through this comprehensive article, we have tried to shed light on various aspects of bone cancer vs bone marrow cancer.
The difference between bone cancer and bone marrow cancer lies in their origins, symptoms, and treatment approaches.
Origin: Bone cancer originates within the bones. On the other hand, bone marrow cancer starts in the bone marrow, which is the spongy tissue inside the bones that produces blood cells.
Symptoms:Bone cancer symptoms are typically localized and specific to the affected bone. On the other hand, bone marrow cancer symptoms are more systemic, impacting the entire body due to the role of the bone marrow in blood cell production.
Cancer spread: Bone cancer tends to stay localized to the bone, though it can spread to other parts of the body, whereas bone marrow cancer often spreads throughout the body early in its progression because the bone marrow is a crucial part of blood cell production, affecting multiple organs and systems.
What is bone cancer, and how it is different from bone marrow cancer depends on their origin and symptoms. Bone cancer starts in the bones, while bone marrow cancer begins in the bone marrow, affecting blood cell production and causing more systemic symptoms. The difference between bone cancer and bone marrow cancer extends to treatment, with bone cancer often requiring surgery and chemotherapy, while bone marrow cancer may involve chemotherapy and stem cell treatments. Understanding the causes of bone cancer, such as genetic factors, helps in determining effective treatments and improving survival rates.
Dr. Sunit Lokwani
Consultant - Medical Oncology And Clinical Haematology
MBBS, MD (General Medicine), DM (Medical Oncology)
Dr. Sunit Lokwani is an accomplished hematology and medical oncology consultant who specializes in treating and managing different types of cancer through systemic treatment approaches. He is available for consultations at HCG Cancer Centre, a leading cancer hospital in Indore. His credentials include an MBBS degree, an MD (General Medicine) degree, and a DM (Medical Oncology). Additionally, he is a certified intensivist from the Indian Society of Critical Care Medicine (ISCCM) and the Chinese University of Hong Kong (CUHK), along with DM Certification by IDF.
Before HCG, he was associated with several prestigious healthcare institutes, including Kokilaben Hospitals (Indore), Shalby Hospitals (Jabalpur), Vydehi Institute of Medical Sciences and Research Centre (Bangalore), and CMC (Vellore), among many others.
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