Watch out for persistent bone pain
As in many other parts of the body, tumours are also seen in bones. We recommend people experiencing persistent bone pain to seek specialist medical attention regardless of family background. Pointing out to the fact that the reason for which many bone tumours develop are unknown and the potential of genetic involvement, Orthopaedics and Traumatology specialist Professor Kaan Erler provides insight into bone cancer and the available treatments.
What are the most common forms of bone tumours?
The most common variants of primary bone cancers are:
Multiple Myeloma: is the most common form of primary bone cancer and a malignant type of bone marrow. Annually it could be responsible of the death of over 20 per 1 million people. It is commonly seen between the ages 50 to 70 and can affect any bone.
Osteosarcoma: is the second most common primary malignancy of bone. It is frequently seen in adolescence in the knee region followed by lesser frequent occurrences in the hip and shoulder. Annually it is seen in 2-3 per 1 million people.
Ewing's Sarcoma: Its prevalence is higher between the ages 5 to 20. It causes bone degeneration with extensive soft tissue masses. It is most frequently seen in upper and lower extremities as well as pelvis and thorax.
Chondrosarcoma: is frequently seen between ages 40 to 70. It causes a mass in the hip region, pelvis and shoulder.
What findings help diagnose the presence of such tumours?
Most patients feel persistent pain. Even at rest, the patient will continue to feel pain, which often worsens at night. Pathological fractures may be seen in weakening bone structures, which in return enhances pain. Some tumours may even cause fever and nocturnal sweating. But not all bone tumours are symptomatic. Some tumours are identified by accident when following X-rays for example.
What examinations would I need?
The doctor will ask detailed questions to explore a patient’s medical background, including the current prescribed medication and all previous illnesses. The patient may also be asked to provide a regular X-ray. Various bone tumours will appear different in regular x-ray films. Whilst some reveal calcification others will appear as bone loss (osteoporosis), and sometimes it will be a combination of the two. Whilst some tumours can be identified in regular X-rays, some will require advanced screening to exactly determine the type of tumour. Doctors will then investigate the size, movement, and adherence of the tumour and its relation to joints. Further examinations may be performed if necessary.
How are malignant bone tumours treated?
We recommend getting a second opinion should you have been diagnosed with a malignant tumour. Bone cancer treatment requires teamwork including an orthopaedic oncologist, medical oncologist, radiologist, radiation oncologist and pathologist. The objective of treatment is to remove the tumour while trying to preserve the extremity.
What recent innovations have taken place in bone cancer treatment?
Previously the way to save bone cancer patients was to amputate. However, today we try to preserve the extremity as much as possible and to maintain functionality. We therefore tend to use the latest developments in reconstructive surgery as much as possible. Prosthetics, bone grafting (surgically replacing bone with material from the patient's own skeleton) and biological regeneration are frequently used in modern medicine.
What other methods are available?
Some malignant bone tumours are sensitive to radiotherapy. Radiotherapy can be used alone or simultaneously with other treatment. Depending on biology of the tumour, radiotherapy may even be therapeutic. It may also be applied before or after surgery.
What about gender?
Current data does not suggest that one gender would be more prone to bone cancer than the other.