Understanding different types of bone cancer

Bone cancer is relatively rare, accounting for 1% of all cancer cases in the United States.

There are two main types of bone cancer. In adults, cancers that form in the organs and spread to the bones, or metastasize, are the most common and are called secondary bone cancers. Primary bone cancers, also called bone sarcomas, develop in the bones and often spread to other areas.

The prognosis for bone cancer patients depends on the type of cancer, where it's found in the body, and whether it has spread.

The primary types of bone cancer

There are several types of primary bone cancer. Some are more common in older adults, while others are more often diagnosed in young adults and children.

The primary forms of bone cancer from most common to least common include:

• Osteosarcomas are tumors of the bone and are the most common form of bone cancer. Osteosarcomas are usually diagnosed in young people, but they do occur in older adults. These tumors often form in the arms, legs, or pelvis.
• Ewing tumor (Ewing sarcoma) is the second most common bone cancer in young people and third most common overall. These bone tumors often form in the hip, ribs, shoulder blades, spine, and legs.
• Chondrosarcoma forms in cartilage cells. The risk for this type of cancer increases with age and is rare in patients under 20. Chondrosarcomas are graded by severity from one to three.
• High-grade undifferentiated pleomorphic sarcoma (UPS) is another rare form of cancer that is often found in the soft tissues but can also occur in the bones, especially the legs, arms, and abdomen. It can also occur in areas of the body where radiation was received. UPS is most common in middle-aged and elderly adults.
• Fibrosarcoma is also rare in bones, occurring mostly in the soft tissues. It usually forms in the legs, arms, and jaw and is most common among adults 50 and older.
• Chordoma is a rare bone tumor that most often forms at the bottom of the spine or the base of the skull. It's commonly diagnosed in older adults.

Giant cell tumor is another primary bone tumor often occurring in young people between age 20 and 30. However, the tumor is noncancerous, or benign, and usually forms near the joints of long bones, such as the shins and thighs.

The secondary types of bone cancer

There are several types of secondary bone cancer. These cancers are slightly different from metastasized bone cancer because they don't form in the bone cells. Instead, they form in the blood or immune cells found in bone marrow.

The secondary types of bone cancer include:

• Multiple myeloma forms in a type of immune cells called plasma cells that are in the bone marrow. This type of bone cancer may develop as a single tumor but is usually found in several bones.
• Leukemia forms in the blood cells of bone marrow. There are many different types of leukemia. It can happen to people of all ages but is the most common cancer among young people.
• Non-Hodgkin lymphoma develops in the white blood cells of areas in the body that have lymph tissue. Primary non-Hodgkin lymphoma of the bone is a very rare type of lymphoma that forms in the bones.

Bone cancer risk factors

Radiation exposure is one of the few non-genetic or biologic risk factors for developing bone cancer because it can damage healthy cells in the body. Otherwise, bone cancer risk cannot be reduced, unlike many other cancers, with lifestyle behaviors.

Other risk factors for bone cancer include:

• Age. Bone cancer is most common among older people, including both men and women aged 50 and older.
• Benign bone or cartilage tumors. Noncancerous tumors can sometimes increase an individual's risk of developing bone cancer.
• Familial chordoma. This refers to a small number of patients who inherited a gene mutation that increases the risk for chordoma bone tumors.

Signs and symptoms

Symptoms of bone cancer or bone tumors may be different for every person. Many of the signs and symptoms may be confused with other conditions. It's important to report any ongoing or worsening symptoms to your provider, including:

• Fatigue
• Fractures
• Lump or swelling
• Numbness or tingling in the limbs
• Pain
• Weakness in certain areas of the body
• Weight loss

Diagnosing bone cancer

If a provider suspects bone cancer, there are several ways to determine a diagnosis. These include:

• Biopsy of the bone to check for cancerous cells
• Bone scans for more detailed imaging of the bones to locate cancerous cells or growths
• Medical imaging such as an X-ray or MRI to determine disease severity and whether it has spread

Treating bone cancer

Treatment methods depend on the type of bone cancer, the severity, and where in the body it originally formed. Cancer cells that first developed in the breast, for example, will be treated as breast cancer.

It's common to use more than one form of treatment to target bone cancer, including:

• Chemotherapy
• Radiation
• Surgery
• Targeted therapy and medication

Coping with bone cancer

A bone cancer diagnosis can cause people to have many different reactions. Choosing an experienced and compassionate cancer care team is an important first step. Many cancer patients also find it helpful and comforting to join a support group where they can share their feelings and experiences with others who have cancer.

Speak with someone today at the Reid Health Comprehensive Bone & Joint Center or Reid Cancer Center about diagnosing or treating bone cancer.