How does bone cancer start? Here are some warning signs of bone cancer

Sarcomas are a rare group of cancers that begin in the bones or soft tissues of the body and July is observed as Sarcoma Awareness month, pertaining to raising awareness for diagnosing the condition at an early stage and increasing the chances of successful treatment. The disease is rare globally and in India, and more prevalent in children and adolescents than in adults. Sarcoma is considered deadly due to delayed diagnosis, lack of presentation of symptoms and disease progression. Although there are more than 50 types of sarcomas, the disease has two main forms – i) soft tissue sarcoma and ii) osteosarcoma (bone cancer). Let us understand in detail about bone cancer which accounts for 3% of all childhood cancers.

Dr. Ankur Bahl, Senior Director, Medical Oncology and Hemato-Oncology, Fortis Memorial Research Institute says, “Bone cancer usually affects the cells in the bones and cartilages, the cancer cells in these tumours look like early forms of bone cells that normally help make new bone tissue, but the bone tissue in a bone cancer patient is not as strong as that in normal bones. Most of the time, bone cancer starts with long bones – especially leg bones and sometimes arm bones. However, in some cases, bone cancer can start from any bone. In some rare cases, bone cancer can start from soft tissues outside the bone and then spread to the bones. Generally, sarcoma occurs in teenagers and young adults, however it can also occur among younger children and older adults.”
“Localised bone cancer can be seen in the bone or sometimes the tissues next to the bone, like muscle, tendon, or fat. However, metastatic, or advanced bone cancer spreads to other parts of the body such as lungs, other bones, the brain, or other organs making it hard to treat,” he adds.
Early warning signs and symptoms of bone cancer

A general symptom or sign of sarcoma is a lump, sometimes painful, on an arm or leg that keeps growing.

The earliest symptoms of bone cancers are pain and swelling where the tumour is located. The pain may come and go at first which can become more severe and steady later. Sometimes, the pain may worsen with movement, and may cause swelling in nearby tissues. there may be swelling in nearby soft tissue. The pain might be pertinent which doesn’t go away easily, and it can occur while resting or at night. Most bone cancers in children appear around the knees and can be misdiagnosed as "growth pain," leading to a delay in diagnosis.

According to Dr. Bahl, “A tumour may lead to swelling to tenderness or stiffness in the joints, if it occurs in the joints or near the joints. Most of the patients visit their doctor with this symptom when the swelling has increased and progressed to nearby areas. Limping, limited movement, increased pain with lifting can be symptoms of bone cancer.”

One may also undergo weight loss despite any physical activity/ workout and frequent tiredness. If these symptoms prevail, one should consult their doctor and seek medical help.

“In rare occasions, people with bone cancer may have symptoms like fever, generally feeling unwell, weight loss, and anaemia, which is a low level of red blood cells,” says Dr. Bahl.

The diagnostic tests for bone cancer include blood tests and imaging techniques such as X-rays, CT scans, MRI scan, PET scan or radionuclide bone scan, followed by a biopsy of the affected area. These tests and its findings further help an oncologist with the right diagnosis and decide the right treatment option for the patients. Doctors select treatment options based on where the bone cancer starts, the size of the cancer, the type and grade of the bone cancer, and whether the cancer has spread beyond the Treatment usually involves chemotherapy, surgery and, sometimes, radiation therapy. Like all cancers, bone cancer diagnosis is a life-changing event, not only for the person with the tumour but also for family members and other loved ones. The patient’s primary caregiver is a key part of the patient’s healthcare team. Involvement of caregivers is essential for optimal treatment of patients by ensuring treatment compliance, continuity of care and social support.

According to Dr. Bahl, “Surgical treatment was one of the few limited options for now but thanks to the recent advancements in treatment options over the past few years, research and understanding around bone cancer and its treatment, thus helping in improving treatment outcomes and quality of life of patients.”

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