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Bone Cancer in the Elderly

Bone cancers are malignancies that arise from the bone. Cancer of other organs like the breast, prostate or lungs can spread to bone but this type of secondary (metastatic) growth in the bone is not included among bone cancers. Certain type of blood cancer (leukemia, multiple myeloma) which affects the bone marrow are also not included in bone cancers although the marrow is housed within the bone.There are several types of bone cancer with different characteristics which can determine the treatment and prognosis. Surgery, chemotherapy and radiation therapy are the main treatment options.

Bone Cancer Symptoms

Usually different types of bone cancer presents with the same set of symptoms :

  • Bone pain is the most common symptom. Pain gradually increases with time with size increase of the cancerous growth.
  • Swelling (hard bony) arising from the bone sometimes restricting movement.
  • Unexplained and repeated fracture of the bone (weakening of the bone due to bone cancer).
  • General symptoms of cancer like fever, unexplained weight loss, weakness and anemia.

Causes and Risks

Like other cancers, a genetic mutation which is a sudden, unexpected and permanent change in DNA is one of the main reasons behind bone cancers. Cell division and cell death (apoptosis) are under the influence of various genetic factors that strictly maintains the balance between division and death. Mutations of some of these genes usually tilt the balance towards accelerated, uncontrolled cell growth and minimal or no cell death which is seen as cancer. With time these cancerous cells spread to other organs via the blood stream or lymphatic system.

The main risk factors for the development of bone cancer include :

  • Familial genetic disorders
  • Exposure to radiation
  • Paget’s disease which is a precancerous condition.

Types of Bone Cancer

Bone cancers can be of different types. Some are more common in children, others in adults. Some cancers have a predilection for the bone itself while others arise from the cartilages, present at the end of the bones (acting as cushion between bones). The following are the most common bone cancers :

  • Osteosarcoma is one of the most common cancers of children. It usually affects the long bones (femur, tibia, humerus).
  • Chondrosarcoma affects the cartilage at the end of the bones. The pelvis and shoulder are most commonly affected.
  • Ewing’s sarcoma most commonly affects adolescents and young adults. Usually the growing ends of the long bones are affected (commonly femur).

Bone Cancer Treatment

Treatment of bone cancer depends upon the type and stage of the cancer. The aim of surgery is to remove the cancerous growth. The bone growth can be removed on its own but sometimes the entire leg may be amputated. Artificial limbs may then be required. When the cancer has spread and the general health of the patient is poor, then chemotherapy and radiation therapy may be considered. Chemotherapy is the administration of highly toxic drugs to kill cancerous cells whereas radiation therapy uses x-rays to destroy the cells. Both chemotherapy and radiation therapy may be done before or after surgery depending on the individual case.

 


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