Bone Cancer

According to data from the American Cancer Society, primary bone cancers account for less than 0.2% of all cancer cases. Common types of primary bone cancer include:

• Osteosarcoma
   The most common primary bone cancer typically occurs in the upper arm or around the knee. It mainly affects bones that are still growing, making children and adolescents the primary patient group.
   
• Chondrosarcoma
   Derived from cartilage, Chondrosarcoma most commonly occurs in the hip and pelvis but can also develop in other areas. It primarily affects adults.
   
• Ewing's Tumours (Ewing's Sarcoma)
   Originating from immature cells in the bone marrow, Ewing's tumours can occur in any part of the body but are most often found in the thigh bone, pelvis, or chest wall. It predominantly affects children and adolescents.

Due to the rare occurrence of primary bone cancer and the lack of public awareness, combined with inconspicuous early symptoms, it is one of the most challenging cancers to prevent and detect. However, this does not mean there are no signs to be aware of. The following are symptoms of primary bone cancer:

• Bone pain near the tumour - Early-stage bone cancer patients may experience pain, especially at night or during activities such as walking. Leg pain while walking is an example. As the cancer progresses and activities intensify, the pain becomes more noticeable and persistent.
   
• Back pain - Early-stage bone cancer patients may have persistent and unexplained back pain.
   
• Joint swelling and stiffness - If the tumour grows near a joint, the joint may become swollen and stiff, reducing the patient's mobility and causing pain during movement.
   
• Compression symptoms - Due to the bone tumour compressing nerves and blood vessels, early-stage bone cancer patients may experience numbness in the extremities.
   
• Weakening of bones - The bones become fragile, and fractures may occur.
   
• Other - Patients may exhibit atypical bone cancer symptoms, including extreme fatigue, fever, and weight loss.

Currently, the exact causes of primary bone cancer are not fully understood, but research suggests that it may be associated with the following factors:

• Genetic Inheritance: Individuals with a family history of bone cancer may face a higher risk.
• Radiation Exposure: Previous exposure to high doses of radiation may increase the risk of developing primary bone cancer.
• Genetic Mutations: Abnormal variations in specific genes may be associated with bone cancer. For example, Li-Fraumeni Syndrome, a rare hereditary condition, increases the risk of various tumours, including bone cancer. Patients with Hereditary Retinoblastoma also have an elevated risk of developing bone cancer.
• Bone Diseases: Some hereditary or acquired diseases related to the bones, such as multiple osteochondromas (multiple hereditary exostoses), may be linked to an increased risk of bone cancer.
• Radiation Therapy: Individuals who have undergone radiation therapy may develop primary bone cancer several years or decades after treatment.
• Other Diseases: Certain rare diseases, such as Paget's Disease of bone, may increase the risk of developing primary bone cancer.

When doctors suspect a patient may have bone cancer, they first conduct preliminary and straightforward examinations, such as checking for pain, deformities, or noticeable lumps in the body. If these tests indicate a likelihood of bone cancer, further assessments will be conducted for a more accurate diagnosis, primarily using the following methods:

After the diagnosis through the methods above, if the doctor discovers that the patient has bone cancer, further tests may be conducted to determine the stage of cancer accurately. Factors determining the early or advanced stage of cancer include the tumour's size, whether it has spread, and if it has spread to more distant body tissues. The subdivisions of the stages are as follows:

After diagnosis, doctors will choose the most appropriate treatment for patients confirmed with bone cancer. The treatment methods for bone cancer depend on its type, extent of spread, the patient's age, and overall health. The main treatment methods include: