The causes of primary bone cancer are not yet known, but there may be a genetic link because it often seems to run in families. This form of cancer most often occurs in the leg, with it painful swelling just above or below the knee. The pain may be worse while standing or while in bed at night.

HOW IS IT DIAGNOSED?

Patients will he referred to a specialist to have X-rays taken and further tests such as a computerized tomography (CT) scan or magnetic resonance imaging (MRT) will he carried out So that the diagnosis can he confirmed. The most common primary bone cancer is called osteosarcoma.

Tumors are highly malignant and the disease will often spread to the lungs, so patients may also be sent for a chest X-ray.

TREATING BONE CANCER

In most cases the tumorous surgically removed and any bone that is taken away is replaced either by artificial bone or by a section of bone from elsewhere in the body or from a compatible donor. Radiotherapy or chemotherapy is normally given after surgery to get rid of any remaining cancer.

This specimen of a femur – thigh bone – shows a cancerous growth. Bone tumors are highly malignant and the cancer often spreads quickly to the lungs.

BONE METASTASES

Bone metastases or secondary bone cancer are terms for tumors that have spread from other parts of the body. Cancers prone to metastasize to bones include breast, lung, thyroid, prostate and kidney cancers. Bone metastases are more common than primary bone cancers.

Bone metastases tend to occur in elderly people and most often affect the ribs, pelvis, skull and spine. There is a tender swelling of the area and severe hone pain, which is usually worse at night. The affected bones are weakened and may easily fracture.

Patients who have already been diagnosed with cancer elsewhere in the body may have an X-ray or radionuclide scanning to discover if the cancer has spread to the bones. If this is the first sign of cancer, further such tests may be necessary, to locate the site of the primary cancer from which the metastases developed.

Treatment focuses on the primary site. A bone fracture may be fixed with metal plates or screws. Once cancer has spread to the bone any treatment is palliative not curative – chemotherapy, radiotherapy or hormone therapy may relieve pain only.