A bone tumor is an abnormal growth of cells within the bone that may be benign or malignant (cancerous).
Causes, incidence, and risk factors
The cause of bone tumors is unknown. They often arise in areas of rapid growth. Possible causes include inherited mutations, trauma and radiation, but in most cases no specific cause is found.
Bone tumors may be benign or malignant. Osteochondromas are the most common benign bone tumors and occur most often in people between the ages of 10 and 20. Some benign bone tumors go away on their own and do not require treatment. These benign tumors are monitored periodically by X-ray.
Malignant bone tumors occur as a primary bone tumor or as metastasis (cancer spread from another area of the body). Primary bone tumors are rare (less than 1% of all malignant tumors) and are most common in young men.
Malignant bone tumors include osteosarcomas, Ewing’s sarcoma, fibrosarcoma, and chondrosarcoma. The most common cancers that spread to the bone are cancer of the breast, lung, prostate, kidney, and thyroid. These forms of cancer usually affect older people.
Bone cancer was once prevalent among individuals who painted radium on watch faces (to produce glow-in-the-dark dials), a practice that was abandoned in the middle of the 20th century. The painter would ‘tip’ the brush with their tongue (in order to produce fine work) and absorb minute amounts of radium, which deposited in the bone and caused cancer.
The incidence of bone cancer is also increased in families with familial cancer syndromes. The incidence of bone cancer in children is approximately 5 cases per million children each year.
- Bone pain, may be worse at night
- Occasionally a mass and swelling can be felt at the tumor site
- Bone fracture, especially fracture from slight trauma (injury)
Note: Some benign tumors have no symptoms.
Signs and tests
- X-ray of bone
- Bone biopsy
- Bone scan showing size and location of tumor
- Alkaline phosphatase may be elevated
This disease may also alter the results of the following tests:
- Serum phosphorus
- Joints X-ray
- Hands X-ray
- Extremity X-ray
- Calcium (ionized)
- Serum calcium
- ALP (alkaline phosphatase) isoenzyme
Benign bone tumors may not require treatment but may be assessed periodically to check for progression or regression. Surgical removal may be necessary.
Treatment for malignant tumors that have spread to bone depends upon the primary tissue or organ involved. Radiation therapy with chemotherapy or hormone therapy is commonly used.
Primary malignant tumors of bone (tumors that start in the bone) are rare and require treatment at centers with experience treating these cancers. After biopsy, a combination of chemotherapy and surgery is usually necessary. Radiation therapy may be needed before or after surgery.
The stress of illness can often be helped by joining a support group where members share common experiences and problems. For this condition, see cancer - support group.
Prognosis varies depending on the type of tumor. The outcome is expected to be good for people with benign tumors, although some types of benign tumors may eventually become malignant.
With malignant bone tumors that have not spread, most patients achieve a cure. Because the cure rate depends on the type of cancer, location, size, and other factors, the prognosis in particular situations should be discussed with your doctor
- Function may be reduced depending on the extent of the tumor
- Spread of the cancer to other nearby tissues (metastasis)
- Side effects of chemotherapy (if necessary) depend on the specific chemotherapy given
Calling your health care provider
Call your health care provider if symptoms develop that are suggestive of bone tumors.
by Sharon M. Smith, M.D.