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Bone Tumors

Bone tumors happen when cells inside a bone form a lump of abnormal tissue. They tend to form in younger people and are usually benign (non-cancerous).

Treatment options range from observation to surgery. Your treatment will depend on the location, type, and size of your tumor.

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What Are Bone Tumors?

Doctors define bone tumors as abnormal masses that form within a bone. They can be benign or malignant (cancerous).

Bone tumors happen when cells in the bone grow out of control. They can form anywhere in the body, but most often form in the larger bones of the arms, legs, and pelvis. The tumors can grow in any part of the bone, from the surface to the marrow (the spongy center of a bone). 

Although benign bone tumors don’t tend to spread beyond the bone, they can cause pain and swelling. They also make a bone more likely to fracture.

Benign bone tumors usually require treatment, but it's rare for them to become cancerous.

Malignant bone tumors can spread cancer to other parts of the body.

How common are bone tumors?

Both benign and malignant bone tumors are rare. 

Benign bone tumors usually affect children and young adults under age 30. Most grow slowly and often stop growing when a teen’s bones stop growing. 

Malignant bone tumors may affect younger or older people. There are two categories of malignant bone tumors:

  • Primary bone cancer starts in a bone and makes up less than 1% of all cancers, according to the American Cancer Society. Some primary bone tumors, such as osteosarcoma, spread quickly, while others spread slowly.
  • Secondary bone cancer (metastatic) is more common. It begins in another organ, like the breast, colon, or lungs, and moves to a bone. The growth rate of secondary bone cancer depends on the type and severity of the tumor.

What are the types of bone tumors?

Types of benign bone tumors

There are many types of benign bone tumors. There are also health issues that resemble bone tumors, which doctors treat the same way they treat bone tumors.

Bone tumors and similar health problems include:

  • Aneurysmal bone cyst.
  • Chondroblastoma.
  • Enchondroma.
  • Fibrous dysplasia.
  • Giant cell tumor.
  • Nonossifying fibroma.
  • Osteochondroma.
  • Osteoid osteoma.

Types of malignant bone tumors

The most common types of malignant bone tumors are:

  • Chondrosarcoma, which usually occurs in people ages 40 to 70. These tumors tend to appear around the hip, pelvis, or shoulder. Surgery is often the only treatment.
  • Ewing’s sarcoma, which usually occurs in people ages 5 to 20. Common locations are the upper and lower leg, pelvis, upper arms, and ribs. Treatment is chemotherapy and either surgery or radiation therapy.
  • Multiple myeloma, the most common primary bone cancer, affects the bone marrow. It occurs in about seven people per 100,000 each year in the U.S., mostly in those ages 50 to 70. Treatment is chemotherapy, radiation therapy, and sometimes surgery.
  • Osteosarcoma, the second most common primary bone cancer, affects two to five people per million annually in the U.S. Most are children and teenagers. Tumors typically form in the knee and leg bones, and treatment is chemotherapy and surgery.

Cancers that begin elsewhere in the body and spread to the bone include:

  • Breast
  • Kidney
  • Lung
  • Prostate
  • Thyroid

What causes bone tumors?

Doctors don’t know what causes bone tumors.

What are bone tumor risk factors and complications?

Because doctors don’t know exactly what causes bone tumors, risk factors are unclear.

Bone tumor risk factors 

Possible risk factors may include:

  • A family history of bone tumors.
  • Injury to the bone.
  • Undergoing radiation therapy.

Complications of bone tumors

A bone tumor may cause a bone to become weaker, which could lead to a fracture or complete break of the bone.

Malignant bone tumors may spread cancer to other parts of the body.

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What Are the Signs and Symptoms of Bone Tumors?

The symptoms of bone tumors vary. Some people have no symptoms. They may only find out they have a bone tumor when they have an x-ray for another problem. 

Other people have considerable pain and swelling around the tumor.

Symptoms of bone tumors include:

  • A bump or knot under the skin.
  • A dull, aching, constant pain around the tumor.
  • Fever.
  • Night sweats.
  • Pain that increases at night. 
  • Swelling.

When should I see a doctor about my bone tumor symptoms?

If you have an unexplained or painful bump under your skin, you should see your doctor. They'll also check for stress fractures and infections, which have similar symptoms.

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How Do You Diagnose Bone Tumors?

To diagnose a bone tumor, your doctor will ask about your medical history, your overall health, what medicines you take, and your symptoms. They'll want to know if any of your relatives had tumors or cancer.

Your doctor will also do a physical exam to look for:

  • Any changes in the skin around the tumor area.
  • Any problems with your joints near the tumor area.
  • Swelling or tenderness.
  • The presence of a hard mass.

Tests to diagnose bone tumors 

If your doctor suspects that you have a bone tumor, they may order 1 or more of the following:

  • Blood test
  • Bone scan
  • CT scan
  • MRI scan
  • PET scan
  • Urine test
  • X-ray

If your doctor needs to explore the tumor further, you may need a biopsy. A biopsy removes a small piece of the tumor so doctors can examine it under a microscope.

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How Do You Treat Bone Tumors?

Benign bone tumor treatment options

Nonsurgical treatment for benign bone tumors

If your tumor isn’t cancerous or causing pain, your doctor may simply choose to monitor it. Some tumors never cause problems. Some even go away without treatment, especially in children.

Your doctor may prescribe regular imaging tests, like x-rays, to see if the tumor shrinks or grows over time.

Medication to treat benign bone tumors

Doctors may treat some benign tumors with medication, such as bisphosphonates, a group of drugs that help strengthen bones. Some will disappear with medicine alone.

Surgery for benign bone tumors

Some benign bone tumors require surgery. If the tumor could cause a broken bone, or already has, your doctor will need to remove it.

Some bone tumors come back even after surgery. Your doctor may run periodic scans of the area to see if more tumors form. It’s rare but certain benign tumors can spread or become cancerous.

Malignant bone tumor treatment options

Treatment of malignant bone tumors is complex because your doctor will need to find out whether the cancer has spread. Your doctor will choose treatment based on the tumor’s size, location, and stage of development. 

If the cancer is only in the bone tumor, it's easier to treat. If it has spread elsewhere in the body, it's more serious and harder to cure.

To treat a malignant bone tumor, your doctor may use a combination of radiation, chemotherapy, and surgery.

Radiation to treat malignant bone tumors

Your doctor may prescribe radiation treatments for malignant bone tumors. Radiation therapy uses high-dose x-rays to kill cancer cells and shrink tumors. It only treats the tissue exposed to the beam, as opposed to treating cancer elsewhere in your body.

Medication to treat malignant bone tumors

Chemotherapy may be part of your treatment for malignant bone tumors. Chemo is a systemic treatment — doctors use it to kill cancer cells that have spread into your bloodstream.

Doctors will use chemotherapy when there's a good chance that cancer isn't confined to one area. You can take chemotherapy by pill or intravenously (by injection into a vein).

Surgery for malignant bone tumors

You’ll likely need surgery to remove a malignant bone tumor. There are two main types of surgery:

  • Limb salvage surgery removes the cancerous part of the bone but keeps muscles, tendons, nerves, and blood vessels as intact as possible. Your doctor will take out the tumor and some healthy tissue around it. They'll replace the missing bone with a metal implant, bone from elsewhere in your body, or bone from a donor.
  • Amputation is surgery to remove all or part of an arm or leg. It may be the best choice if the tumor is very large, or if nerves or blood vessels become involved. You'll receive a prosthetic limb after amputation.

How effective is treatment?

Your recovery time will depend on the type of bone tumor you had and what type of surgery your doctor did. After treatment, you’ll keep seeing your doctor for regular follow-up visits and tests, likely every few months.

The outcome for people with benign bone tumors is usually good.

The cure rate for malignant bone tumors depends on the type and stage of cancer, its location, and size. Your doctor can give you more information about your specific disease.

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