Primary bone cancer is a type of cancer that starts in the bone and is quite rare. The prognosis of primary bone cancer depends on various factors including the type, site and stage of the cancer.
The type of bone cancer is classified by the type of cell in which it occurs in and makes connective and supporting tissues of the body, like cells of the bone, muscle, cartilage and ligaments.
- Osteosarcoma: is the most common type of primary bone cancer that develops in the ends of growing bones next to the knee and upper arms of young people between 10-25 years of age.
- Ewing’s Sarcoma: Most cases occur in young people between the ages of 10 to 20, but it can occur at any age and commonly affects the pelvis and long bones of the leg.
- Chondrosarcoma: arises from cartilage forming cells but may form in the bone or on the surface of bones and affects the pelvic bones, bones in the shoulder blades, the ribs and the bones of the upper parts of the arms and legs, in people of the age group of 40-75.
- Other rarer types of primary bone cancerinclude fibrosarcoma, leiomyosarcoma, malignant fibrous histiocytoma, angiosarcoma and chordoma.
A doctor suspects that a person has primary bone cancer based on the symptoms that can be seen like, pain, swelling in a bone close to the skin which has the cancer, tiredness, problems in movement, weight loss. He then conducts a number of tests to confirm this diagnosis. These may include.
- An X-ray. Primary bone cancers often have a characteristic appearance on an X-ray.
- A bone scan involves an injection of a small dose of radioactive material. This is taken up by active bone tissue and shows on a scanner as a 'hot spot'.
- MRI scans are useful to show the exact site and size of a tumour.
- A bone biopsy, when a small sample of tissue is removed from a part of the body. The sample is examined under the microscope to look for abnormal cells.
On confirmation that a person has primary bone cancer, more tests are usually done to see whether the cancer has spread, by more x-rays, blood tests and scans.
Once the type of cancer has been identified, it is graded according to whether it is likely to remain in the bone or whether it is more aggressive and likely to spread to other organs in the body. If it has spread then it is no longer a primary cancer and it is a higher stage cancer, such as Stage 2, Stage 3 and so on. The subsequent treatment and the prognosis will depend on these. The International Staging System may be used to predict survival, with a median survival of 62 months for Stage 1, 45 months for Stage 2 and 29 months for Stage3.
The treatment options for primary bone cancer are surgery, chemotherapy and radiotherapy. The of primary bone cancer prognosis: it is difficult to give an overall outlook. Each individual case is different and the success of the treatment depends on the type, site and stage of the cancer. The earlier the stage, the better is theprognosis. With advances in surgery and chemotherapy the outlook for primary bone cancer prognosis has tremendously improved in the last 20 years.
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