ABOUT THE DISEASE

Bone is a living tissue where the hard bone tissue is made of collagen fibres and minerals. There are two main types of cells within the hard bone tissue that make and mould bone i.e osteoblasts and osteoclasts. These cells are active throughout life. They work in a balanced way to make and mould bone, repair damage and keep the bone structure correctly `woven`. There is a slow but constant turnover of bone. Chondrocytes are cells which make cartilage, the tissue that covers the ends of bones in joints.

In the centre of some larger bones is the soft bone marrow. This is where blood cells are made (red blood cells, white blood cells, and platelets).

Depending upon the point of origin of the cancer - they are broadly classified as Primary bone cancers (those which originate from the bones) and Secondary or metastatic bone cancers (that originate in an organ, such as breast, prostate, colon, liver, kidney, lung, etc and then spread to bones)

Bone cancer can occur in any of the bones of the body, but it occurs most often in the long bones of the arms and legs.

While it can occur at any age, the most common types occur in children and young adults. The various types of primary bone cancer are:

• • Osteosarcoma
  Most common type, making up 35 percent of bone cancer cases. This cancer affects primarily children and young adults between the ages of 10 and 25.
  Osteosarcoma often starts in the ends of bones, where new tissue forms as children grow. It arises most often in the knee.
  
  
• • Chondrosarcoma
  Chondrosarcomas, one of the most common types of bone cancer in adults over age 50, form in cartilage -- usually around the pelvis, knee, shoulders, or upper part of the thighs. These cancers make up 26 percent of all bone cancer cases.
  
  
• • Ewing`s Sarcoma
  Occurs most often in the middle part of bones, arising most often in the hip, ribs, upper arm, and thighbones. This cancer affects primarily children and young adults between the ages of 10 and 25. Is responsible for 16 percent of bone cancer cases.
  
  
• • Rarer Bone Cancers
  Rare, and occur primarily in adults:
  
  • • Fibrosarcomas usually appear in the knee or hip area. They can arise in older patients after radiation therapy for other cancers.
  • • Adamantinomas usually occur in the shinbone.
  • • Chordomas are found most often in the sacrum -- the lower part of the spine, also known as the tailbone.

SYMPTOMS

• • Bone pain especially during night
• • Stiffness
• • Bone tenderness / fracture, especially fracture from a slight injury

CAUSES

In most cases no specific reason has been identified however known risk factors include:
- Genetic defects passed down through families
- Radiation
- Paget`s disease of the bone - affects older people
- Injury

DIAGNOSIS

- X-Ray
- Bone scan
- MRI
- Bone biopsy
- Blood tests such as alkaline phosphatase, parathyroid and calcium level

TREATMENT METHODS

The treatment plan used for primary bone cancer comprises of surgery, chemotherapy and radiotherapy. Limb sparing surgery is tried initially. However, Amputation may still have to be done in few cases.

The treatment or combination of treatments advised in each case depends on various factors such as:
• The type of primary bone cancer.
• The exact site of the cancer.
• The stage of the cancer (how large is the cancer and whether it has spread to other parts of the body).
• General health.

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