About Bone Sarcoma
Bone sarcomas are primary malignancies that arise from mesodermal cells found in bone, connective tissue and cartilage. Approximately 3,000 new cases of bone sarcomas are diagnosed each year in the U.S., including Los Angeles, with many of them diagnosed in children. There are numerous subtypes of bone cancer with Osteosarcoma, Ewing’s Sarcoma, and Chondrosarcoma the most frequently diagnosed.
The rarity and severity of bone sarcoma makes it critical to have a bone cancer specialist or an orthopedic oncologist like Dr. Daniel C. Allison consulted in the treatment of the bone tumor. A coordinated, multi-disciplinary team lead by a bone cancer specialist such as Los Angeles’s Dr. Allison offers the extensive resources of a sophisticated medical center which can provide the most advanced treatment for such a relatively rare, but important cancer. Dr. Allison and his dedicated bone tumor treatment team at Cedars-Sinai Medical Center in Los Angeles are exceptionally qualified and experienced with the specialized knowledge and expertise in early detection and treatment of bone tumors.
What Are the Types of Bone Cancer?
Bones are comprised of three different types of tissue:
Compact Tissue – Hard outer portion
Cancellous Tissue – Spongy tissue inside containing the bone marrow
Subchondral Tissue – The smooth bone tissue of the joints. Cartilage surrounds the subchondral tissue to form a cushion around the joints.
The Three Most Common Types of Bone Cancer
Osteosarcoma – This subtype, comprised of several varieties, develops in growing bones and therefore it develops more often in children than adults.
Ewing’s Sarcoma – Ewing’s Sarcoma grouped as a “family of tumors” and can develop either in soft tissue or bone depending on where tumor originally formed. This type of bone cancer is typically aggressive in behavior and common with individuals of European descent.
Chondrosarcoma – One-third of bone tumors found in cartilage and occurs more frequently in adults. This form of bone cancer is common in older adults and often develops in spine and pelvis.
Other less known subtypes of bone cancer include:
- Malignant Fibrous Histiocytoma (connective tissue)
- Fibrosarcoma of Bone
- Hemangioendothelioma of Bone
What are the Symptoms and Risk Factors of Bone Sarcoma?
The size and location of bone tumors influence what kind of symptoms a person experiences when having a form of bone cancer. If a tumor is located around joints, then swelling and tenderness will cause a lot of pain. A person could be prone to fractures as a result of deterioration caused by bone tumors. Additional symptoms can include weight loss, fatigue or anemia.
While a specific cause for bone tumors to develop is not known, there are some risk factors associated with the disease:
Radiation or chemotherapy
Paget’s Disease – stimulates abnormal growth
Hereditary Conditions – caused by gene mutations
Diagonsis for Bone Sarcoma
Accurate diagnosis of bone cancer cannot be formed until extensive medical history, blood tests, and a physical examination by a qualified orthopedic physician like Dr. Allison in Los Angeles. This includes X-rays, MRI, and bone scans which aid in a thorough diagnosis. Often a primary symptom of bone sarcoma can be elevated levels of alkaline phosphatase since 55% of patients with primary bone cancer present develop this.
Tissue sampling through biopsy, however, remains an essential test for a conclusive diagnosis. Biopsy can be performed through a fine needle, a large coring needle, or through a small surgical incision. The type of biopsy chosen will depend on the size and location of the tumor, the preference of the treating surgeon, and the preference of the patient, as each have their risks and benefits.
Staging & Prognosis
Staging aids in determining prognosis as well as guiding treatment. If a doctor suspects a patient has osteosarcoma, staging is likely to be completed prior to biopsy. Staging is comprised of several steps which include an x-ray and MRI of the entire affected bone, a scan to look for tumors in any other areas, and a CT scan of the chest to ascertain if the tumor has spread to the lungs.
The disease is often localized and determined by the type of bone sarcoma. In cases where tumors have not spread, swift and appropriate treatment usually can lead to a complete cure. Patients with metastatic form of the disease have a lower 5-year survival rate on average and though not technically curable, current modalities can prolong a high quality of life for indefinite periods of time without a spread of the bone cancer.
Bone Sarcoma Treatment Options in Los Angeles
The treatment of bone sarcomas usually involves wide resection of the tumor, reconstruction of the bone and/or joint, and appropriate soft tissue coverage; however, this treatment may vary according to the type of sarcoma and stage of disease. Bone sarcoma treatment requires a coordinated, multi-disciplinary team approach at a high-level center with extensive resources and a team experienced in and dedicated to the treatment of these relatively rare, but important bone cancers (such as the dedicated sarcoma team at CSMC).
In all cases, there should be periodic follow-up over a five-year span immediately following surgery, and depending upon the case, sometimes for a longer period.