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Bone Cancer (Bone Tumor)

Primary bone cancer is cancer that forms in cells of the bone. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

Types of Bone Cancer

What works? Research summarized

Evidence reviews

Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital

Venous thromboembolism (VTE) is a term used to include the formation of a blood clot (a thrombus) in a vein which may dislodge from its site of origin to travel in the blood, a phenomenon called embolism. A thrombus most commonly occurs in the deep veins of the legs; this is called deep vein thrombosis. A dislodged thrombus that travels to the lungs is known as a pulmonary embolism.

Easing of bone pain caused by metastatic cancer: single versus multifraction radiotherapy

The spread of tumour to the bone (metastasis) is a common characteristic of many malignancies including cancers of the prostate, breast and lung. This may be associated with pain, compression of the spinal cord and the potential for bone fracture. Radiotherapy is used to treat bone metastases, however, the optimum treatment schedule is unclear. This review compares whether a single fraction of radiotherapy is better than multifractions of radiotherapy for alleviating the symptoms associated with tumours that have spread to the bone. Eleven randomised trials were identified in the published literature that compared single versus multifraction radiotherapy for bone metastases. Pooled analysis of these trials suggested that single fraction radiotherapy was as effective as multifraction radiotherapy in controlling bone pain. However, there were more bone fractures in patients treated by single fraction radiotherapy, and they received further treatment sessions more often than those receiving multifraction radiotherapy.

Bone agents for breast cancer

When breast cancer (BC) has spread to the bones (bone metastases, BM), bone agents (added to anti‐cancer treatment for breast cancer) can reduce pain, fractures and other bone problems. Women and men with advanced breast cancer (ABC) commonly develop bone metastases. Cancer in bones can cause pain, fractures, hypercalcaemia (too much calcium in the blood) and tumour compression of the spinal cord, resulting in serious and permanent nerve damage. This is because cancer deposits can erode into bone using bone‐absorbing cells. Bisphosphonates, and the more recent novel targeted‐therapy denosumab, are drugs that reduce the activity of these bone‐absorbing cells. This review of trials in women with advanced BCBM found that the use of bisphosphonates or denosumab (in addition to their other cancer treatments), can reduce these serious bone problems. It is of great interest to see if bisphosphonates prevent recurrence and improve survival for patients who have been treated for early breast cancer (EBC). However, this review of trials in women with EBC has not identified a benefit of bisphosphonates as an adjuvant therapy at this stage. We have to wait for the reporting of a number of large clinical trials before firm conclusions can be made. Adverse effects are not common for bisphosphonates and include mild gut reactions, transient fever, hypocalcaemia and a small risk of osteonecrosis of the jaw (ONJ), depending on which drug is used. Denosumab appears to be at least as well tolerated as the bisphosphonates.

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Summaries for consumers

Easing of bone pain caused by metastatic cancer: single versus multifraction radiotherapy

The spread of tumour to the bone (metastasis) is a common characteristic of many malignancies including cancers of the prostate, breast and lung. This may be associated with pain, compression of the spinal cord and the potential for bone fracture. Radiotherapy is used to treat bone metastases, however, the optimum treatment schedule is unclear. This review compares whether a single fraction of radiotherapy is better than multifractions of radiotherapy for alleviating the symptoms associated with tumours that have spread to the bone. Eleven randomised trials were identified in the published literature that compared single versus multifraction radiotherapy for bone metastases. Pooled analysis of these trials suggested that single fraction radiotherapy was as effective as multifraction radiotherapy in controlling bone pain. However, there were more bone fractures in patients treated by single fraction radiotherapy, and they received further treatment sessions more often than those receiving multifraction radiotherapy.

Bone agents for breast cancer

When breast cancer (BC) has spread to the bones (bone metastases, BM), bone agents (added to anti‐cancer treatment for breast cancer) can reduce pain, fractures and other bone problems. Women and men with advanced breast cancer (ABC) commonly develop bone metastases. Cancer in bones can cause pain, fractures, hypercalcaemia (too much calcium in the blood) and tumour compression of the spinal cord, resulting in serious and permanent nerve damage. This is because cancer deposits can erode into bone using bone‐absorbing cells. Bisphosphonates, and the more recent novel targeted‐therapy denosumab, are drugs that reduce the activity of these bone‐absorbing cells. This review of trials in women with advanced BCBM found that the use of bisphosphonates or denosumab (in addition to their other cancer treatments), can reduce these serious bone problems. It is of great interest to see if bisphosphonates prevent recurrence and improve survival for patients who have been treated for early breast cancer (EBC). However, this review of trials in women with EBC has not identified a benefit of bisphosphonates as an adjuvant therapy at this stage. We have to wait for the reporting of a number of large clinical trials before firm conclusions can be made. Adverse effects are not common for bisphosphonates and include mild gut reactions, transient fever, hypocalcaemia and a small risk of osteonecrosis of the jaw (ONJ), depending on which drug is used. Denosumab appears to be at least as well tolerated as the bisphosphonates.

Calcitonin used to treat metastatic bone pain

People who have cancer which has spread to their bones and the nerves adjacent to the bones often suffer severe pain. There are several treatments to help relieve this pain: radiotherapy, analgesic drugs (pain killers) such as opioids, and bone‐modulating drugs such as bisphosphonates and calcitonin. Calcitonin has the potential to relieve pain and maintain bone strength, thus reducing the risk of broken bones. This review looked at the effectiveness of calcitonin for controlling pain from bone metastases. However, only two studies were found with very low quality evidence to support the use of calcitonin for patients suffering from bone pain. We updated the review in 2015 and did not find any more studies. There were slightly more side effects for the patients given calcitonin. Unless new studies provide additional relevant information about this treatment, other therapeutic approaches should be considered.

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Terms to know

Bone
A living, growing tissue made mostly of collagen.
Ewing Sarcoma
A type of cancer that forms in bone or soft tissue.
Malignant Fibrous Histiocytoma (MFH)
A soft tissue sarcoma that usually occurs in the limbs, most commonly the legs, and may also occur in the abdomen.
Metastasis
The spread of cancer from one part of the body to another.
Osteosarcoma
A cancer of the bone that usually affects the large bones of the arm or leg. It occurs most commonly in young people and affects more males than females.
Primary Cancer
Site where the original tumor is located. Primary cancer is usually named after the organ in which it starts. For example, cancer that starts in the breast is always breast cancer even if it spreads (metastasizes) to other organs such as bones or lungs.
Sarcoma
A cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

More about Bone Cancer

Photo of an adult woman

Also called: Bone tumour, Cancer of the bone

Other terms to know: See all 7
Bone, Ewing Sarcoma, Malignant Fibrous Histiocytoma (MFH)

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