Bone Tumors and associated Fractures: How We Deal with Them

A tumour is a lump of tissues formed by abnormal or uncontrollable cell division in the body. Bone tumour are associated with the skeletal system. As tumour tissues grow, they can invade and replace the healthy tissues in the body. Sometimes these tissues can cause cancer, and sometimes not, but they must be treated properly and in good time to avoid uncontrolled and extensive growth. If not treated in a timely fashion, cancer can spread to the whole body (called Metastasis). There may be numerous reasons causing bone tumours, for example :

• Inherited conditions ( gene or chromosomal defects )
• Environmental or dietary toxins / poisons
• Smoking or some recreational drugs
• Immune system suppression due to other illness or drugs
• Radiation dose

To the lay person, it is not easy to diagnose a bone tumour. However, certain ‘classical’ symptoms may appear in the case of bone tumour, such as :

• You might feel pain in the tumour area.
• Progressive weight loss, tiredness and loss of apetite
• You might wake up at night ( nocturnal pain )
• Pathological fractures ( the bone breaks with even little activity )
• The best way is to consult your doctor (if you have these symptoms) as soon as possible. Your doctor may ask you about the symptoms and may take a few image tests, for example, Bone scans, CT scans, X-rays, or MRI scans.

He / She  might order certain other tests like the blood tests and the urine tests to properly diagnose the disease.

There are a special group of fractures caused by bone tumours. These fractures are called pathological fractures. The bone tumour typically grows into the bone and makes it weaker and more brittle, therefore more likely to break. Pathological fractures are most commonly caused by spreading cancer cells ( metastatic  deposits )

There are two primary types of bone tumours :

• Malignant bone fracture

This is the worst type of bone tumour and is cancerous in nature. They are relatively rare but more fatal than the benign types. The term Malignant means that there is a strong possibility that the tumour will spread more beyond the place where it develops initially. It can spread throughout the body through the blood cells and the bone network unless it is treated properly. It may also damage the lungs other than the bones. It may occur at almost any age in life. Typical examples of malignant bone tumours include :

• Chondrosarcoma

When the growing cartilage cells get out of control in the human body, it is called chondrosarcoma. It is a special type of bone tumour that affects cartilage cells that line the joints and are responsible for the safety of bone ends. It is commoner in adults. The scientists are still struggling to know the exact cause of chondrosarcoma, but at this time, it remains unknown.

It its worst type, it requires a long and protracted treatment regimen. It is mandatory to remove the tumour completely. The doctors, in this case, prefer limb Salvage surgery. Typically, radiation or chemotherapy alone is not enough in this case.

• Ewing’s sarcoma

Like chondrosarcoma, this tumour also affects cartilage cells, but it is very rare. Unlike chondrosarcoma, there are higher chances of being cured of this type of bone tumour. It can affect both children and adults equally.

In the case of many bone tumour conditions like Ewing’s sarcoma, a multi-disciplinary team works on the patient. It is important that the patient must be seen by radiologists, pathologists, surgeons, and radiation oncologists. A proper plan is made by the doctors keeping in view certain factors like the stage of the disease, the age of the patient, and the best resources available.

• Neuroblastoma (NB) 

Neuroblastomas are caused by genetic conditions or genetic mutations. It usually occurs at a very early age, for example, in children under five years old. This type of bone tumour requires a detailed check-up. In the worst conditions, the patient may undergo surgery, stem cell transplant, or chemotherapy therapy.

• Benign bone fracture

These bone tumours are non-invasive and do not spread all over the body ( unlike sarcomas for example ). However, they can still be dangerous because of their local growth effect and still warrant being treated on time. Benign bone fractures oftenaffect relatively bigger bones like the pelvis, arm bones, thigh bones, etc. There are various examplesin the Benign bone tumourcategory like;

• Multiple myeloma

In the case of Multiple Myeloma, the body produces abnormal proteins that further the results into various problems and complications.

Multiple myeloma is found in older adults. It affects the bone marrow most of the time. It affects the plasma cells, which help you to fight against germs by creating antibodies. Multiple treatments are available in the case of multiple myeloma. A Haematological and Oncological consultation is an important first step in its treatment.

• Osteoid Osteoma

Osteoid osteoma is a less aggressive benign bone tumour. Unlike the others, it is a very small tumour. Anyone may be affected by it and they may feel some pain at night. It is very easy to diagnose and treat. The treatment plan is determined by the doctor depending upon the size of the tumour. Usually, a small surgical excision is enough if the size of the tumour is not very big.

The above is a quick snap-shot summary of bone tumours. If you want to know more and clarify doubts about bone tumours, please reach out to Dr.GowreesonThevendran or visit www.orthofootMD.com.