Bone-Cancer-Treatment
Bone Cancer Treatment

Bone cancer can refer to either primary bone cancer or secondary bone cancer, and the two types are completely different. Cancer that starts in the bones is called primary bone cancer. Secondary (metastatic) bone cancer refers to cancer that begins elsewhere in the body and has spread to the bones. Primary bone cancer is rare, whereas secondary bone cancer is more common, often named after the primary site where it originated, such as lung cancer with secondary bone involvement.

What are the most common types of bone cancer?

There are more than 30 different types of primary bone cancer, also known as bone sarcoma. The form of bone cancer varies according to the type of cells that begin to grow malignantly. The most common types of sarcoma include:
Osteosarcoma starts in the cells that form bone tissue.
Chondrosarcoma begins in the cells that form cartilage.
Ewing's sarcoma affects the cells in the bones or soft tissues that proliferate rapidly.

The difference between sarcoma and cancer:

Cancerous tumors form in cells or tissues lining internal organs such as the kidneys and liver. Meanwhile, tumors in the bones and soft tissues, such as muscles, tendons, and blood vessels, are called sarcomas. Sarcomas can be classified as benign or malignant. Benign sarcomas are non-cancerous tumors and are 100 times more common than their malignant counterparts.

Can a benign bone tumor turn into cancer?

Yes, but this is not common. However, individuals with benign bone tumors may require treatment to reduce the risk of other issues, such as weakened bones, joint problems, and destruction of healthy bone tissue.

Sarcoma cancer in children:

Sarcoma cancer primarily targets children and is a rare type of cancer that affects the bones or surrounding tissues. It is considered one of the most aggressive types of cancer because it targets children during their bone growth phase, as well as individuals under 20. Adults rarely develop this type compared to children.
Sarcoma can affect long, large bones such as the femur, leg, and arm, and in rare cases, it may appear in other bones. Its symptoms can sometimes resemble those of inflammation, so doctors require clinical examinations to confirm the presence of a tumor and rule out inflammation.
Like any other type of cancer, early detection of sarcoma facilitates treatment, while advanced stages, especially metastatic stages, become more difficult to manage. At Warith International Cancer Institute (WICI), there is a specialized clinic for treating sarcomas in the limbs and bone tumors anywhere in the body. This sarcoma treatment clinic provides a comprehensive medical team from various specialties to monitor patients throughout their treatment journey and ensure continuous progress. Additionally, psychological support is offered to patients, especially children, to help them through this challenging time.

What are the symptoms of bone cancer?

When studying the symptoms of bone cancer in men, women, and children, the most common symptom of bone tumors is pain, which includes bone and joint pain that may worsen at night or during activity. Other effects of bone cancer may include:
Swelling in the affected area of the bone.
Bone stiffness.
Mobility problems.
Unexplained weight loss.
A broken bone.
Loss of sensation in the affected limb.
Fatigue.
Early symptoms of bone cancer include pain in the affected bone, which gradually develops into persistent pain or pain that comes and goes, especially at night and during rest. This pain is one of the key symptoms of bone cancer in children.

Symptoms in various body areas:

Symptoms of bone cancer in the pelvis: Bone cancer in the pelvis can cause pain, swelling, reduced mobility, and limping, significantly affecting the individual's quality of life.
Symptoms of bone cancer in the leg: Symptoms in the leg include pain, swelling, and fractures due to weakened bones, leading to mobility issues and limping.
Symptoms of bone cancer in the foot: Common symptoms in the ankle and foot include lumps, swelling, fractures, joint pain, and general pain.
Symptoms of bone cancer in the back: When back pain is caused by a tumor in the spine, it typically starts gradually and worsens over time. The pain does not improve with rest and may intensify at night, manifesting as sharp or shock-like pain in the upper or lower back, potentially radiating to the legs, chest, or other areas of the body.
Symptoms of knee cancer: The most common symptoms include:
o Bone Pain: Pain may start intermittently and worsen at night. Over time, it can become constant and increase with activity, causing some individuals to limp.
o Swelling: Swelling develops after the person has already experienced pain in the knee area. In some cases, a visible lump may form.
o Fractures: Although bone cancer can weaken the knee bones, knee fractures are rare.
o Additionally, individuals may experience general symptoms such as fatigue and weight loss.
Symptoms of bone cancer in the shoulder:
o A firm lump may be felt in the shoulder area. This lump appears without injury and typically increases in size over time, potentially being painful or painless.
o Shoulder bone pain is a common symptom, initially intermittent but becomes continuous and increasing with movement, affecting work and daily activities.
o Minor fractures in the shoulder can occur as shoulder cancer makes bones brittle.
o Tumors around the shoulder joint can cause swelling, pain, and restricted range of motion.
Symptoms of bone cancer in the thigh, arm, and hand generally do not differ from those mentioned above.

Causes of bone cancer:

Several factors can increase the risk of developing bone cancer, including:
Previous radiation therapy, especially for individuals who received high doses at a young age.
Other bone conditions, such as Paget's disease.
Genetic factors, including inherited syndromes and a strong family history of certain cancers. Thus, genetics represent one of the main causes of bone cancer in children.

How long does it take for bone cancer to spread?

The rate of spread of bone cancer depends on the grade of the cancer, where higher-grade cancers tend to spread more rapidly. The size and location of the tumor, as well as the patient's age and overall health, also affect the rate of spread.
Unlike malignant tumors, benign bone tumors generally do not spread. Symptoms of benign bone tumors appear when they grow and exert pressure on surrounding organs. Benign bone tumors do not have the same ability to invade other tissues or metastasize to distant parts of the body.

The difference between bone cancer and bone marrow cancer:

Bone marrow cancer (Multiple Myeloma) is a type of blood cancer that affects plasma cells in the bone marrow. It is characterized by the abnormal proliferation of plasma cells, leading to various types of bone marrow cancer.
The causes of bone marrow cancer are unknown. It may relate to exposure to certain chemicals, high levels of radiation, and viruses (such as HIV), which increase the risk of developing bone marrow tumors.

Symptoms of bone marrow cancer include:

Bone fractures.
Bone pain, often in the ribs or lower back.
Increased infections.
Kidney damage.
Elevated calcium levels in the blood.
Unexplained bleeding.
Weakness.

Bone cancer diagnosis:

Warith International Cancer Institute in Iraq prioritizes optimal diagnosis using the following tests to determine bone cancer:
Blood tests: Blood tests include a complete blood count to check overall health.
X-rays: X-rays are used to examine the bones for any damage.
Computed Tomography (CT): This test uses X-rays and computer technology to create three-dimensional images of the body's interior, revealing any bone irregularities.
Magnetic Resonance Imaging (MRI): MRI scans create images of your body that help highlight any bone irregularities.
Biopsy: This involves removing some cells and tissue from the affected bone for microscopic examination.

After a bone cancer diagnosis:

If cancer is detected, the best oncologists in Iraq will determine the grade and stage of the cancer. The grading indicates how quickly the tumor is growing, while the staging describes how far the cancer has spread.
At the Warith International Cancer Institute's laboratory in Iraq, the histopathology department offers immunohistochemical stains (IHC) provided by internationally accredited companies. These stains are crucial for achieving an accurate diagnosis of bone tumors and sarcomas, as they help assess tumor grade and determine treatment options. Notably, these stains are available free of charge for children under the age of fifteen, just like other treatment services.

What are the stages of bone cancer?

The stage of a tumor is determined by its size and location, as well as whether the cancer has spread to other areas. Primary bone cancer is classified into four stages:
Stage 1: The tumor is low-grade, and cancer cells are still localized.
Stage 2: Cancer cells remain localized, but the tumor is high-grade.
Stage 3: The tumor is high-grade and has spread to other bones.
Stage 4: Cancer has spread from the bones to other organs, such as the liver or lungs.

Bone cancer treatment in Iraq:

The treatment of bone cancer involves a range of techniques. Primary bone cancer can be treated with surgery, chemotherapy, radiation therapy, or a combination of these treatments, which vary in type and duration from patient to patient based on the type of bone cancer, tumor size, and whether it has spread to other parts of the body. The most commonly used treatments include:

1- Limb preservation surgery:

Surgery to remove the cancer while preserving the limb is one of the most common types of surgeries for bone cancer at the best cancer treatment center in Iraq. Under general anesthesia, the surgeon removes the affected part of the bone where the cancer is growing, along with some surrounding healthy tissue. The removed bone is replaced either with a prosthesis or with bone grafts, using a healthy piece of bone from another part of the body to replace the excised bone.

2- Chemotherapy for bone cancer:

Chemotherapy drugs are used to destroy or damage cancer cells orally or injectable. For certain types of bone cancer, chemotherapy can be used alongside surgery either to shrink the tumor before surgery or after surgery to kill any remaining cancer cells. Chemotherapy can also be used as a form of palliative care to stop growth or control symptoms of advanced cancer.

3- Radiation therapy for bone cancer:

Radiation therapy uses high-energy rays to destroy or damage cancer cells. It can be given before surgery to help make the surgery easier and safer by shrinking the tumor, or after surgery to reduce the chance of cancer cells regrowing.

4- Hormonal therapy for bone cancer:

Hormonal therapy can be used to treat breast or prostate cancer that has spread to the bones. The goal of this treatment is to lower hormone levels in the body or prevent hormones from reaching cancer cells, thereby starving the cancer cells that need hormones to grow.

5-Minimally invasive procedures for bone cancer treatment:

Thermal or cryoablation techniques are used to treat bone tumors without traditional surgery. This technique uses imaging guidance, such as ultrasound, MRI, or CT scans, to pass a needle or probe through the skin to the bone tumor to destroy tumor cells instead of surgically removing it. 
Some methods used in the ablation of bone tumors include:
Cryoablation: In this method, a thin metal probe is directed to the bone tumor, and extremely cold temperatures are passed through the probe to freeze the tumor and cause cancer cell death.
Radiofrequency Ablation (RFA): This is one of the more common ablation methods where a needle or probe is passed through the skin to the bone tumor, and high-frequency electrical currents are transferred through the probe or electrode in the needle to heat the tumor and destroy cancer cells.
Microwave Ablation (MWA): This method is similar to RFA and uses energy from electromagnetic or microwave waves to heat and destroy the bone tumor using a probe.

Early detection of bone cancer:

Currently, there are no widely recommended screening tests for bone cancer in individuals without symptoms. However, most bone cancers are detected early, before they have spread to other parts of the body, as symptoms like bone pain or swelling prompt individuals to seek medical examination.
Doctors recommend careful monitoring for certain individuals at increased risk of bone cancer due to specific bone conditions. Monitoring early symptoms can sometimes be helpful in detecting bone cancer early and treating it successfully.

Can bone cancer be prevented?

As experts do not fully understand the causes of bone cancer, there is currently no known way to prevent it. It can be difficult to completely avoid bone cancer, as radiation therapy (another known cause of bone cancer) is essential for treating other types of cancer.

Is bone cancer curable?

Many cases of bone cancer are successfully treated. In these cases, the cancer never returns, and the individual is completely cured of bone cancer. Sometimes, patients may require multiple surgeries to achieve this outcome. Other individuals with bone cancer may need to continue treatment, including radiation and chemotherapy, to prevent the cancer from spreading.
It is important to follow up regularly with the best cancer doctors in Iraq to increase the chances of recovery from secondary bone cancer and to look for signs of recurrence or spread. The earlier a recurrence is detected, the quicker treatment can begin, leading to better outcomes for bone cancer.

Does bone cancer lead to death?

Not usually. While some individuals may die from bone cancer, many others recover completely by seeking treatment at the best institution in Iraq. Several cases have been cured of bone cancer at Warith International Cancer Institute (WICI), so we advise you to seek treatment at the best cancer institution in Iraq instead of traveling abroad far from your family, even if you have the most serious types of bone cancer.

How long does a bone cancer patient live?

Many people with bone cancer undergo successful treatment and continue to live fulfilling lives. Those diagnosed with early-stage bone cancer have a better chance of complete recovery. When bone cancer is detected later, survival rates decrease.
A team of experts from Oxford University, led by British doctor Duncan Whittle, is present at the Warith International Cancer Institute. The latest treatment technologies for bone tumors are being utilized, and these techniques are available for the first time in Iraq. Thanks to this advancement, individuals with bone tumors can receive treatment that helps them preserve their limbs without resorting to amputation.