Bone cancer

Signs and Symptoms

Bone cancer is accompanied by the following signs and symptoms:

• Dull, aching pain in the bone or joint
• Swelling or tenderness of the joints
• Fractures
• Fatigue, fever, weight loss, anemia
• Stiffness
• Decreased appetite and nausea
• Walking with a limp

Who Is Most At Risk?

People with the following conditions or characteristics may be at risk for developing multiple myeloma:

• Radiation exposure
• Exposure to petroleum products, benzene, herbicides, and insecticides
• Genetic factors
• Advanced age (over 65)
• African American descent (twice the risk of Caucasians)

People with the following conditions or characteristics may be at risk for developing osteosarcoma:

• Benign tumors and other bone diseases
• Radiation exposure
• Genetic factors
• Children, adolescents
• Males more than females

What to Expect at Your Provider's Office

If you have symptoms associated with bone cancer, you should see your health care provider. It's helpful to remember that many symptoms of bone cancer are also associated with other, less serious health conditions. In addition to taking a personal and family medical history, your health care provider may suggest a blood test to measure the level of alkaline phosphate, an enzyme that increases when a tumor causes production of abnormal bone tissue. X-rays and other imaging procedures can show the location, size, and shape of a bone tumor. New research suggests that combination positron emission tomography (PET) and computed tomography (CT) may be the most sensitive technique for detecting bone cancers. Not all tumors are cancer. A biopsy -- the removal of a sample of tissue from the bone tumor -- will reveal whether cancer is present.

Treatment Options

Treatment Plan

The treatment plan depends on the type, size, location, and stage of the cancer, as well as the patient's age and general health.

Drug Therapies

Your health care provider may prescribe the following therapies:

• For multiple myeloma -- Chemotherapy drugs, radiation treatment, medication for pain relief, and bisphosphonates (to protect the bone).
• For osteosarcoma -- Cytotoxic drugs.
• For pain -- biphosphonates and denosumals.

Surgical and Other Procedures

Surgery is usually performed after chemotherapy to shrink the tumor and reduce the risk of recurrence. If chemotherapy is not likely to alter the course of the cancer, surgery or amputation may be the first part of the treatment plan. With multiple myeloma, a physician may perform a bone marrow transplant. With bone sarcomas, surgery is usually the main treatment. In most cases, chemotherapy has made limb-sparing surgery possible and amputation unnecessary.

Complementary and Alternative Therapies

A comprehensive treatment plan for bone cancer may include a range of complementary and alternative therapies. Make sure to inform your health care provider about the herbs and supplements you are taking. Some supplements can interfere with conventional cancer therapies, so always work with a qualified health care professional, and tell all of your providers about every herb, supplement, medication, and treatment you are using.

Various nutrients and herbs may be beneficial in dealing with bone cancer. But many may also interfere with conventional treatment. Work with a physician who is trained in the use of natural therapies for cancer care, and keep all of your providers informed about any and all supplements or regimens you are considering.

Following these nutritional tips may help reduce symptoms:

• Eat a diet rich in whole foods with a focus on preserving your body weight with quality proteins, healthy fats, and carbohydrates. Your oncologist may be able to recommend a nutritionist who can design a personalized food plan for you.
• Use healthy cooking oils, such as olive oil or coconut oil.
• Reduce or eliminate trans-fatty acids, found in such commercially-baked goods, as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid caffeine and other stimulants, alcohol, and tobacco.
• Exercise, if possible, 5 days a week. Discuss an appropriate regimen with your doctor.
• Probiotic supplement (containing Lactobacillus acidophilus), 5 to 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Refrigerate your probiotic supplements for best results. In cases of severe immunosuppression or immunodeficiency, probiotics may not be appropriate. Speak with your doctor.
• Omega-3 fatty acids, such as fish oil, 1 to 2 capsules, or 1 tablespoon (15 mL) of oil, 1 to 2 times daily, to help reduce inflammation and enhance immunity. Cold-water fish, such as salmon or halibut, are good sources. Omega-3 supplements may increase the blood-thinning effects of certain medications, such as warfarin (Coumadin) and aspirin. Speak to your provider.

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of bone cancer based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual. You should only use homeopathic treatment, especially in the case of cancer, under the guidance of a licensed and certified homeopath.

• Arnica Montana. For a bruised sensation and restlessness.
• Bryonia. For fractures with stitching pains that are worse with the slightest movement.
• Eupatorium. For excruciating, aching bone pain that worsens with motion and is often accompanied by stiffness and chills.
• Symphytum. For fractures that heal poorly and are accompanied by persistent pain.

While acupuncture does not treat cancer, evidence suggests it can be a valuable therapy for cancer-related symptoms, particularly the nausea and vomiting that often accompany chemotherapy treatment. Studies show that acupuncture may help reduce pain and shortness of breath. Acupressure (pressing on rather than needling acupuncture points) may also help control breathlessness. Patients treat themselves using this technique.

Some acupuncturists prefer to work with a patient only after the completion of conventional medical cancer therapy. Others provide acupuncture or herbal therapy during active chemotherapy or radiation. Acupuncturists treat cancer patients based on an individualized assessment of the excesses and deficiencies of qi (energy) located in various meridians. In many cancer-related cases, a qi deficiency is detected in the spleen or kidney meridians.

Chiropractors will not perform spinal manipulation over areas of the body where bone cancer is present. But they may use this procedure over areas that are free of bone cancer in an attempt to relieve pain associated with the condition.

Prognosis/Possible Complications

Patients with multiple myeloma generally live for 15 months to 5 years. Complications may include heart attack, lung disease, diabetes, and stroke. With bone sarcomas, 65% to 75% of patients experience long-term survival, and almost everyone who is treated with limb-sparing surgery ends up with an arm or leg that is painless and works well. Potential complications include those arising from surgery and possible spread of the cancer to the lungs.

Following Up

Your health care provider will see you regularly to check for complications, and to make sure the cancer has not returned. You may have frequent CT scans of the lungs and bone scans and x-rays of the arm or leg to ensure the tumor hasn't come back or spread to the lungs.

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