Bone cancer

Doctors often refer to bone cancer as bone sarcoma. Below are three of the more common types of bone cancer:

• Osteosarcoma– this is the most common type of bone cancer and primarily affects children and young adults.2 It usually starts in cells that grow bone tissue.
• Chondrosarcoma– this cancer usually starts in bone cells that grow cartilage but can also start in soft tissue near the bones.
• Ewing sarcoma– a cancer that usually starts cells in the bone and can also occur in the soft tissue in the chest, abdomen or other parts of the body.

A common symptom of bone cancer is pain or tenderness in the bones or joints, which may worsen while sleeping or during movement. Other symptoms may include but are not limited to:

• swelling
• unintended weight loss
• fatigue
• a fracture caused by weakened bones

Having any of these symptoms doesn’t mean you have bone cancer, but you should see your doctor for a check-up.

There is no clear cause of bone cancer. However, some factors appear to increase the risk. These include:

• inherited genetic conditions, like Li-Fraumeni syndrome and hereditary retinoblastoma²
• Paget’s disease or other bone conditions²
• radiation therapy for cancer during childhood²

Treatment for bone cancer will depend on the type of cancer, how advanced it is and your individual circumstances and preferences. Treatments may include one or a combination of:

• Chemotherapy
• Radiation therapy
• Surgery

Whether you experience side effects, and how severe they are, depends on the type and dose of chemotherapy treatment you are given and your reaction from one treatment cycle to the next. Most side effects are short-term and can be managed. These may include but are not limited to:

• fatigue
• nausea or vomiting
• constipation or diarrhoea
• hair loss
• temporary loss of libido
• temporary loss of erection
• lower sperm production

These symptoms tend to improve gradually once treatment stops. Talk to your doctor or nurse if you feel upset or anxious about how long treatment is taking or the impact of side effects.

• Get as much rest as possible
• Aim for a wholefood, varied diet, but we also encourage you to eat foods that interest you rather than what you think you should eat
• Appetite changes are common, and you may experience taste changes or nausea. Help manage this by eating small, frequent snacks and avoiding smells that make you nauseated
• Drink lots of water
• Reach out to support groups and others who have had chemotherapy
• Ask your team about topical treatments for your skin if you have irritation or pain
• Stay out of the sun as much as possible throughout your treatment
• Record your side effects in a diary or journal
• Take some gentle exercise, such as walking, if you feel up to it. Light to moderate exercise can reduce treatment-related fatigue and improve your mood. Plan your exercise for times in the day when you know you have more energy
• It is important to acknowledge when you are fatigued and rest when you need to
• Ask for and accept help from family, friends and neighbours
• Be open with employers about your treatment and discuss flexible working options if you need them

General side effects include:

• soreness and swelling around the treatment area
• tiredness and lethargy for a few weeks after you finish
•  hair loss
• nausea
• diarrhoea

Most of these side effects will ease soon after treatment is finished. However, your team will discuss any long-term considerations with you, depending on the tumour type.

Your doctor will talk to you about any risks before surgery. General side effects of bone surgery include pain and swelling.

References

1. Australian Institute of Health and Welfare, Cancer in Australia; 2019. https://www.aihw.gov.au/getmedia/8c9fcf52-0055-41a0-96d9-f81b0feb98cf/aihw-can-123.pdf.aspx?inline=true
2. Brown HK et al. Biology of Bone Sarcomas and New Therapeutic Developments. Calcif Tissue Int; 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805807/