Treatment Plan

Best Hospitals for Bone cancer treatment in India Treatment Plan

What is bone cancer?

Any cancer of the bone is referred to as bone cancer. Primarily there two types of bone cancers. They are true bone cancers that originate from the bone and metastatic bone cancers that have spread from other organs. Here we are going to discuss about both true bone cancers than bone cancers due to metastasis.

As we all know, bone forms the framework that support our body. Bones are made up of an outer core and an inner hollow where the bone marrow resides. At the end of the bone, is a soft bone like tissue called the cartilage. This acts as a cushion in joints, the area where one bone connects with another bone. The joints are stabilised by connective tissues like ligaments, tendons, fat tissue and muscles. Cancer can occur in any of these tissues, apart from cancers originating from the bone and cartilage cells.

Types of bone cancer:

Bone cancer can occur due to the spread or metastasis of cancer from other organs. These are more common than true bone cancers. There is a fundamental difference between metastatic bone cancer and true bone cancer. Metastatic bone cancer cells retain the original character of the cells from which the cancer has spread. If the cancer has spread from another organ, the bone cancer cells look and act like cancer cells of respective organs. Hence the treatment for these types of cancers is the same as that of the respective cancers. That is, a metastatic spread of a lung cancer to the bone should be treated like a lung cancer. This holds true for cancers from other cells as well. Bone cancers can be classified according to the tissue of origin.

Osteosarcomas are tumours that originate from the bone tissue. Chondrosarcomas originate from the cartilages. Ewings sarcoma are tumours of the nerve cells in the bone marrow.

Bone cancer risk factors:

Certain genetic disorders like Li-fraumeni syndrome, Rothmund-Thompson syndrome, Multiple exostoses syndrome

Certain diseases like Pagets disease, multiple endochromatosis

Previous history of radiotherapy

History of bone marrow transplantation

Bone cancer stages:

There are four stages of bone cancer. Each of these stages have certain sub stages as well.

Stage 1

The tumour is less than 8cm 

There is no lymph node involvement

Cancer is low grade

TNM Stage- T1N0M0G1

Stage 1b

The tumour is more than 8cm

The tumour can be seen in different parts of the same bone.

No lymph node involvement

TNM Stage-T2N0M0G2 0R T3N0M0G2

Stage 2a

Tumour is more than 8cm long

No lymph node involvement

No spread to distant sites

Tumour is aggressive or high grade

TNM Stage T1N0M0G2 or T2N0M0G2

Stage 2b

The cancer is more than 8 cm long

No lymph node involvement 

No distant spread

High grade tumour

TNM Stage T2N0M0G3 OR T3 N0M0G3

Stage 3 

Tumour is more than 10 cm 

Different parts of the bone are affected

No lymph node involvement 

No distant spread

High grade tumour

TNM STAGE T3N0M0G3

 Stage 4a

The tumour can be any size  

No lymph node involvement

Has spread only to the lungs

TNM STAGE T3N0M1Ag3

 Stage 4b

Tumour  can be any size

Has spread to surrounding lymph nodes

Has spread to other organs

TNM Stage any T, any N, M1 b and G3

Bone cancer signs and symptoms:

Some of the common symptoms of bone cancer are-

Pain ranging from mild to moderate to severe depending on the stage

swelling of the affected area

stiffness and swelling of the joints close to the affected area

fracture of the affected bone 

Some other general symptoms are:

Fever 

Weight loss

Malaise

Anemia

Diagnosis of bone cancer:

Apart from physical examination other diagnostic tests for bone cancer are:

Blood tests- In cases of osteosarcoma and Ewing sarcoma alkaline phosphatase levels are increased

Bone scan- is done with the help of a radioactive tracer. Normal bone appears gray while tumours appear dark.

CT scans, MRI scans, PET CT scans are very useful in determining the extent of the tumour. It also helps in the determination of soft tissue involvement.

Biopsy- this helps in accurately diagnosing the grade and type of tumour.

Bone cancer treatment in India:

As in other types of cancers treatment of bone cancer is also multidisciplinary. Surgery, chemotherapy, radiation therapy, as well as palliative treatment, are all used. 

Surgery-surgery for bone cancer involves the removal of the tumour along with a part of normal tissue. Wide excision surgery is the most preferred mode of treatment. This helps to eliminate the need for an amputation of the limbs. Reconstructive surgery after wide excision helps to restore the size and shape of the limbs. But amputations may be necessary if the bone cancer is not in an area that can be easily approached.

Chemotherapy-Chemotherapy destroys cancer cells by preventing their multiplication. High grade and fast growing tumours are treated with chemotherapy before surgery. The aim is to reduce the tumour size and to destroy metastatic deposits. Chemotherapy before surgery is referred to as neo-adjuvant chemotherapy. Chemotherapy may also be given after surgery to destroy any remnants of cancer. This type of chemotherapy is called as adjuvant chemotherapy.

Radiation therapy- Radiation therapy uses x-rays or other high energy rays to destroy cancer cells. External beam radiation therapy and brachytherapy using implantable radioactive devices are the common methods. Radiation therapy is used in cases of bone cancer where surgery is not feasible due to a variety of factors. It may also be used to shrink the tumours before surgery.

Palliative treatment aims to reduce the symptoms and to improve the quality of life. It uses medicines to relieve the pain. It also provides emotional and social support to the patients and their families to cope up with the situation.

Is bone cancer curable?

The chances of complete cure are much more if the cancer is detected very early. Treatments can bring about remission, but the periods may vary. If the condition is detected reasonably early, the bone cancer survival rate is estimated as five years.

Bone cancer treatment cost in India:

Bone cancer treatment is available in all major hospitals in India. The total cost of bone cancer treatment in India depends on the individual cost various treatment procedures involved like the chemotherapy, radiation, surgery as applicable 

 

What is bone cancer?

Any cancer of the bone is referred to as bone cancer. Primarily there two types of bone cancers. They are true bone cancers that originate from the bone and metastatic bone cancers that have spread from other organs. Here we are going to discuss about both true bone cancers than bone cancers due to metastasis.

As we all know, bone forms the framework that support our body. Bones are made up of an outer core and an inner hollow where the bone marrow resides. At the end of the bone, is a soft bone like tissue called the cartilage. This acts as a cushion in joints, the area where one bone connects with another bone. The joints are stabilised by connective tissues like ligaments, tendons, fat tissue and muscles. Cancer can occur in any of these tissues, apart from cancers originating from the bone and cartilage cells.

Types of bone cancer:

Bone cancer can occur due to the spread or metastasis of cancer from other organs. These are more common than true bone cancers. There is a fundamental difference between metastatic bone cancer and true bone cancer. Metastatic bone cancer cells retain the original character of the cells from which the cancer has spread. If the cancer has spread from another organ, the bone cancer cells look and act like cancer cells of respective organs. Hence the treatment for these types of cancers is the same as that of the respective cancers. That is, a metastatic spread of a lung cancer to the bone should be treated like a lung cancer. This holds true for cancers from other cells as well. Bone cancers can be classified according to the tissue of origin.

Osteosarcomas are tumours that originate from the bone tissue. Chondrosarcomas originate from the cartilages. Ewings sarcoma are tumours of the nerve cells in the bone marrow.

Bone cancer risk factors:

Certain genetic disorders like Li-fraumeni syndrome, Rothmund-Thompson syndrome, Multiple exostoses syndrome

Certain diseases like Pagets disease, multiple endochromatosis

Previous history of radiotherapy

History of bone marrow transplantation

Bone cancer stages:

There are four stages of bone cancer. Each of these stages have certain sub stages as well.

Stage 1

The tumour is less than 8cm 

There is no lymph node involvement

Cancer is low grade

TNM Stage- T1N0M0G1

Stage 1b

The tumour is more than 8cm

The tumour can be seen in different parts of the same bone.

No lymph node involvement

TNM Stage-T2N0M0G2 0R T3N0M0G2

Stage 2a

Tumour is more than 8cm long

No lymph node involvement

No spread to distant sites

Tumour is aggressive or high grade

TNM Stage T1N0M0G2 or T2N0M0G2

Stage 2b

The cancer is more than 8 cm long

No lymph node involvement 

No distant spread

High grade tumour

TNM Stage T2N0M0G3 OR T3 N0M0G3

Stage 3 

Tumour is more than 10 cm 

Different parts of the bone are affected

No lymph node involvement 

No distant spread

High grade tumour

TNM STAGE T3N0M0G3

 Stage 4a

The tumour can be any size  

No lymph node involvement

Has spread only to the lungs

TNM STAGE T3N0M1Ag3

 Stage 4b

Tumour  can be any size

Has spread to surrounding lymph nodes

Has spread to other organs

TNM Stage any T, any N, M1 b and G3

Bone cancer signs and symptoms:

Some of the common symptoms of bone cancer are-

Pain ranging from mild to moderate to severe depending on the stage

swelling of the affected area

stiffness and swelling of the joints close to the affected area

fracture of the affected bone 

Some other general symptoms are:

Fever 

Weight loss

Malaise

Anemia

Diagnosis of bone cancer:

Apart from physical examination other diagnostic tests for bone cancer are:

Blood tests- In cases of osteosarcoma and Ewing sarcoma alkaline phosphatase levels are increased

Bone scan- is done with the help of a radioactive tracer. Normal bone appears gray while tumours appear dark.

CT scans, MRI scans, PET CT scans are very useful in determining the extent of the tumour. It also helps in the determination of soft tissue involvement.

Biopsy- this helps in accurately diagnosing the grade and type of tumour.

Bone cancer treatment in India:

As in other types of cancers treatment of bone cancer is also multidisciplinary. Surgery, chemotherapy, radiation therapy, as well as palliative treatment, are all used. 

Surgery-surgery for bone cancer involves the removal of the tumour along with a part of normal tissue. Wide excision surgery is the most preferred mode of treatment. This helps to eliminate the need for an amputation of the limbs. Reconstructive surgery after wide excision helps to restore the size and shape of the limbs. But amputations may be necessary if the bone cancer is not in an area that can be easily approached.

Chemotherapy-Chemotherapy destroys cancer cells by preventing their multiplication. High grade and fast growing tumours are treated with chemotherapy before surgery. The aim is to reduce the tumour size and to destroy metastatic deposits. Chemotherapy before surgery is referred to as neo-adjuvant chemotherapy. Chemotherapy may also be given after surgery to destroy any remnants of cancer. This type of chemotherapy is called as adjuvant chemotherapy.

Radiation therapy- Radiation therapy uses x-rays or other high energy rays to destroy cancer cells. External beam radiation therapy and brachytherapy using implantable radioactive devices are the common methods. Radiation therapy is used in cases of bone cancer where surgery is not feasible due to a variety of factors. It may also be used to shrink the tumours before surgery.

Palliative treatment aims to reduce the symptoms and to improve the quality of life. It uses medicines to relieve the pain. It also provides emotional and social support to the patients and their families to cope up with the situation.

Is bone cancer curable?

The chances of complete cure are much more if the cancer is detected very early. Treatments can bring about remission, but the periods may vary. If the condition is detected reasonably early, the bone cancer survival rate is estimated as five years.

Bone cancer treatment cost in India:

Bone cancer treatment is available in all major hospitals in India. The total cost of bone cancer treatment in India depends on the individual cost various treatment procedures involved like the chemotherapy, radiation, surgery as applicable