There are several forms of bone cancers, including osteosarcomas, chondrosarcomas, chordomas, Ewing's sarcoma and malignant fibrous histiocytoma, which are all rare, according to the American Cancer Society (ACS). Metastasized bone cancer is cancer that has spread beyond the point of origin in the bone to other organs or other bones in the body. Bone cancers mainly metastasize to the lungs and sometimes to the brain or liver, explains the American Cancer Society. Treatment choices in bone cancer depend on the type of cancer, the extent of spread, the age of the patient, state of health of the patient and the patient's preferences.
Surgery
Surgery is one option in the treatment of metastasized bone cancer. According to the ACS, limb sparing surgery can be attempted to remove the primary cancer mass, if possible. Where the tumor is extensive, amputation might be necessary. When the metastasis is in the lungs and not widespread, surgery might be attempted to remove the metastases.
Chemotherapy
According to the American Society of Clinical Oncologists (ASCO), chemotherapy is useful in metastatic bone cancer. Chemotherapy can be used before surgery as neo-adjuvant therapy to attempt to shrink the primary tumor mass and make surgical removal easier. It is also used after surgery, as adjuvant surgery to reduce the chances of recurrence where surgery is successful, and to treat the metastases in other organs. Drugs commonly used in chemotherapy for metastasized bone cancer include methotrexate, dactinomycin, ifosfamide, cyclophosphamide, doxorubicin, cisplatin and etoposide. They may be used in diverse combinations to increase the effectiveness of therapy.
Radiation Therapy
According to the ACS, radiation therapy, the use of high powered radiation to kill cancer cells or stop them from growing, is used in metastasized bone cancer in cases where the cancer cannot be surgically removed, even after chemotherapy. There are two approaches to radiation therapy: external radiation, using external sources of radiation and internal radiation, using implants and wires to introduce the radiation close to, or into, the cancer mass. According to the ACS, some bone cancers require high doses of radiation or a proton beam radiation. Intensity-modulated radiation therapy (IMRT), a form of external radiation may be used alone or in combination with proton beam radiation for certain tumors. Radiation is also used to slow the growth of advanced or metastasized bone cancers, and to relieve the pain and discomfort seen in terminal cases. It can be combined with chemotherapy for more effectiveness.
References
- American Cancer Society: What Are the Key Statistics About Bone Cancer?
- American Cancer Society: How Are Bone Cancers Staged?
- American Cancer Society: Treatment Based on the Extent of the Osteosarcoma
- American Society of Clinical Oncologists: Bone Cancer Treatment
- American Cancer Society: Treatment Choices by Stage of Bone Cancer
