Bone Cancer Symptom Guide

May 1, 2024

Bone cancer is a disease where a cancerous tumor develops in or around a bone that destroys healthy bone tissue. Primary bone cancer begins in any cells of the bone itself, while secondary bone cancer starts elsewhere in the body and spreads to the bones. There are four stages of bone cancer. Stage one is cancer that has not spread beyond the bone. Stage two is more aggressive cancer but has not spread beyond the bone. Stage three is where there are two or more cancerous places within the same bone. Stage four means cancer has spread past bone tissues to other parts of the body. While there is no clear cause of bone cancer, there are factors that increase an individual's risk including young age, previous radiation therapy, Paget's disease, familial bone cancer history, hereditary retinoblastoma, and Li-Fraumeni syndrome. While bone cancer signs differ by the bones affected, most bone cancers have several symptoms in common.

Pain In The Bones

Most bone cancer patients will experience pain in the bones due to malignant tumor growth. Bone pain feels like a deep or dull ache in the bone or a region such as the pelvis, ribs, back, legs, and arms. In the early stages of bone cancer, the affected individual may only feel pain when they are active, or during the night hours. As bone cancer progresses to advanced stages, the pain from the tumor becomes more persistent. A malignant bone tumor causes an individual to feel pain because the cancerous cells invade and disrupt the delicate balance of regular cellular activity in the bone, causing the bone tissue to become damaged. Healthy bone is continually being broken down, remodeled, and reconstructed. Malignant cells in the bone cause an interruption in this balance of action between the osteoblasts, cells that build the bone, and the osteoclasts, cells that break old bone down. The result is an excess of bone build-up or extensively weakened bone. The tumor or damage from the malignant mass can stretch the thick membrane covering the bone or the periosteum. The tumor can also stimulate specific nerves in the bone causing pain.

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Unexplained Weight Loss

Most individuals with bone cancer will experience unexplained weight loss, or they will lose body weight for no known reason. Patients with cancer lose weight from losses of fat tissue and muscle mass. Usually, an unexplained loss of ten pounds or more can be one of the first indicators of cancer. Malignant cells in the bone tumor can use up a disproportionate quantity of the patient's energy supply, taking away from other crucial cellular processes. Cancerous cells can secrete substances that change the entire mechanism of how the body processes energy from the food individuals consumed. Not only do the rapidly multiplying cancer cells use up more energy itself then other cells do, but they also use up more of the valuable nutrients absorbed from the food. Without the proper nutrients, the body is unable to carry out normal muscle building and fat storage processes. Other symptoms such as severe bone pain can cause a patient to lose their appetite and consume less food they usually would, which can also result in unexplained weight loss.

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Chronic Fatigue

Chronic fatigue is commonly associated with bone cancers because of the nature of their function. While bones have many structural functions, they are also responsible for creating new red blood cells in the bone marrow. A malignant tumor of the bone can cause a significant disruption in the healthy production of red blood cells, especially if it is located in a large bone like the femur or pelvis. When the body produces less red blood cells than it should, the condition is called anemia. Without enough red blood cells, the tissues around the body do not receive a sufficient amount of oxygen, and without adequate amounts of oxygen, the cells will struggle to carry out their designated functions and cause the patient to feel sluggish. In addition, cancerous tumors often produce substances such as tumor necrosis factor that cause an individual to feel tired. Other bone tumors can release toxic substances that inhibit healthy cells from producing chemicals in the body like calcium and potassium, which are essential for the proper function of the heart and muscles. When such chemical levels in the body are too low, patients will feel fatigued frequently.

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Weakened Bones

Some bone cancer patients present with weakened bones as a result of their malignancy. Healthy bone is consistently being broken down by specialized cells in the bone called osteoclasts, and other specialized cells called osteoblasts rebuild it. In order to maintain optimal bone strength and health, both processes are carefully calibrated and coordinated with each other. However, individuals with bone cancer experience an interruption in this healthy balance. Disruption of the osteoblast and osteoclast action balance can result in the breakdown of more bone than the body is able to replace. With bone loss, there is reduced density and calcification of the bones. The decrease in these characteristics causes the bones to become weaker than normal. Often times, the symptom of weakened bones will not be apparent until the patient experiences a fracture in the affected bone. An initial fracture due to weak bones is caused by minimal impact or a simple fall. Healthy bones are able to withstand considerable forces of impact, where weakened or low-density bones will fracture with from a simple bump.

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Swelling And Tenderness

Bone cancer may manifest in the form of swelling and tenderness in the area where the cancerous tumor is growing. Tenderness and swelling can be the result of one or more factors in bone cancer. When any cancer develops in the body, the immune system naturally deploys its defense mechanisms to fight off the cancerous cells. These defense mechanisms are what causes inflammation of the tissue around the tumor, or the swelling and redness. In addition, swelling and tenderness can occur because of where the growing tumor is located within the skeleton. A tumor that develops in the bones of or around the body's major joints can become sore and swollen due to regular use of the joint. When the bones that make up the joints cannot move normally and smoothly against each other because of a large mass, the tissues in the region will become irritated and may even incur damage. Damaged tissue stimulates the same immune system defense mechanisms for tissue repair that result in swelling, pain, and redness. Furthermore, the tumor itself may appear as swollen tissue on the exterior of the body before it manifests as a solid mass or lump in the affected area.

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