Bone Tumours
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Key Takeaways
- Bone tumours are abnormal growths that can grow on any bone. Most bone tumours are non-cancerous, though there is still a risk of malignant (cancerous) bone tumours.
- Not all bone tumour cases cause symptoms and may only present themselves much later.
- Bone tumour treatment depends on the type of bone tumour. Malignant bone tumours may require a multi-disciplinary treatment plan, including radiotherapy and surgery.
What are Bone Tumours?
Bone tumours are abnormal growths found within any bone in your skeletal system. However, bone tumours may typically be found on the larger bones in your body, including the femur, tibia, humerus, ribs, spine, and pelvis. In most cases, bone tumours are benign (non-cancerous) and will usually go away after some time, even without non-surgical interventions. However, some bone tumours can be malignant (cancerous) and can cause various complications that are detrimental to your health.
Benign Bone Tumours
Benign bone tumours are the most common type and are typically non-threatening. They can be found in people under the age of 30, including children, whose skeletons are still developing. Benign bone tumours can come in various forms, including:
- Enchondromas, which typically start in the cartilage within bone.
- Chondroblastomas, which affects the joint end of bones in children and young adults.
- Osteochondromas, which mainly appears during childhood or adolescence on bones near the developing cartilage tissue called growth plates.
Malignant Bone Tumours
Malignant bone tumours are rarer than benign ones but are more dangerous to your well-being. These are cancerous and can spread to other parts of your body via the blood stream or through lymph vessels. They are divided between primary and secondary tumours.
- Primary: These bone tumours start primarily in the bone. The most common one is multiple myeloma, which affects the bone marrow.
- Secondary: These tumour lesions start somewhere else in the body before spreading or metastasizing to the bone.
What Causes Bone Tumours?
The exact cause of bone tumours is still unknown. What is known is that they can divide uncontrollably, gradually replacing normal bone tissue with abnormal tissue and potentially weakening the bone itself.
Symptoms of Bone Tumours
Symptoms may vary depending on the type of bone tumour you might have. In most cases, the most common symptom is pain or discomfort (and noticeable swelling) where the bone tumour is growing, especially if you apply pressure on it or at night when the pain suddenly intensifies. Some other symptoms that may appear include infrequent fevers or night sweats.
Some people report feeling a dull ache initially before the pain sets in, while others report no symptoms but will still notice a “new mass of tissue” where the bone tumour grows. A bone tumour may also be found incidentally during a routine medical check-up.
How to Diagnose Bone Tumours
Diagnosing with a Physical Examination
Your doctor will perform a physical examination to determine whether you have bony tenderness. In addition to taking your medical history, including any family history of tumours or cancers, they will carefully assess the affected area where you exhibit symptoms, for swelling or tenderness. Additional checks may be helpful to rule out the possibility of other bone tumour growths in different regions of your body.
Diagnosing with Imaging Tests
Additional tests can help confirm the diagnosis, especially if the physical exam does not give a satisfactory result. These imaging tests can accurately determine the presence or absence of bone tumours or whether another condition may be present.
- X-ray scan: X-ray scans provide a clear picture of bone, allowing the doctor to look for any sign of bone tumours affecting the bone.
- Computerised tomography (CT) scan: A CT scan creates a 3D image of your internal bony structures to accurately diagnose bone tumours.
- Magnetic resonance imaging (MRI): This diagnostic test allows your doctor to examine your cartilage and deeper areas of your body to look for signs of bone tumours or to determine whether a secondary tumour has spread to other areas.
- Needle biopsy: Your doctor inserts a needle into the area with the bone tumour (after applying local anaesthetic), removing small bits of tissue for laboratory testing.
- Open biopsy: Your doctor performs this test during surgery, where you will be given general anaesthesia to put you to sleep while the doctor surgically removes tissue for laboratory testing.
How to Treat Bone Tumours
Non-surgical treatment methods are the best way to treat benign bone tumours. For more severe cases, especially malignant bone tumours, more extensive treatment methods will be needed to treat the cancer-affected regions in your body.
Treating Benign Bone Tumours
In most cases, your doctor will adopt a watchful waiting approach. They will closely monitor the benign bone tumour’s condition via regular checkups to ensure it does not exhibit signs of malignancy. For many people, a benign bone tumour does not present any symptoms and disappears after some time, with or without medical support. Others may have some mild symptoms but nothing too significant, that it interferes with daily activities.
If necessary, your doctor may recommend a wide excision, a surgical method that removes the bone tumour and some healthy tissue surrounding it to prevent further complications. They will examine the excised tissue to determine if the benign bone tumour may be malignant or have traces of cancerous cells. A positive result means that further treatment is necessary to prevent the cancerous cells from spreading to other areas of your body.
Treating Malignant Bone Tumours
Treatment for malignant bone tumours will require a multi-disciplinary approach to ensure the best possible outcomes for your treatment. Depending on whether you have a primary or secondary bone tumour and the extent of the cancer’s spread in your body, you will need a combination of treatments, such as chemotherapy and radiotherapy, as well as surgery to remove the bone tumour.
Treatment via Chemotherapy
This method uses medical drugs to kill cancerous cells and prevent them from spreading. It can be given in various ways, such as intravenous infusions, injections, or oral medications. While potent, it can also potentially cause side effects.
Treatment via Radiotherapy
Radiation therapy is a cancer treatment method that uses intense beams of X-rays to kill cancerous cells and prevent them from spreading. It is a precise treatment method that focuses the X-rays on the bone tumour, ensuring that the therapy does not affect the surrounding healthy tissue and organs. The good news is that healthy cells can still repair themselves even if exposed to radiation, but radiotherapy can still cause side effects during or after treatment.
Treatment via Limb Salvage Surgery
Limb salvage surgery involves surgically removing the bone tumour and surrounding cancerous tissues without damaging nearby blood vessels, nerves, muscles, and other structures. The procedure is essentially a wide excision, which also involves replacing the excised area with a bone graft or artificial implant.
Treatment via Amputation
For severe cases where the malignant bone tumour has spread to a significant section of your arm or leg, your surgeon may need to amputate the entire limb to mitigate the damage caused by these cancerous cells. A prosthesis will be provided to replace the amputated limb, and you will undergo physiotherapy sessions to get used to the prosthesis.
Can You Prevent Bone Tumours?
Further studies are needed to understand what causes bone tumours, so while preventive measures are not set in stone, early screenings can detect bone tumours early to ensure you get the necessary medical attention. Benign bone tumours will go away after some time, either with or without medical intervention, but there remains a risk that they will become malignant, which can potentially spread to other parts of your body. If you have any doubts or concerns, speak to an orthopaedic specialist immediately to help you allay your worries and ensure a robust treatment plan to ensure positive recovery outcomes.
Even after successful treatment, follow-up checks can ensure that bone tumours no longer form and cause further complications. Be sure to maintain a healthy and active lifestyle to help minimise your risk of bone tumours.
Getting Professional Medical Attention
If you suspect a bone tumour, visit our orthopaedic specialists at Avant Orthopaedics for a prompt medical diagnosis to determine whether you have a benign or malignant bone tumour. Contact us to book an appointment and receive personalised care, where we will diagnose your condition and recommend the best course of action.
Frequently Asked Questions (FAQ)
Malignant bone tumours can be considered as a form of bone cancer, as they can metastasise to spread cancerous cells to other areas of your body. Benign bone tumours are non-cancerous, but there is still a small risk of becoming malignant.
Even without treatment, the exact reasons why bone tumours disappear are still unknown, and medical scientists are still working hard to learn more about them.
In some cases, a person may not exhibit any symptoms even if a bone tumour grows on one of their bones. Whatever the symptoms are, they only suggest that there may be a bone tumour, which may either be benign or malignant. A thorough medical examination will reveal the type of bone tumour.
Related Conditions
Fractures and dislocations are common injuries caused by trauma, falls, or accidents that affect bones and joints. A fracture refers to a break or crack in a bone, while a dislocation occurs when bones in a joint are forced out of position. Symptoms include pain, swelling, deformity, and limited mobility. Diagnosis involves physical examinations and imaging tests such as X-rays or MRI scans. Treatment varies depending on severity, including immobilisation, the PRICE method, or surgery such as open reduction and internal fixation. Proper care, rehabilitation, and preventive measures like regular exercise, bone screening, and a healthy diet support recovery and help prevent future injuries.
Ligaments are strong, fibrous connective tissue that binds your bones together across joints. They help to stabilize and support your joints and keep your bones in place. When a ligament around your joint is partially injured, it is a sprain. If it’s completely injured and loses fibres continuity, it is termed a rupture. Ligament sprains are common injuries and can happen to anyone.
