Malignant Bone Tumours

Malignant Bone Tumours represent about 5% of cancers in childhood and adolescents. There are two major types of bone cancer; Osteogenic Sarcoma and Ewings Sarcoma.

These tumours are most often seen in adolescence when independence, self-esteem and body image are a high priority, so can have psychological effects.

Osteogenic Sarcoma

This is the most common type of bone tumour and usually appears between the ages of 10 and 25 years. It occurs commonly in the long bones, especially above or below the knee or in the upper arm.

The tumour usually develops at the ‘growing ‘end of the long bone and may become obvious because of swelling, pain, limp or a pain-free fracture.

Symptoms

Bone pain

Swelling

Local tenderness

Diagnosis

Diagnosis is confirmed by biopsy but is usually suspected based on the patient’s symptoms along with x-rays, bone scans, CT or MRI.

Treatment 

Treatment usually involves approximately two months of chemotherapy followed by surgery to remove the tumour. The patient will then undergo several more months of chemotherapy after surgery.

In most cases limb-sparing surgery is used in order to avoid the need for amputation.  In this case the diseased bone is removed and replaced with synthetic metal rods or plates (prostheses), or pieces of bone (grafts) taken from the patients own body or bone removed from the body of a donor. In rare cases amputation may be required to remove the remaining cancerous tissue. 

Prognosis

The overall cure rate of children with Osteogenic Sarcoma is around 70%. This figure will vary depending on whether the cancer has spread and how well it responds to chemotherapy.

Ewings Sarcoma

The type of bone tumour occurs mostly in the 5-15 year age group. The tumours, which usually grow towards the middle of the bone, are mostly found in long bones, such as the thigh bone, but 40% occur in flat less accessible bones like the pelvis or vertebrae.

Symptoms

Bone pain

Swelling

Local tenderness

Treatment

Treatment may include surgery, chemotherapy and/or radiotherapy.

Prognosis

The overall cure rate for Ewings Sarcoma is about 70%, although the position of the tumour and the degree of spread will affect the outcome.