Bone cancer

Introduction:

Bone cancers are rare forms of cancer that can affect any bone in the body. Two types of bone cancer are multiple myeloma and bone sarcomas. About 2,000 primary bone cancers are diagnosed in the United States each year. Bone cancers can also happen when tumors that start in other organs, such as breasts, lung, and prostate, metastasize (spread) to the bone. Multiple myeloma is the most common type of bone cancer. The two most common bone sarcomas are osteosarcoma, which develops in new tissue in growing bones, and chondrosarcoma, which develops in cartilage. Osteosarcoma occurs more frequently in people ages 10 - 30, while chondrosarcoma occurs more often in adults.

Signs and Symptoms:

Bone cancer is accompanied by the following signs and symptoms:

• Pain
• Swelling or tenderness of the joints
• Fractures
• Fatigue, fever, weight loss, anemia

Who's Most At Risk?:

People with the following conditions or characteristics may be at risk for developing multiple myeloma:

• Radiation exposure
• Exposure to petroleum products, benzene, herbicides, and insecticides
• Genetic factors
• Over 68 years of age
• African-Americans (twice the risk of Caucasians)

People with the following conditions or characteristics may be at risk for developing osteosarcoma:

• Benign tumors and other bone diseases
• Radiation exposure
• Genetic factors
• Children, adolescents
• Males more than females

Your risk for developing chondrosarcoma is higher if you are age 40 - 60.

What to Expect at Your Provider's Office:

If you have symptoms associated with bone cancer, you should see your health care provider. It's helpful to remember that many symptoms of bone cancer are also associated with other, less serious health conditions. In addition to taking a personal and family medical history, your health care provider may suggest a blood test to measure the level of alkaline phosphate, an enzyme that increases when a tumor causes production of abnormal bone tissue. X-rays and other imaging procedures can show the location, size, and shape of a bone tumor. New research suggests that combination positron emission tomography (PET) and computed tomography (CT) may be the most sensitive technique for detecting bone cancers. Not all tumors are cancer. A biopsy -- the removal of a sample of tissue from the bone tumor -- will reveal whether cancer is present.

Treatment Options:

Treatment Plan

The treatment plan depends on the type, size, location, and stage of the cancer, as well as the patient's age and general health.

Drug Therapies

Your health care provider may prescribe the following therapies:

• For multiple myeloma: chemotherapy drugs, radiation treatment, medication for pain relief, and bisphosphonates (to protect the bone)
• For osteosarcoma: cytotoxic drugs

Surgical and Other Procedures

With multiple myeloma, a physician may perform a bone marrow transplant. With bone sarcomas, surgery is often the main treatment. In most cases, chemotherapy has made limb-sparing surgery possible and amputation unnecessary.

Complementary and Alternative Therapies

A comprehensive treatment plan for bone cancer may include a range of complementary and alternative therapies. Make sure to inform your health care provider about the herbs and supplements you are taking.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

• Try to eliminate suspected food allergens, such as dairy (milk, cheese, and ice cream), wheat (gluten), soy, corn, preservatives and chemical food additives. Your health care provider may want to test you for food allergies.
• Eat foods high in B-vitamins, calcium, and iron, such as almonds, beans, whole grains (if no allergy is present), dark leafy greens (such as spinach and kale), and sea vegetables.
• Eat cruciferous vegetables (such as broccoli, cabbage, and cauliflower).
• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell pepper).
• Avoid refined foods, such as white breads, pastas, and sugar.
• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy is present) or beans for protein. Use quality protein sources, such as organic meat and eggs, whey, and vegetable protein shakes, as part of a balanced program aimed at gaining muscle mass and preventing wasting, a side effect of cancer therapies.
• Use healthy cooking oils, such as olive oil or vegetable oil.
• Reduce or eliminate trans fatty acids, found in such commercially baked goods as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Drink soy milk, for bone health (if no allergy is present).
• Avoid caffeine and other stimulants, alcohol, and tobacco.
• Exercise, if possible, 5 days a week.

You may address nutritional deficiencies with the following supplements. Consult your oncologist before adding any nutritional supplements or herbal medicines to your regimen.

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
• Calcium citrate, 500 - 1,000 mg daily, for bone support.
• Vitamin D, 400 IU daily, for bone support.
• Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Refrigerate probiotic supplements for best results.
• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tbsp. of oil one to two times daily, to help decrease inflammation and help with immunity. Cold-water fish, such as salmon or halibut, are good sources.
• Vitamin C, 500 - 1,000 mg one to two times daily, as an antioxidant and for immune support.
• Lycopene, 5 mg one to three times daily, for antioxidant and anticancer activity.
• Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
• Resveratrol, 50 - 200 mg daily, to help decrease inflammation and for antioxidant effects.
• Glucosamine-Chondroitin combination supplement, 500 - 1,000 mg three times daily with food, for support of bone and connective tissue.
• Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant, immune, and muscular support.
• N-acetyl cysteine, 200 mg daily, for antioxidant effects.
• Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant and immune activity.
• Melatonin, 2 - 6 mg at bedtime, for immune support and sleep. Higher doses may be needed in cancer. Consult your health care provider.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment.

You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

• Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anticancer, and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
• Reishi mushroom (Ganoderma lucidum) standardized extract, 150 - 300 mg two to three times daily, for anticancer and immune effects. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
• Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for anticancer, immune, and antibacterial or antifungal activity.
• Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.
• Fermented wheat germ extract, 1 packet dissolved in a favorite beverage once daily, for anticancer and immune effects.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of bone cancer based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual. Homeopathic treatment, especially in the case of cancer, should only be used with guidance from a licensed and certified homeopath.

• Arnica Montana -- for a bruised sensation and restlessness
• Bryonia -- for fractures with stitching pains that are worse with the slightest movement
• Eupatorium -- for excruciating, aching bone pain that worsens with motion and is often accompanied by stiffness and chills
• Symphytum -- for fractures that heal poorly and are accompanied by persistent pain

Acupuncture

While acupuncture is not used as a treatment for cancer itself, evidence suggests it can be a valuable therapy for cancer-related symptoms (particularly nausea and vomiting that often accompany chemotherapy treatment). Studies indicate that acupuncture may help reduce pain and shortness of breath. Acupressure (pressing on rather than needling acupuncture points) has also proved useful in controlling breathlessness. Patients can learn this technique to treat themselves.

Some acupuncturists prefer to work with a patient only after the completion of conventional medical cancer therapy. Others provide acupuncture or herbal therapy during active chemotherapy or radiation. Acupuncturists treat cancer patients based on an individualized assessment of the excesses and deficiencies of qi (energy) located in various meridians. In many cancer-related cases, a qi deficiency is usually detected in the spleen or kidney meridians.

Chiropractic

Chiropractors will not perform spinal manipulation over areas of the body where bone cancer is present, but they may use this procedure over areas that are free of bone cancer in an attempt to relieve pain associated with the condition.

Prognosis/Possible Complications:

Patients with multiple myeloma generally live for 15 months to 5 years. Complications may include heart attack, lung disease, diabetes, and stroke. With bone sarcomas, 65 - 75% of patients experience long-term survival. Potential complications include those arising from surgery and possible spread of the cancer to the lungs.

Following Up:

Your health care provider will want to see you regularly to check for complications and to make sure the cancer has not returned.

Alternative Names:

Cancer - bone