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bone cancer in early ages like leukemia. • Other normal cells of the body are affected like hair-loss, blood-forming cells, cells lining the digestive system that can be affected after the chemotherapy. • The main disadvantage can include cancer reoccurrence, infections, injury to near areas of the surrounding tissue. The uncontrollable cell mutation in a mass of area is known as cancer. Bone cancer can affect the bones of any part of the body or can start in the specific bone area and then can spread over and affect the other parts of the body. A malignant tumor is bone cancer. This cancer is most commonly found in the children and younger age groups and while the adults have metastatic cancer which spreads from the other tumors. Over more than 2,000 people have been diagnosed in the US every year with this cancer. The market will grow at a CGAR of 5.4% by 2025. The treatment and effective medications will give rise and create high demand in the global market. Cancer destroys the tissues by developing in the skeletal system. As the bones serve several purposes in the body as preventing and supporting the internal organs, bone cancer spreads over other organs too such as lungs and brain by the ribs and skull. Bone cancer is rare the term benign and metastatic are used for bone cancer most often where benign is non-cancerous and metastatic mean cancerous. However, benign is the most common cancer to be found than the metastatic. Types Types of bone cancers are divided into two categories like benign and malignant bone cancer and benign or primary bone cancer are – Osteochondroma, Giant cell tumor, Osteoid osteoma, Osteoblastoma, and Enchondroma. Osteochondroma- The most common cancer and happens under the age of 20. Giant cell tumor- This one can be cancerous in rare cases, and usually happens in the legs. Osteoid osteoma- It happens in the long bones in the body and usually under the age of early ’20s Osteoblastoma- This grows in the spine and long bones but mostly in adults. It is a rare tumor. Enchondroma- A most common type of hand tumor with no symptoms which occurs in hands and feet. Malignant or secondary bone cancer are osteosarcoma, Ewing’s sarcoma, Chondrosarcoma, Malignant fibrous histiocytoma (MFH), Fibrosarcoma, and Chordoma. Osteosarcoma- Mostly happens to the teens and young adults, often found in another form in adults having Paget’s diseases of bone. It occurs around the knees and upper arms. Ewing’s sarcoma- It happens in children between the age of 5 -20 years. The most site of this cancer is the ribs, pelvis, leg, and upper arm. Chondrosarcoma- It happens in adults between the age of 40 -70 years. Most site of this cancer is the hips, pelvis, leg, shoulder, and arm, which begins from cartilage cells. Malignant fibrous histiocytoma (MFH)- It is found in adults usually occurring at the age of 50-60 years. Affects soft tissues, ligaments, tendons, and fat. It is known as the most common soft-tissue malignancy. Fibrosarcoma- It is much rarer than other tumors, which is slightly common in males rather than females and commonly affects the soft tissues of the leg behind the knee at an age of 35-55 years. Chordoma- chordoma is one of the rare tumors in this type of tumor average survival is 6 years after diagnosis. It is common in young adults having age of 30 years. The lower and upper spinal cords are affected by this tumor. Treatment Treating bone cancer is complex, the proper diagnosis is required for better outcomes. Diagnosis can be done by X-Ray, CT- SCAN, MRI, or Angiogram. However, a biopsy is done to remove the tissue to determine the bone cancer present. needle biopsy is also done in which the surgeon makes the hole to remove the sample tissue by the needle-like instrument. Treatment is done by knowing the following factors the type, location, age, health and fitness, and the stage of cancer. The treatment is done by surgery, radiation therapy, chemotherapy, and sometimes the combination of all the treatments. Surgery- The surgery aims to remove all the cancer tissue with a small area of healthy tissue surrounded by that cancerous region. For limb-sparing surgery or limb-salvage surgery reconstructive surgery is required, the surgeon may fit artificial bone by taking a bone from another part of the body. Separation of a limb might be also done by a surgeon for the removal of cancer. Radiation therapy- “High-energy X-Rays” is used to remove the cancer cells. The most common and standard treatment used for treating the Ewing sarcoma. To have more effective results, radiation therapy is used with other types of treatment of bone cancers. Chemotherapy- The treatment is done by the medications to kill the cancer cells. The therapy is required for the new diagnosis of osteosarcoma and Ewing sarcoma. The combination of radiation therapy and chemotherapy can be recommended by the doctor. Cryosurgery- to destroy the cancerous cells the surgeon aims the cancer cells with liquid nitrogen so as to freeze the cells. The technique is sometimes also replaced by surgery. Targeted therapy- Denosumab (Xgeva) drug is used in the treatment which stops the cancer cell to grow by interacting with the cells. It is a monoclonal antibody. It gives prevention to osteoclasts which can destroy the bone tissue and is a type of blood cell. Before procedure Before procedure involves certain tests like CT-Scan, MRI, PET, X-Rays, Bone biopsy. Computerized Tomography CT-Scan is done to take the 2-D and 3-D X-ray images of the area where the bone cancer. The bone scan is done by the liquid that contains radioactive material is given intravenous into the vein. In abnormal areas the detection is done by scanner and the image is captured in special film. Magnetic Resonance Imaging “MRI” uses a magnetic field and radio waves through a coil that is slid by the technician. A detailed image is taken of the body. Nuclear medicine imaging is used in Positron emission tomography-scan where 3- D images are generated by computer analysis of functional processes of the human body. X-Ray detects the damage that has been caused by cancer and new bone cells growth in nearby areas of the tumor. The surgeon gets a clear picture to decide the prognosis of the disease and to proceed with treatment. Bone Biopsy is used to take out the sample of tissues by target bone through inserting a long thin needle into the bone. It is known as the best method to diagnose bone cancer. After procedure After procedure requires precautions in case om amputation, physical therapy, and other rehabilitative therapies are most required and the regular follow up is also mandatory as any new symptom arises like swelling or bone pain require consulting a doctor is must and all other factors like regular physical examinations, blood tests, imaging studies as per doctor suggests. In some cases when surgeons do curettage the tumor is scraped out which causes a hole in the bone and is treated after the removal of the tumor the treatment is done by a surgeon of nearby bone tissue to kill the remaining tumor, this can also be done by bone cement or cryosurgery. Risk factor • The people having Paget’s disease can have a high-risk factor of getting bone cancer. • A patient with a previous bone marrow transplant might affect with bone cancer. • Hereditary retinoblastoma, eye cancer in children have risks. • Radiation exposures for past radiation surgery for some other cancer treatment or diagnosis. • The pain in the bones at an early age or for a long period of time. Pros The best thing about the treatment of bone cancer is the pain relief, helps in preventing complications, and improves the quality of life. A healthy lifestyle builds up. Cons • Damage to the soft tissues, fatigue, loss of appetite, and damage can cause by radiation therapy. • The risk of other can be possible for the children getter bone cancer in early ages like leukemia. • Other normal cells of the body are affected like hair-loss, blood-forming cells, cells lining the digestive system that can be affected after the chemotherapy. • The main disadvantage can include cancer reoccurrence, infections, injury to near areas of the surrounding tissue.
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