BONE

Cancer
GROUP 5 MEMBERS:
Maria Cristy Capiloyan
Jeah Mae Julapong
Edjeline Ligan
Angel Mae Suelto
 Description
Bone cancer is an abnormal growth of tissue
in bone, traditionally classified as
noncancerous (benign) or cancerous
(malignant). Bone cancer is the term for
several different cancers that develop in the
bones. When cancer cells grow in a bone, it
can harm normal bone tissue. The type of
cell and tissue where cancer begins
determines the type of bone cancer.
 Description
Cancers that form in the bone itself are called primary
bone cancers. Many tumors that begin in organs or
other parts of the body can spread to the bones, as
well as other body parts. These growths are called
secondary or metastatic bone cancers. Breast,
prostate and lung tumors most commonly
metastasize (spread) to the bones.

Bone cancers are rare. While they can develop at any

age, they are more common in children, teenagers and
young adults than in older adults.
Types of bone cancer:
Benign
1. Osteoid osteoma- small tumor that usually grows in the
long bones of a person's lower extremities. The thighbone
is the most common location, although it can occur in the
bones of the hand, and it sometimes occurs in the lower
part of the spine. Osteoid osteomas may occur at any age,
but are most common between the ages of 4 and 25 years
old. Males are affected approximately three times more
often than females.
 Types of bone cancer:
Benign
2. Chondromyxoid fibroma, or CMF- is a tumor of the
cartilage found between your bones. Cartilage is a rubber-
like tissue that cushions and protects the ends of your
bones, sits in between the disks in your spine, and makes up
the ear and nose. It is usually found in older children and
young adults. This type of tumor usually affects people
between the ages of 10 and 30
 Types of bone cancer:
Benign
3. Osteoblastoma bone-forming tumor that is extremely
rare, accounting for only 1 percent of all primary bone
tumors. Unlike most primary bone tumors, which favor the
extremities, osteoblastoma occurs most often in the lower
vertebrae of the spine or long bones of the lower extremity.
typically occurs in the second decade of life, but patients
range in age from about 5 to 45. It affects males more than
females at a ratio of 3:1.
 Types of bone cancer:
Benign
4. Endochroma- Intramedullary cartilage tumor usually
found in cavity of a single hand or foot bone; rare malignant
transformation can occur; if tumor becomes painful,
surgical resection is done, peak incidence in people ages 10-
20.
 Types of bone cancer:
Benign
5. Osteochondroma- is an overgrowth of cartilage and
bone that happens at the end of the bone near the growth
plate. Most often, it affects the long bones in the leg, the
pelvis, or the shoulder blade. Most common noncancerous
bone growth. It most often occurs between ages 10 and 30.
 Types of bone cancer:
Benign
6. Osteoclastoma(giant cell tumor): These usually arise
in the metaphysis and extend into the epiphysis of
long bones. Patients range in age from about 5 to 45. It
affects males more than females at a ratio of 3:1.
 Types of bone cancer:
Malignant
1. Ewing sarcoma: These tumors can form in the bones and
in surrounding soft tissues. Most commonly grows in
the hips, ribs and shoulder blades, or on long bones such
as the legs. Occurs most often in teenagers during
puberty or younger children. Between the ages of 10 and
20. Rarely seen in adults over the age of 30 yrs old. More
males are affected than females
 Types of bone cancer:
Malignant
2. Chordomas - are tumors that can occur anywhere
within the spine or the base of the skull. It can affect
individuals of any age, including young children, but
most often are diagnosed in individuals between 40-75
years of age (the average age at diagnosis is 55 years).
 Types of bone cancer:
Malignant
3. Osteosarcoma : The most common type of bone cancer.
It develops in the cells where new bone tissue forms. It
can start in any bone, but it usually begins at the ends of
large bones such as the arms and legs. It may also start in
the hips or shoulders. Providers most commonly diagnose
osteosarcoma in children and teenagers. Children and
young adults 10 -30 years old.
 Types of bone cancer:
Malignant
4. Chondrosarcoma: The second most common type of
bone cancer. Chondrosarcoma begins in tissue called
cartilage. This cancer typically forms in the arm, leg or
pelvis bones. Unlike osteosarcoma and Ewing sarcoma,
chondrosarcoma occurs more frequently in adults than
in younger people. Middle age or older adults.
 Stages of Bone Cancer:
Staging is determined by the size and location of the
tumor, and whether or not cancer has spread to other
areas. Primary bone cancer is categorized into four
stages:

Stage 1: The tumor is low-grade, and the cancer cells are

still localized.
Stage 2: The cancer cells are still localized, but the tumor
is high-grade.
Stage 3: The tumor is high-grade and cancer has spread
to other areas within the same bone.
Stage 4: Cancer had spread from the bone to other areas
of the body, such as the lungs, brain or liver.
Etiology:
IDIOPATHIC
Anatomical Structure
Anatomical Structure
 Anatomical Structure of
affected parts
Osteosarcoma
Most common primary bone cancer; occurs
mostly in young males between ages 10 and 25;
most often in bones of arms, legs, or pelvis.

Location; Metaphysis of long bones

Mutation; RB,TP53, mutation (arise from
osteoblast cells)
Findings Risk factors: Retinoblastoma, Paget
Disease, radiation
Xray; Sunburst appearance on x-ray and lifting
of the periosteum
 Anatomical Structure of
affected parts
Ewing Sarcoma
Develops in medullary cavity of long bones, especially the
femur, humerus, pelvis, and tibia; usually occurs in
children and teenagers;
.
Epidemiology; White boys <15 y/o
Mutation; T11, 22, EWSR1 translocation, (arise from
neuroectodermal cells)
Location; Diaphysis of long bones
Findings; Onion skin appearance on x-ray
Neuroectodermal originating small blue cells that
resemble lymphocytes t(11,22) translocation leads to
overexpression of EWS-FL1
 Anatomical Structure of
affected parts
Chondrosarcoma
Occurs in cartilage most commonly in arm, leg. and
pelvic bones of older adults ages 50-70; can also arise
from benign bone tumors (osteochondromas); wide
surgical resection is mostly done as tumor rarely
responds to radiation and chemotherapy; survival rate
depends on stage, size, and grade of tumor.

Location; Medulla of pelvis, central skeleton

Malignant tumor of connective tissue, that sometimes
resides in medullary cavity
Pelvic bones, shoulders most common
metaphysis
Pathophysiology
 Diagnostics/ Lab test
CT SCAN CT scans are usually used to help make an initial bone cancer diagnosis and to see whether the cancer
has spread to other areas of the body. CT scans may also be used to guide the biopsy needle.

X-RAY An x-ray of the bone is often the first test done if some type of bone tumor is suspected. Tumors
might look “ragged” instead of solid on an x-ray, or they might look like a hole in the bone.

MRIs can help determine the exact extent of a tumor, as they can show the marrow inside bones and
MRI the soft tissues around the tumor, including nearby blood vessels and nerves. MRIs can also show any
small bone tumors several inches away from the main tumor (called skip metastases).

A bone scan is a test that uses nuclear imaging to helps diagnose and track several types of bone disease.
BONE SCAN Nuclear imaging involves using small amounts of radioactive substances (radiotracers), a special camera
that can detect the radioactivity and a computer to see structures such as bones inside the body.

Positron emission tomography (PET) scans can help show the spread of bone cancer to the lungs, other
PET SCAN
bones, or other parts of the body. They can also be used to see how well the cancer is responding to
treatment.
CORE NEEDLE BIOPSY

The doctor makes a small cut in the skin over the bone.
Then the doctor places the needle into the bone to take out
the sample.
 Clinical Manifestation
Fatigue
Fever
Weight loss
Weakness
Bone Pain
Weakened bones
Swelling and tenderness
Mass
 Medical Management
chemotherapy
Often used to treat Ewing’s sarcoma and osteosarcoma
Chemotherapy may be given to treat recurrence of bone cancer or
and relieve pain or control the symptoms of bone cancer advanced
stage.

Radiation therapy
Use of high energy particles to kill cancer cells
For ewings sarcoma it can be administered after surgery if the
margins contain cancerous cells can not widely be removed.

Drugs/Medications
Doxorubicin (Adriamycin) morphine
Methotrexate Dopamine
Cisplatin Vicodin
Codeine Prednisone, Prednisolone, Dexamethasone
 Surgical management
Limb-sparing surgery
Removing the section of affected bone and some of the surrounding tissue (in case any
cancerous cells have spread into the tissue).
The removed section of bone may then be replaced with a metal implant called a prosthesis
or a piece of bone from elsewhere in your body (bone graft).
 Surgical management
Amputation
A surgery to remove all or part of a limb
the cancer has spread beyond the bone into major blood vessels or nerves
you developed an infection after limb-sparing surgery and the prosthesis or bone graft had to be
removed
the cancer has developed in a part of the body where limb-sparing surgery is not technically
possible
 Surgical management
Bone Curettage

Tumor of the bone is scraped without removing a section of bone

Benign bone tumors are commonly treated by a procedure called curettage.
When the bone is surgically shaved or smoothed during a bone curettage procedure, the bone
matrix is activated and begins the regeneration process.
 Nursing management

- Assess for pain scale

- Evaluate pain characteristics and intensity
- Administer pain medication as ordered
- Watch out for possible side effects
- Assist with activities and transfers, as needed
- Provide well ventilated environment
- Watch out for post-operative infection
- Change the dressing of the surgical site as ordered
THANK
YOU