Bone cancer: Teenagers and young adults

About

Bone cancer in teenagers and young adults is a rare form of cancer, but it can be very serious and cause significant physical and emotional suffering. It occurs most often in the long bones of the body, such as the femur and tibia, but can also occur in any bone. Symptoms of bone cancer can include pain and swelling in the affected area, a lump or mass near the site of the cancer, and weakened bones. Treatment options include surgery to remove the tumor, radiation therapy, and chemotherapy. Patients may also be eligible for clinical trials to test the effectiveness of new treatment approaches. It is important for patients and their families to work closely with their oncologist to find the best treatment plan for their particular situation.

Symptoms

The most common symptoms of bone cancer in teenagers and young adults include:

Swelling and pain around the area of the tumor, typically in the arms, legs, chest or back.
Weakness or tiredness.
Unexplained weight loss.
Recurring fever.
Joint stiffness or swelling.
Limping due to pain in the affected area.
Decreased range of motion.
Numbness or tingling in the affected area.

Causes

The exact cause of bone cancer is unknown, but some known risk factors in teenagers and young adults may include:

Genetics, including certain inherited syndromes and certain gene mutations
Prolonged exposure to radiation
Previous treatment with radiation, chemotherapy or certain drugs
Certain conditions that put individuals at a higher risk of developing bone cancer, such as Paget’s disease of the bone and Ollier’s disease
Family history of bone cancer, or having a parent or sibling with the disease
Family history of multiple endocrine neoplasia (MEN) syndrome, which increases the risk for certain types of tumors

Risk factors

The exact cause of bone cancer is not known, but certain factors may increase a teenager or young adult’s risk, including:

Exposure to radiation or chemotherapy, which can increase the risk for certain types of bone cancer.
Certain inherited genetic disorders, such as Li-Fraumeni syndrome, which make a person more likely to develop certain types of bone cancer.
A family history of bone cancer, which means that other members of the family have had the disease.
Having a weakened immune system due to certain medical conditions or medications.
Having a certain type of bone disorder, such as Paget’s disease, which increases the risk for certain types of bone cancer.

Diagnosis

Bone cancer in teenagers and young adults is diagnosed by performing a physical exam and a series of tests, including imaging tests (X-ray, CT, MRI, PET), biopsy and blood tests. Imaging tests help to detect abnormalities within the bones, while a biopsy helps to determine whether the abnormal tissue is cancerous or not. Blood tests are used to measure tumor markers and check for the presence of abnormal proteins. If the cancer is found, further tests may be done to determine what stage the cancer is at and what type of treatment options are available.

Sub-types

Osteosarcoma: Osteosarcoma is the most common type of bone cancer seen in teenagers and young adults. It typically affects the long bones and occurs most often in the arms and legs. It is also known as osteogenic sarcoma.

Ewing’s Sarcoma: Ewing’s sarcoma is a rare type of cancer that can occur in teenagers and young adults. It affects the bones and soft tissues and can occur in any part of the body.

Chondrosarcoma: Chondrosarcoma is a type of bone cancer that occurs in the cartilage. It is typically seen in older adults, but can also occur in young adults.

Chordoma: Chordoma is a rare type of cancer that can occur in any part of the body, but is most commonly seen in the skull and spine. It is most common in teenagers and young adults.

Giant Cell Tumor: Giant cell tumor is a rare type of bone cancer that typically affects the long bones and can occur in any part of the body. It is most commonly seen in those between the ages of 20-40.

Treatments

Treatment options for bone cancer in teenagers and young adults often depend on the stage and location of the cancer as well as the patient’s age and overall health. Generally, treatment options may include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, or a combination of treatments.

Surgery is one of the most common treatments for bone cancer. This can include removing the cancerous tumor, a portion of the affected bone, and nearby healthy tissue to ensure all of the cancer cells are removed.

Chemotherapy can help destroy cancer cells that are too small to be seen or removed with surgery. Chemotherapy may be used before or after surgery to reduce the size of a tumor or help prevent it from coming back.

Radiation therapy is used to kill cancer cells with high energy X-ray beams. This type of therapy is typically used if the cancer has spread or if the patient is not able to have surgery.

Targeted therapy is a type of treatment that uses drugs or other substances to target and destroy cancer cells specific to the type of cancer.

Immunotherapy works by stimulating the body’s own immune system to fight cancer cells. This type of therapy is often used in combination with other treatments and may be used before or after surgery, or in cases when the cancer has spread.

Prevention

There are several things that teenagers and young adults can do to reduce their risk of bone cancer.

One is to avoid smoking and using any tobacco products. Studies have shown that people who smoke are at an increased risk of developing bone cancer.

Another is to be sure to get plenty of exercise and maintain a healthy diet. Eating a balanced diet low in fat and high in fiber can help protect against cancer. Also, regular exercise helps to keep bones, muscles, and joints healthy and strong.

Finally, it is important to stay away from substances that are known to be cancer-causing, such as exposure to radiation. Teenagers and young adults should wear protective clothing and use sunscreen when exposed to the sun to avoid overexposure.

These are just a few ways that teenagers and young adults can reduce their risk of developing bone cancer.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of bone cancer in teenagers and young adults. Females are more likely than males to present with primary bone cancer (i.e. cancer that originates in the bone) whereas males are more likely to present with secondary bone cancer (i.e. cancer that has spread from another location to the bone). Similarly, females are more likely to be diagnosed with osteosarcoma, the most common type of bone cancer, while males are more likely to be diagnosed with Ewing’s sarcoma.

In terms of management, females have been found to have better prognoses and better response to chemotherapy when compared to males, while males tend to have more advanced stages of the cancer at diagnosis. Additionally, males are more likely to develop chemotherapy-related side effects.

Nutrition

Nutrition plays a vital role in the management of bone cancer for teenagers and young adults. Proper nutrition can help boost energy levels and strengthen the immune system which can help reduce the risk of infection during and after treatment. Eating a well-balanced diet rich in fruits and vegetables can also provide additional antioxidants, vitamins and minerals which can help reduce inflammation. Proper hydration and a healthy balance of nutrients can help reduce pain, fatigue and slow down the progression of the cancer. Additionally, a diet that is tailored to the individual patient’s needs can help improve the overall quality of life and provide additional support during treatment.

Physical Activity

Physical activity can play a beneficial role in reducing the risk of developing bone cancer through its ability to help maintain a healthy body weight and by increasing calcium absorption. Studies have found that physical activity and exercise can help to strengthen bones, thereby reducing the risk of bone fractures that can lead to the development of bone cancer. Additionally, physical activity can help to improve muscle and bone strength, reduce the risk of chronic diseases, provide psychological benefits, and reduce stress, all of which can help to improve the overall quality of life of teenagers and young adults.