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Bone Cancer

About the Department

Bone cancer may originate in any bone in the body. However, it generally affects the long bones in the legs and the arms or the pelvis bone. Bone cancer is a rare type of cancer and only constitutes less than 1% in comparison to all other types of cancers. Primary bone cancer are cancers that start in the bone. Secondary bone cancers such as breast or lung cancer may also spread to the bone and metastasize. 

Children and teenagers are prone to certain specific types of bone cancer which may be related to the changes that happen when their bones are building in the body. Adults are vulnerable to the remaining types of bone cancer. The most common form of treatment is surgical therapy in combination with radiation and chemotherapy. The type of treatment route to be used is determined by the type of bone cancer. 

Researchers have been unable to find what exactly is the cause behind bone cancer. Development of some bone cancers have been connected with genetic factors, while others may be linked to radiation exposure in the past. Scientists are continuously researching any other causes that might be linked to the development of bone cancer. 

Of all types of bone cancers, primary bone cancers roughly constitute 0.2% of them. Chondrosarcomas accounts for 40% of primary bone cancers in adults followed by osteosarcomas at 28%, chordomas at 10%, Ewing tumours at 8% and fibrous histiocytoma or fibrosarcomas at 4%. The rest of the bone cancer types are extremely rare and the numbers affecting people are insignificant. 

Young adults, teenagers and children less than 20 years of age are mostly affected by osteosarcoma which is roughly at 56% compared to other types of bone cancers. The remaining types of bone cancers that they are teenagers and children are prone to include Ewing tumours at 34% and chondrosarcoma at 6%. Adults are affected mostly by Chondrosarcomas, with the average age of diagnosis being around 51 years. 

Fortis Hospitals, Bannerghatta Road, is a centre of excellence for bone cancer treatment. We actively combine supportive treatments with advanced cancer therapies, thus creating an individualised treatment plan for our bone cancer patients. Your cancer care team will include experts like medical oncologists, surgical oncologists or radiation oncologists, various supportive care clinicians, pain management doctors, registered dietitians, naturopathic medicine providers or chiropractors who will look into fighting your bone cancer with a 360-degree, multi-disciplinary approach. With state-of-the-art facilities, the latest technologies in bone cancer diagnostic screenings and cutting-edge therapies, you will be monitored and cared for, round the clock. 

As soon as you choose Fortis as your healthcare partner in your cancer cure journey, we assign a dedicated team of bone cancer specialists who will constantly communicate with you and your family on the progress that you are making and providing exceptional care within our hospital facilities. We believe in focussing on 100% patient care so that you and your family can concentrate your energies on your healing. 

Areas of Care

As a patient of bone cancer, the introduction to your journey in cancer care is filled with a lot of unknowns. At Fortis Hospitals, we aim to prepare you for this difficult phase in your life right from the very beginning. Depending on the type of cell and where the cancer started, bone cancers can be broken down into various types including:

- Malignant bone tumours

- Osteosarcoma
- Chondrosarcoma

  • Dedifferentiated chondrosarcomas
  • Clear cell chondrosarcomas
  • Mesenchymal chondrosarcomas

- Ewing tumour    
- Malignant fibrous histiocytoma
- Fibrosarcoma
- Giant cell tumour of bone
- Chordoma

There are other types of cancers that do not originate in the bone cells per say, but affect them nevertheless. These types of bone cancers include:

- Non-Hodgkin lymphomas
- Multiple myelomas

Not all bone tumours are cancerous in nature. The tumours that are benign are not life threatening and usually do not metastasize to other nearby organs in the body. They are often curable through surgical therapy. These include:

- Osteoid osteoma 
- Osteoblastoma 
- Osteochondroma
- Enchondroma
- Chondromyxoid fibroma

Cancers that originate in other organs in the body may also affect the bones and result in bone cancer. Secondary bone cancers include:

- Bone metastases or metastatic cancer starting from breast cancer, prostate cancer, and lung cancer
- Blood cancers includes multiple myeloma, leukaemia and lymphomas

At Fortis, we understand that the needs of every bone cancer patient are different. With several years of experience in diagnosing and staging all types of bone cancer cases, we develop a tailored treatment plan that addresses the requirements and preferences of the individual patients; thus, adhering to our patient first approach.

Symptoms & Diagnosis

Signs and Symptoms of Bone Cancer

As the bone cancer grows and develops, it shows many symptoms including:

- If you experience severe pain that is deep or dull in a bone or a particular bone region, for example, the back, pelvis, legs, ribs, arms. In the early stages of bone cancer, the pain may only be felt at night or during the time that you are most active. As the cancer grows, the ache may become more persistent and becomes more noticeable. 
- If you observe that the ache is localised and starts showing signs of inflammation. It may also result in a mass or lump. 
- Bone cancer cells may sometimes weaken the bones resulting in a fracture. This could be in a bone area that is already sore or experiencing pain for a significant duration of time.
- If you experience any difficulty in movements which may be caused by the location of the tumour near a joint.
- If you experience sudden bouts of tiredness accompanied by pain in the bones
- If you notice that you are losing weight without any plausible reason
- If you have trouble in breathing which may happen if the bone cancer has spread to other organs

Bone cancer symptoms may be similar to other conditions like osteoporosis or injury. Persisting symptoms is a cause for concern and you should immediately seek medical assistance to identify the reason behind it. It is important to get proper treatment at the right time. 

Our Diagnostic Services

The first step to developing the right bone cancer treatment plan is to get an accurate diagnosis. The multi-disciplinary team of bone cancer experts at Fortis by using advanced diagnostic screenings, is able to evaluate the type and stage of the disease. 

If the specialist team at Fortis suspects primary bone cancer, the following tests will be recommended:

  • Physical Examination:

This will be done by your consulting specialist during the initial appointment. The specialist does a physical check-up and discusses the symptoms that you are currently experiencing.

  • Blood Test:

A Complete Blood Count or a CBC test checks for any unusual increase or decrease in the red and white blood cells. 

  • Bone X-rays:

Bone cancers are easily detectable through bone x-rays as the region in the bone affected by bone cancer shows up as ragged instead of solid. The cancer may also show up as a hole in the bone in the x-ray. At times, specialists may be able to detect a tumourous growth surrounding the bone that may penetrate to the nearby muscle or fat tissues. Sometimes radiologists can also tell if the tumorous growth is cancerous or not; however, a biopsy is able to accurately confirm the malignancy. 

  • MRI Scans:

During this diagnostic test, magnetism is used in creating a detailed visual of the suspected area. MRI scans are one of best screenings to diagnose bone cancer, especially in the brain and the spinal cord regions.

  • Bone Biopsy:

During a biopsy, a sample of the suspected malignant tissue is collected from the tumorous growth and later analysed under microscopic conditions. Bone biopsies can be of two types:

Needle biopsies can be of two types where the area is numbed using a drug:

- Fine needle aspiration or FNA is a process where the doctor uses a thin needle along with a syringe to collect a tiny sample of the fluid along with a few cells from the suspected area. If the tumour is closer to the surface of the body, the doctor may target the needle by way of feeling the tumour. On the other hand, if the tumour location is way too deep and the doctor is unable to feel it, in that case, a CT scan is used that guides the doctor in aiming the needle in the right direction. 

- Core needle biopsy is a procedure where a larger needle is used to remove the tissue in approximately 1/16 inch in diameter and ½ inch long which is a tiny cylindrical shape. 

Surgical bone biopsy can also be of two types including:

- Incisional biopsy requires a surgeon to make an incision through the skin to reach the tumour in order to remove a small portion of the tissue.

-Excisional biopsy involves removal of the whole tumour.

If the outcome of the recommended diagnostic screenings confirms bone cancer, the next round of tests that will be prescribed by your consulting specialist at Fortis, will check for the stage and grade of the bone cancer. Possible screenings may include:

  • CT scan
  • Bone scan
  • Bone marrow sample
  • PET/CT scan
  • Chest x-ray

At Fortis, comfort is extremely important to us while the patient is undergoing such a strenuous phase of diagnostic testing. That is why we use state-of-the-art equipment, that is padded well for patient comfort. Using a number of positioning tools, we help the patient to feel relaxed whilst undergoing the scans and other screenings. We also realise that waiting for the outcome of the diagnostic tests can be stressful too. Feeling overwhelmed during this time is not at all extraordinary. With access to counselling, we answer any concerns and questions that the patient and their families may have about the type of bone cancer and what it all means.

Treatment Options

At Fortis Hospitals, Bannerghatta Road, we use the most modern bone cancer treatment technologies available. The department of bone cancer has pioneered in radiation, surgical therapy and chemotherapy along with concentrating on high standards of patient care. Before your treatment starts, your cancer care team will lay down the treatment options that are available to you keeping in mind your overall health condition and any preferences that you may have. With all the information at your disposal, you will be able to make an informed decision about the route of treatment for your bone cancer that may possibly include one or more of the following therapies:

- Surgical therapy is the primary form of treatment for bone cancer where expert surgeons work in collaboration with a specialist team. The goal is to remove the tumorous growth from the bone whilst retaining the functionalities of that particular bone as much as possible. There are several types of surgical therapies available including:

- Limb-sparing surgery is a procedure that involves removal of the suspected part in the bone. That area is then replaced with a custom-built endoprosthesis or a metal fitting. A bone from another part of the body may also be used as a replacement. It is known as bone grafting. However, if the bone cancer has spread to the nearby joint, then the entire joint is replaceable with an artificial setting. 

- Amputation is a surgical process that is performed when limb-sparing surgery is not possible. In this instance, the cancer can only be removed entirely by amputation. 

- Radiation therapy is a treatment process where high powered energy beams are targeted on the malignant cells. The beams do not harm the normal cells in the body. Radiation therapy works best in case of Ewing’s sarcoma in combination with surgery and chemotherapy. If surgical therapy cannot be used to remove the tumour, then radiation therapy is the primary form of bone cancer treatment. 

- Chemotherapy is a procedure where cancer cells are destroyed using anti-cancer or cytotoxic medication administered through IV lines. These drugs act as growth disruptors to the cancer cells and prevents them from expanding. The drugs do not affect the normal cells in the body. Chemotherapy is generally given prior to surgery or radiation therapy. 

At Fortis, we hand-hold all our bone cancer patients throughout the diagnosing and treatment journey as we don’t want them to face cancer alone. As a patient, being aware of the goals of your treatment, how it will be administered and what are the possible side effects, helps you to grasp your condition better. Your specialist team at Fortis will always encourage you to participate and be involved in your care process and make the treatment decisions as a collaborative unit.

Our Team That Cares

It is important to choose the right healthcare partner during your cancer journey. It is one of the significant decisions that you take during this time. Your evaluation at Fortis Hospitals, Bannerghatta Road through our team of experts will include a review of your medical history, several health assessments, diagnostic screenings that will help to locate the type of bone cancer, its stage and the extent of its growth. 

Depending on your needs and preferences, you will have access to a dietitian, naturopathic oncology provider, chiropractor and/or other supportive care service providers who will offer to support your treatment through making lifestyle transformations in your daily habits that will expedite your remedial process.

At Fortis, we realise that every cancer is as distinctive as the patient who is battling it. We have a comprehensive understanding that in this day of modern medicine, treatment of cancer has to be personalised with advanced medical techniques that are evolving every day. Dedicating their time and talent in treating bone cancer at every stage, the cancer specialists at Fortis use evidence informed supportive therapies. This assists in the management of the overall patient condition, side effects whilst maintaining the patient’s energy levels and helping them stay strong throughout the treatment.