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Bone and Soft Tissue Cancer

Cancer type

Definition of Bone and Soft Tissue Cancer

Bone and soft tissue cancers are types of sarcomas, which are rare cancers that develop in the connective tissues of the body. They can occur anywhere in the body but are most commonly found in the limbs, pelvis, chest, or abdomen.

  • Bone Cancer
  • Soft Tissue Cancer

Bone Cancer

Bone cancer is a type of cancer that starts in the cells of the bones. It can be primary (originates in the bone) or secondary (spreads to the bone from another part of the body).

Primary Bone Cancer: Includes cancers that develop directly in the bone cells, such as:

  • Osteosarcoma: Common in teenagers and young adults; usually occurs in the arms or legs.
  • Chondrosarcoma: Develops in cartilage; more common in adults.
  • Ewing Sarcoma: Often affects children and young adults; typically found in the pelvis, legs, or ribs.
  • Secondary Bone Cancer: Occurs when cancer from other parts of the body (like breast, lung, or prostate) spreads to the bones.

Soft Tissue Cancer

Soft tissue cancer refers to sarcomas that develop in the soft tissues of the body, such as muscles, fat, blood vessels, nerves, and connective tissues.

  • Examples of Soft Tissue Cancer:
  • Liposarcoma: Develops in fat tissue.
  • Leiomyosarcoma: Starts in smooth muscle tissue (e.g., in the uterus, intestines).
  • Rhabdomyosarcoma: Affects skeletal muscles; often occurs in children.
  • Angiosarcoma: Arises in blood or lymph vessels.
  • Fibrosarcoma: Develops in fibrous tissue (tendons or ligaments).
Key Characteristics

Bone and Soft Tissue Cancer

  • Both types of cancers can grow locally and damage nearby tissues.
  • They can also metastasize (spread) to other parts of the body, such as the lungs or liver.
  • Symptoms depend on the location but often include swelling, pain, or a noticeable lump. Early detection and proper treatment are critical for managing bone and soft tissue cancers effectively.
  • Bone Pain
    • Persistent pain in the affected bone, often worsening at night or with activity.
    • Pain may start as mild and become more severe over time.
  • Swelling or Lump
    • A noticeable lump or swelling near a joint or on a bone.
    • Swelling may limit movement in the affected area.
  • Fractures (Broken Bones)
    • Bones may become weak and break easily, even with minor injuries (pathological fractures).
  • Reduced Mobility
    • Difficulty moving the affected limb or joint due to pain or stiffness.
  • Unexplained Weight Loss and Fatigue
    • Losing weight without trying or feeling unusually tired may indicate advanced disease.
  • Other Symptoms
    • Fever or night sweats (less common).
    • Numbness or tingling if the tumor presses on nerves.
  • Osteosarcoma
  • The most common type of primary bone cancer.
  • Originates in bone-forming cells (osteoblasts).
  • Commonly affects teenagers and young adults, usually in the long bones like the arms or legs.
  • Chondrosarcoma
  • Develops in cartilage cells.
  • More common in adults over 40.
  • Typically found in the pelvis, shoulder, or ribs.
  • Ewing Sarcoma
  • Affects bones or the surrounding soft tissues.
  • Often seen in children and young adults, particularly in the pelvis, legs, or chest.
  • Fibrosarcoma of Bone
  • Originates in the fibrous tissue of the bone.
  • Usually affects middle-aged adults and occurs in the legs, arms, or jaw.
  • Chordoma
  • A rare type of bone cancer that starts in the spine or base of the skull.
  • Often affects adults over 30.
  • Painless Lump
    • A growing lump under the skin, often in the arms, legs, or trunk.
    • Initially, these lumps are often painless, but they may become painful as they grow.
  • Pain or Pressure
    • Pain occurs if the tumor presses on nearby nerves, muscles, or organs.
  • Swelling or Swollen Limbs
    • Swelling in the arms or legs, especially if the tumor blocks blood or lymph flow.
  • Difficulty Breathing or Digestive Problems
    • If the tumor is located in the chest or abdomen, it can cause:
      • Shortness of breath.
      • Nausea or difficulty eating.
  • Fatigue and Weakness
    • Feeling constantly tired or weak, especially in advanced stages.
  • Skin Changes
    • Tumors near the surface may cause redness, warmth, or changes in the skin over the lump.
  • Liposarcoma
  • Arises in fat cells, usually in the arms, legs, or abdomen.
  • Can vary in aggressiveness.
  • Leiomyosarcoma
  • Develops in smooth muscle tissue (e.g., in the uterus, digestive tract, or blood vessels).
  • Common in middle-aged and older adults.
  • Rhabdomyosarcoma
  • Starts in skeletal muscle cells.
  • Most common in children and teenagers, often in the head, neck, or genitals.
  • Angiosarcoma
  • Develops in the lining of blood vessels or lymphatic vessels.
  • Can appear anywhere in the body, including the skin or internal organs.
  • Fibrosarcoma
  • Originates in fibrous (connective) tissue.
  • Typically occurs in the limbs or trunk.
  • Synovial Sarcoma
  • Affects the tissues around joints, such as tendons or ligaments.
  • Commonly found in young adults.
  • Malignant Peripheral Nerve Sheath Tumor (MPNST)
  • Develops in the protective lining of nerves.
  • Often associated with neurofibromatosis (a genetic disorder).
  • Gastrointestinal Stromal Tumor (GIST)
  • A type of soft tissue sarcoma that occurs in the digestive tract, most often in the stomach or intestines.
  • Kaposi Sarcoma
  • Arises from the lining of blood or lymphatic vessels.
  • Often associated with HIV/AIDS or weakened immune systems.

TREATMENT OF BONE AND SOFT TISSUE CANCER

The treatment of bone and soft tissue cancers depends on factors such as the type, location, size of the tumor, and whether it has spread. A multidisciplinary team usually plans the treatment, which may involve a combination of therapies. Here are the primary treatment options:

Surgery

  • Goal: Remove the tumor completely, often the first-line treatment.
  • Bone Cancer:
  • Limb-Sparing Surgery: Removes the tumor without amputating the limb.
  • Amputation: Rarely needed but may be required for extensive tumors.
  • Reconstruction using metal implants, bone grafts, or prosthetics is often performed after surgery.
  • Soft Tissue Cancer:
  • Removes the tumor along with a margin of healthy tissue to prevent recurrence.

Radiation Therapy

  • Goal: Use high-energy beams (e.g., X-rays) to destroy cancer cells.
  • Often used before surgery to shrink the tumor or after surgery to kill any remaining cancer cells.
  • Advanced techniques like Intensity-Modulated Radiation Therapy (IMRT) or Proton Beam Therapy can minimize damage to surrounding healthy tissues.

Chemotherapy

  • Goal: Use drugs to kill cancer cells or stop their growth.
  • More commonly used in bone cancers like Ewing sarcoma and osteosarcoma, as they tend to respond well to chemotherapy.
  • May be combined with other treatments, such as surgery and radiation.
  • Common drugs include doxorubicin, cisplatin, and ifosfamide.

Targeted Therapy

  • Goal: Attack specific molecules or pathways in cancer cells without harming normal cells.
  • Imatinib (Gleevec): Used for gastrointestinal stromal tumors (GIST).
  • Pazopanib (Votrient): Treats certain soft tissue sarcomas.
  • Denosumab: Targets bone destruction in specific bone tumors like giant cell tumors.

Immunotherapy

  • Goal: Help the immune system recognize and destroy cancer cells.
  • Checkpoint Inhibitors (e.g., pembrolizumab): Being tested for sarcomas.
  • Emerging therapies include vaccines and CAR-T cell therapy.

Cryotherapy and Radiofrequency Ablation (RFA)

  • Cryotherapy: Freezing the tumor using liquid nitrogen, often for bone tumors.
  • RFA: Using heat from radio waves to destroy cancer cells, mainly in soft tissues.

Clinical Trials

  • Patients can participate in trials testing new drugs, therapies, or treatment combinations.
  • Oncolytic viruses: Engineered viruses that target and destroy cancer cells.
  • Gene therapy: Modifying genes to fight cancer.

Palliative Care

  • Focuses on improving quality of life by managing symptoms such as pain, swelling, and mobility issues.
  • May include physical therapy, occupational therapy, and psychological support.

Combination Treatments

  • Many cases require a mix of surgery, chemotherapy, and radiation for the best outcome.
  • Osteosarcoma is often treated with pre-surgery chemotherapy, surgery, and post-surgery chemotherapy.
  • Soft tissue sarcomas might involve radiation before surgery, surgery, and then targeted therapy.

Factors Affecting Treatment Decisions

  • Type and Stage: Whether the cancer is localized or has spread.
  • Tumor Location: Nearby vital structures, such as nerves or blood vessels, can influence the choice of treatment.
  • Patient’s Overall Health: Determines the suitability of aggressive therapies.

Modern treatments and advancements like personalized medicine are improving survival rates and quality of life for patients with bone and soft tissue cancers. Early diagnosis and expert care are crucial for better outcomes.

PREVENTION OF BONE AND SOFT TISSUE CANCER

While there’s no guaranteed way to prevent bone and soft tissue cancers, as their exact causes are not always known, you can reduce certain risk factors and take proactive steps to lower the likelihood of developing these cancers. Here’s how:

Avoid Exposure to Harmful Radiation

  • Limit unnecessary exposure to high-dose radiation, such as repeated X-rays or CT scans, unless medically necessary.
  • Follow safety precautions if working in environments with radiation exposure.

Minimize Exposure to Harmful Chemicals

  • Avoid prolonged contact with carcinogenic chemicals like herbicides, pesticides, and industrial toxins.
  • Use protective equipment if you work in industries involving such substances.

Maintain a Healthy Lifestyle

  • Balanced Diet: Eat plenty of fruits, vegetables, and whole grains, which contain antioxidants that may protect cells from damage.
  • Regular Exercise: Staying active can strengthen your immune system and overall health.
  • Healthy Weight: Obesity may increase the risk of certain cancers, including soft tissue sarcomas.

Avoid Smoking and Limit Alcohol

  • Smoking is linked to many cancers, and quitting reduces overall cancer risk.
  • Limiting alcohol consumption can also lower the risk of various cancers.

Monitor and Protect Against Genetic Risk

  • If you have a family history of cancer or genetic disorders like Li-Fraumeni syndrome, Paget’s disease, or neurofibromatosis, consider genetic counseling and regular screenings.
  • Early detection of genetic predispositions can lead to preventive measures.

Prevent Bone Injuries and Stress

  • Protect bones from repeated injuries or stress, which can occasionally lead to complications over time, though rare.
  • Use protective gear during sports or other high-impact activities.

Regular Medical Checkups

  • Routine health screenings can help detect any early signs of abnormalities in bones or soft tissues.
  • Promptly report unusual symptoms, such as persistent lumps, swelling, or unexplained pain, to a doctor.

Vaccinations and Immune Health

  • Strengthen your immune system by staying up-to-date on vaccinations, such as the HPV vaccine, which can reduce the risk of certain cancers.
  • Manage chronic conditions like diabetes or HIV/AIDS, which can weaken the immune system.

Limit Exposure to Chronic Irritation

  • In rare cases, chronic irritation or inflammation (e.g., untreated injuries) may contribute to abnormal cell growth.

Stay Informed About Occupational Risks

  • If you work in industries where exposure to harmful substances is common, learn about associated risks and follow all safety protocols.