Athena Vale
Bone cancer is a rare form of cancer that includes several types of malignant tumors that start in your bones. The symptoms of bone cancer vary from person to person, but typically, the first sign is pain. This pain may get worse at night or when the bone is used, such as when walking if the tumor is in a leg bone. The pain can become more constant over time and may be accompanied by muscle weakness and fatigue. This muscle weakness is caused by reduced muscle mass or reduced muscle function and is a significant co-morbidity of bone metastases. While bone cancer is not common, it is important to see a doctor if you are experiencing any unusual or persistent symptoms to ensure an accurate diagnosis and prompt treatment if needed.
| Characteristics | Values |
|---|---|
| Pain | The first sign of bone cancer is usually pain in the area of the tumor. The pain might not be there all the time at first but can become more persistent and worsen at night or with activity. |
| Tumor Location | Tumors located near a joint can interfere with normal movements and make them painful. Tumors in the bones of the neck can cause swelling that forms a lump in the back of the throat, leading to difficulty swallowing, eating, or breathing. |
| Fractures | Bone cancer can weaken bones and increase the risk of fractures. Fractures occurring near or through a bone tumor can cause sudden severe pain. |
| Swelling | Swelling can occur around the affected area of the bone and cause difficulty moving, especially if near a joint. |
| Weight Loss and Fatigue | Weight loss and fatigue accompanying bone pain are possible signs of bone cancer. |
| Muscle Weakness | Muscle weakness and dysfunction are common in advanced cancer patients with bone metastases. This can increase the risk of fractures. |
| Cachexia | Cancer cachexia is a syndrome characterized by severe wasting due to loss of skeletal muscle mass. It occurs in about 80% of patients with advanced malignancy and is responsible for about 20% of cancer-related deaths. |
| Treatment | Treatment for bone cancer includes surgery, radiation therapy, and chemotherapy. Pain related to bone cancer often improves soon after treatment starts. |
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What You'll Learn
Cancer-induced muscle wasting (CIMW)
The prevalence of muscle loss has been reported to be between 20% and 70%, depending on the type of tumour and assessment criteria. In advanced cancer patients, the prevalence of muscle loss depends on the tumour type, stage, and assessment tools used. In early-stage cancer patients, the prevalence of muscle loss ranged from 16% in breast cancer to 40.3% in hepatocellular carcinoma patients. Muscle wasting is associated with serious clinical consequences, including physical impairment, poor quality of life, reduced tolerance to treatments, and shorter survival.
Several pharmacological therapies are currently in pre-clinical and clinical testing, showing promising results as adjuncts to current CIMW therapies. These include resiniferitoxin, a targeted inhibitor of nociptive nerve fibres, and selective androgen receptor modulators, which show promise in increasing lean mass. Other medications, such as mirtazapine and olanzapine, provide benefits beyond muscle wasting, including 24-hour nausea control, increased appetite, anxiety control, and improved sleep. Exercise has also been proposed as a crucial component of the multimodal approach to CIMW. However, exercise programs to promote skeletal muscle hypertrophy require a high degree of effort, and some individuals may not be able to achieve the required intensity due to cancer treatment side effects and other limitations.
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Tumours causing difficulty in movement
Bone cancer can cause muscle pain and weakness. This is due to the interdependence of bone and muscle physiology, which is altered in cancer patients. Tumour metastasis to bone disrupts the normal functioning of bone and muscle. This results in muscle dysfunction, which can range from weakness to profound muscle wasting and cachexia. Cachexia is characterised by severe wasting due to loss of skeletal muscle mass.
Tumours can cause difficulty in movement, depending on their location. Brain tumours, for example, can cause a variety of symptoms depending on their location and growth rate. A tumour in the cerebellum, at the back of the head, may cause trouble with movement, walking, balance, and coordination. Tumours affecting the optic pathway can cause vision changes, and a tumour affecting the brainstem can cause difficulty in speaking or understanding language.
The pressure exerted by a tumour on healthy brain tissue can also cause symptoms such as partial or complete loss of vision, difficulty understanding or using language, and memory issues. Malignant brain tumours are cancerous and typically grow rapidly, invading surrounding healthy brain structures. They can be life-threatening due to the changes they cause to vital brain structures.
Tumours in other parts of the body can also cause movement difficulties. For example, spinal tumours can cause paralysis or weakness in the legs, and tumours in the legs or feet can make walking difficult.
Imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) are important tools for evaluating movement disorders caused by tumours. Early recognition of these disorders is crucial to prevent further complications.
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Cancer cachexia
Cachexia can make patients feel tired and unable to perform their daily activities. It is a wasting syndrome that leads to weakness, fatigue, and loss of skeletal muscle (also called sarcopenia) and fat. It is most common in people with advanced cancer. Unlike malnutrition, it cannot be reversed with nutritional support alone and must be treated with medicines.
There are currently no effective medical interventions to completely reverse cachexia and no approved drugs. Adequate nutritional support is the main method of cachexia treatment, while drugs that target the inhibition of catabolism, cell damage, and excessive activity are also being studied.
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Cancer treatment side effects
Cancer and its treatment can cause several side effects. A side effect is any problem that affects healthy tissue and organs as a result of cancer treatment. The side effects of cancer treatment vary from person to person and depend on the type of treatment and medication. For example, chemotherapy can cause hair loss, while radiation therapy can cause hair loss in the part of the body that receives radiation.
Some of the most common side effects of cancer treatment include nausea, vomiting, weight changes, dehydration, malnutrition, pain, fatigue, anemia, mouth problems, hair loss, skin and nail problems, and trouble concentrating or remembering things. Cancer treatment can also cause tiredness, trouble eating, and depression.
In addition, cancer-associated muscle weakness is a common side effect, especially in advanced stages of cancer. This can be caused by reduced muscle mass or function, or a combination of both. Muscle weakness is often accompanied by bone pain, fractures, hypercalcemia, and nerve compression syndromes.
It is important to discuss any side effects with your doctor, as they can provide treatment or advice to help manage these problems and improve your quality of life.
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Cancer-induced bone pain (CIBP)
Bone cancer symptoms vary from person to person, and some people may experience no pain at all. However, for those who do, the pain can become more persistent and intense over time. It is important to note that bone pain can also be caused by other conditions, such as injuries, arthritis, or Lyme disease, so a proper diagnosis is crucial.
The underlying cause of CIBP is the disruption between osteoclasts and osteoblasts, along with alterations in various signalling pathways. This disruption is caused by the metastasis of tumour cells to the bone, which also affects muscle function. The bone releases multiple growth factors during physiological remodelling, impacting the surrounding muscles. In turn, the myokines secreted by skeletal muscle cells significantly affect the bone.
Additionally, cancer-induced muscle wasting (CIMW) is a significant clinical problem in advanced-stage cancer, often associated with bone pain. Muscle weakness can be caused by reduced muscle mass or function, or a combination of both. Tumour cells that metastasize to the bone can disrupt normal bone remodelling, leading to morbidity and increased fracture risk. Therapeutic interventions and pharmacological therapies, such as resiniferitoxin and selective androgen receptor modulators, are currently being explored to manage CIBP and CIMW.
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Frequently asked questions
The first sign of bone cancer is usually pain, which may worsen at night or when the bone is in use. The pain can become more persistent and intense over time. Other symptoms include a painless or painful lump in the affected area, swelling, and difficulty moving around.
Treatment for bone cancer may involve surgery, radiation therapy, and chemotherapy. With treatment, bone cancer pain often improves soon after treatment starts. However, side effects may occur, and recovery can take several months to a year, depending on the cancer type, stage, and specific treatments.
The exact cause of bone cancer is unknown. Bone tumors form due to problems with cell DNA, causing cells to grow out of control and damage surrounding healthy tissue. Radiation therapy is also a known cause of bone cancer.
