Now Know Different Types of Bone Cancer in Children

Bone cancer in children is a rare but serious form of cancer that primarily affects the bones and connective tissues. Pediatric bone cancers account for about 3-5% of all childhood cancers. While rare, these cancers can be aggressive and require prompt diagnosis and treatment. The most common types of bone cancer in children are osteosarcoma and Ewing sarcoma, which differ in origin, symptoms, and treatment approaches.

This article provides a detailed overview of the different types of bone cancer in children, their characteristics, symptoms, diagnostic procedures, treatment options, and prognosis. Understanding these cancers is crucial for early diagnosis and improving survival outcomes. (Source)

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What Is Bone Cancer?

Bone cancer occurs when abnormal cells in the bone grow uncontrollably, forming a malignant tumor. These tumors can either start in the bone (primary bone cancer) or spread to the bone from other parts of the body (secondary or metastatic bone cancer). In children, primary bone cancers are more common. The bones most frequently affected are the long bones, such as those in the arms and legs.

Types of Bone Cancer in Children

1. Osteosarcoma

• Definition: Osteosarcoma is the most common type of bone cancer in children and adolescents, accounting for about 56% of all cases. It originates in the osteoblasts, the bone-forming cells, and typically occurs in areas of rapid bone growth, such as the ends of the long bones, particularly around the knee (distal femur and proximal tibia) and upper arm (proximal humerus).
• Characteristics: Osteosarcoma is an aggressive cancer that can spread (metastasize) to other parts of the body, most commonly the lungs.
• Symptoms: Pain in the affected bone, which may worsen at night or with activity, swelling near the affected area, and, in some cases, fractures due to weakened bones.
• Diagnosis: X-rays, MRI, CT scans, and a biopsy are commonly used to diagnose osteosarcoma. A bone scan or PET scan may also be used to determine if cancer has spread.
• Treatment: Treatment typically involves a combination of surgery to remove the tumor, chemotherapy to kill cancer cells, and in some cases, radiation therapy. Limb-sparing surgery is often possible, though some children may require amputation if the tumor is too large or close to nerves and blood vessels.
• Prognosis: The prognosis for children with localized osteosarcoma is generally good, with a 5-year survival rate of about 70-75%. However, the prognosis is less favorable for metastatic or recurrent osteosarcoma. (Source)

2. Ewing Sarcoma

• Definition: Ewing sarcoma is the second most common type of bone cancer in children, representing about 34% of pediatric bone cancers. It arises from the primitive nerve tissue in the bones or soft tissues. This cancer most commonly affects the pelvis, femur, and ribs, but it can develop in any bone.
• Characteristics: Ewing sarcoma is highly aggressive and can spread to other parts of the body, including the lungs, bone marrow, and other bones.
• Symptoms: Pain at the tumor site, swelling, tenderness, fever, and occasionally, a palpable mass. Children may also experience fatigue, weight loss, and unexplained bone fractures.
• Diagnosis: Similar to osteosarcoma, diagnosis involves imaging tests like X-rays, MRI, CT scans, bone scans, and a biopsy. Genetic testing may also be performed to confirm the presence of specific chromosomal changes, such as the EWSR1-FLI1 gene fusion, which is associated with Ewing sarcoma.
• Treatment: Ewing sarcoma is treated with a multimodal approach, including surgery, chemotherapy, and radiation therapy. Chemotherapy is often given before surgery to shrink the tumor and afterward to prevent recurrence. Radiation therapy is used when complete surgical removal of the tumor is not possible.
• Prognosis: The 5-year survival rate for children with localized Ewing sarcoma is about 70-80%, but the prognosis drops to 30% or lower if the cancer has spread. (Source)

3. Chondrosarcoma (Rare in Children)

• Definition: Chondrosarcoma is a rare type of bone cancer in children, typically occurring in older adolescents. It originates in the cartilage cells that are part of the body’s connective tissue.
• Characteristics: Chondrosarcoma grows more slowly compared to osteosarcoma and Ewing sarcoma, and it is less likely to spread to other parts of the body.
• Symptoms: Symptoms include persistent pain in the affected area, swelling, and stiffness, especially in the bones near the pelvis, ribs, and shoulder.
• Diagnosis: Imaging tests such as X-rays, MRI, CT scans, and biopsy are used to diagnose chondrosarcoma.
• Treatment: Surgery is the primary treatment for chondrosarcoma, as this tumor type is less responsive to chemotherapy and radiation. The goal of surgery is to completely remove the tumor.
• Prognosis: The prognosis depends on the size and location of the tumor, but chondrosarcoma generally has a better outlook than other forms of pediatric bone cancer. (Source)

4. Other Rare Types of Bone Cancer

• Chordoma: A rare bone cancer that can affect the bones at the base of the skull and spine. It tends to grow slowly but can be difficult to treat due to its location near critical structures.
• Fibrosarcoma: A rare cancer that can develop in the bone or soft tissues. It is more common in adults but can occasionally be seen in children. (Source)

Symptoms of Bone Cancer in Children

The symptoms of bone cancer in children can often be mistaken for growing pains, sports injuries, or other less serious conditions. Common symptoms include:

• Bone pain: Persistent pain that worsens over time and is more severe at night or during activity.
• Swelling: Swelling or a noticeable lump near the affected bone.
• Fractures: Bones weakened by cancer may fracture with minimal trauma.
• Fatigue: Generalized fatigue and lethargy.
• Weight loss: Unexplained weight loss.
• Fever: Low-grade fever, especially in the case of Ewing sarcoma.

If these symptoms persist or worsen, it is essential to seek medical attention for proper diagnosis and treatment. (Source)

Diagnostic Procedures for Bone Cancer in Children

To diagnose bone cancer in children, healthcare professionals typically use a combination of the following tests:

• Imaging Tests: X-rays are often the first step in detecting bone abnormalities. MRI and CT scans provide detailed images of the tumor and surrounding tissues. A bone scan or PET scan may be used to detect metastasis.
• Biopsy: A biopsy is necessary to confirm the diagnosis of bone cancer. A small sample of the tumor tissue is removed and examined under a microscope to determine the type and grade of cancer.
• Genetic Testing: In the case of Ewing sarcoma, genetic testing may be performed to detect specific chromosomal changes, such as the EWSR1-FLI1 fusion gene. (Source)

Treatment Options for Pediatric Bone Cancer

1. Surgery: Surgery is a key treatment for most types of bone cancer in children. The goal is to remove the tumor while preserving as much function as possible. Limb-sparing surgery is often used to avoid amputation, but amputation may be necessary in some cases.
2. Chemotherapy: Chemotherapy is commonly used for osteosarcoma and Ewing sarcoma to kill cancer cells and shrink the tumor before surgery. It is also used after surgery to prevent recurrence.
3. Radiation Therapy: Radiation therapy is often used for Ewing sarcoma, especially when surgery is not feasible or to treat any remaining cancer cells after surgery.
4. Targeted Therapy: Researchers are exploring targeted therapies for certain types of bone cancers, focusing on specific genetic mutations or pathways involved in tumor growth.
5. Clinical Trials: Clinical trials may offer access to new and experimental treatments for children with high-risk or recurrent bone cancers. (Source)

Prognosis and Survival Rates

The prognosis for children with bone cancer depends on several factors, including the type of cancer, its stage at diagnosis, and the child’s overall health:

• Osteosarcoma: The 5-year survival rate for localized osteosarcoma is 70-75%. For metastatic osteosarcoma, the survival rate drops to around 30%.
• Ewing Sarcoma: The 5-year survival rate for localized Ewing sarcoma is 70-80%, but for metastatic cases, it falls to 15-30%.
• Chondrosarcoma: This cancer generally has a better prognosis than osteosarcoma and Ewing sarcoma, with higher survival rates, particularly for low-grade tumors. (Source)

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Conclusion

Bone cancers in children, while rare, require early diagnosis and aggressive treatment to improve outcomes. The most common types, osteosarcoma, and Ewing sarcoma are both aggressive cancers that typically affect the long bones. Treatment often involves a combination of surgery, chemotherapy, and radiation therapy. Advances in treatment have significantly improved survival rates for many children with bone cancer, but ongoing research is essential to develop new therapies, particularly for high-risk and recurrent cases.