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Health & Fitness

Bone Pain That Signals Cancer

 

We marked 'World Cancer Day' this week. The most worrying thing is that most cancers (up to 70 or 80 per cent are diagnosed in advanced stages).

A majority of patients do not recognise the early warning signs and ignore symptoms until it is too late.

In addition, most health workers lack the expertise to recognise cancer in early stages, hence misdiagnosis is a common occurrence.

Your bones could be speaking to you

Bones are a common site for cancer. The cancer could either be arising from the bone itself or it could have spread from another part of the body.

Cancers arising from the bone: These are more common in children, teenagers and young adults. They tend to be aggressive and can lead to disability. They include osteogenic sarcoma, Ewing's sarcoma, chondrosarcoma and chordoma. They affect the arms, legs, pelvis and back bone.

Most of these cancers need radical surgery that often involves amputation of the affected limb. Additional therapy (chemotherapy or radiotherapy) is tailored to each patient's needs.

Cancers that have spread from other organs: These are most common in adults. Cancer that has spread from another organ to the bones, known as a 'metastasis'.

The cancer can reach the bone through two major routes: either cancer seeds are carried in the blood stream from one organ to the bones (for example, cancer of the prostate can send seeds to the back bone) or the cancer can move to adjacent organs in advanced disease (for example, in advanced breast cancer, there may be cancer cells in the rib cage).

Usually, bone metastasis is a sign of advanced disease and cure in these patients is rarely possible.

Cancer arising from the bone marrow: The bone marrow has cells that form blood and other types of cells that are responsible for a healthy immune system.

Cancers from the bone marrow are usually not considered to be primary bone cancers and are treated without the use of surgery (most respond well to chemotherapy). These cancers include certain lymphomas, leukaemia and multiple myeloma.

Cancer warning signs:

Bone pain: Cancer-related bone pain starts in a subtle manner — and most people ignore it for several months before seeking treatment. As it progresses, it feels as though the pain is 'deep inside the bone' and it does not respond to over-the-counter pain medication.

Most people experience persistent pain in the back, leg or arm. The pain may be worse at night.

Broken bones: Affected bones usually break easily.

Disability: Cancer of the backbone can lead to disability. This is because cancer cells can eat away and erode the back bone. The destruction of the back bone and compression of the spinal cord can lead to disability.

Swelling of the limb: This is prominent in children and young adults. Most of the time, it is ignored because we assume the swelling is as a result of a fall (especially in children). This swelling increases in size with time. Weight loss: Cancer causes weight loss.

Fever: Cancer can also present with a persistent fever, chills and night sweats. Usually, lab tests done to look for infections will not find any offending organisms.

Fatigue: Cancer can also present with persistent fatigue which does not resolve despite sleeping adequately.

What to do

If you are worried about the bone pains, see a doctor. Your initial check up can be done by a general practitioner.

He/she should perform a full physical examination and, in most cases, will perform some imaging to check on the affected bones (usually a plain radiograph — referred to as an 'xray' will give an indication as to what is wrong with your bones).

If need be, more complex imaging such as MRI/CT scans and blood tests may be requested for by a doctor. Depending on the results, the doctor may refer you to a bone specialist or an oncologist if there are any concerns of cancer.

Early diagnosis increases your chances of cure. If you have any concerns regarding your bones or if you have a family history of cancer, talk to a doctor about the best way to assess your health issues.

Send your health questions to [email protected] or [email protected]

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