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Bone Cancer Causes

As is the case with all types of cancer, the causes of bone cancer are not known. What can be considered the primary causes of bone cancer, however, are the risk factors associated with the disease. While there are a few steps an individual can take to reduce his or her risk for developing bone cancer, many of these risk factors of bone cancer are unchangeable.

Generally speaking, the risk factors are linked to unpreventable and unchangeable factors such as age, medical history, and family medical history. It should be said that although risk factors may increase an individual's chance of developing bone cancer, many people with bone cancer do not display any risk factors whatsoever. Similarly, having one or more risk factors does not cause one to develop bone cancer. Here are the biggest known risk factors of bone cancer:
1. Smoking:n> Smoking is known to be a high risk factor for lung, larynx, mouth, bladder, kidney, and bone cancer, as well as others. The addictive nature of the main drug in cigarettes, nicotine, makes quitting smoking difficult, especially if an individual has been smoking his or her entire life. In spite of this, smoking is one of the few preventable causes of bone cancer. Quitting smoking can also offer a slew of health benefits beyond lower one's risk for bone cancer.
2. Genetic Disorders: Certain genetic disorders (very rare) seem to be associated with high rates of bone cancer. Children with rare genetic syndromes have been found to be at higher risk for developing osteosarcoma, including children with Li-Fraumeni syndrome, Rothmund-Thompson syndrome, and retinoblastoma. Multiple exostoses, also known as multiple osteochondromas, has been found to increase the risk forchondrosarcoma. Additionally, research has found that chordoma runs in some families.
3. Radiation: Overexposure to radiation, especially bone exposure, may increase the risk of bone cancer. While a normal x-ray does not pose such a threat, certain diagnostic tests or radiation therapy can develop a new cancer of the bone. This is particularly true for those treated at a young age. Small amounts of radiation stemming from microwaves, cellphone use, and similar appliances do not pose such a risk.
4. Paget Disease: Paget disease is a non-cancerous condition that predicts cancer (pre-cancerous). Most common among people older than 50 years old, Paget disease causes abnormal bone tissue to form making bones heavy and thick, yet fragile. 
5.  Injuries: While many bone cancer patients are convinced that their past injuries were causes of bone cancer, doctors predict that the cancer has led the patients to remember the injury, not that the injury caused bone cancer.  As such, there is still little to no research backing up this risk factor.
Also known as osteogenic sarcoma, osteosarcoma is the most common form of primary bone cancer. This particular type of bone cancer has cells that develop similar to osteoblasts, cells found in the bone that form the connective tissue and minerals that provide strength. Osteosarcoma is found primarily in adolescents and young adults, accounting for approximately 5 percent of cancer found in children. The tissue formed by these cancerous cells, however, are not as strong as normal bone tissue. About 80% of osteosarcoma in children and adolescents develops in the bones around the knee, in the distal femur and proximal tibia. Osteosarcoma can spread beyond the bone, or metastasize, to other tissues such as muscle, tendons, and fat. Osteosarcoma does prevent good survival rate, especially when the entire affected bone is removed and followed by chemotherapy.
Symptoms: The symptoms of osteosarcoma are similar to other bone cancer symptoms. There are generally two main symptoms of osteosarcoma and bone cancer:
Pain: Pain is the most common symptom for all bone cancers. Specifically to osteosarcoma, pain in the longer bones of the body, such as below the knee or in the upper arm, may develop. This pain can be worse while exercising or before bedtime.  If an individual is experiencing pain that wakes him or her up can be particularly worrisome. 
Swelling: Swelling or a lump may develop in a specific affected area, usually several weeks after the pain begins.This swelling may be followed by broken bones, such as an arm or a leg, as the bone cancer has continually weakened the bone.
Diagnosis: Osteosarcoma is detected using a number of diagnostic tests, including physical examinations, x-rays, CT scans, or MRI scans.  As it is the case with all cancers, a proper diagnosis is unreachable without a biopsy of the suspcious tissue, usually done by an othopedic oncologist. 
Treatment: Typical treatment of osteosarcoma usually involves a trial of chemotherapy to reduce the size of the tumor and kill cancer cells. After the first treatment of chemotherapy, the patient will usually undergo surgery, followed by more chemotherapy.  This treatment procedure ensures three things: that the surgery is as minimally invasive as possible (pre-surgery chemotherapy), that the tumor and cancer cells are removed (surgical procedure), and that recurrence is unlikely (post-surgery chemotherapy). The two most common surgeries performed to treat osteosarcoma are amputation and limb-salvage surgery. To avoid amputation, many patients choose to undergo limb-salvage surgery.  In this type of surgery, the affected area of the bone and muscle are removed, which is then replaced by a bone graft or metal prosthesis. New treatments are constantly being researched, especially in the field of chemotherapy drugs. Surgery remains the most prominent bone cancer treatment. The main goal of surgery for bone cancer treatment is to completely remove the cancer found in the cells of the bone. Surgery is also often required to obtain a biopsy of the suspicious growth for examination for possible cancer cells.
Other forms of bone cancer treatment are often used in conjunction with surgery, most notably chemotherapy and radiation therapy. In these cases, chemotherapy or radiation therapy may be used before the surgery to reduce the size of the tumor; these bone cancer treatments may also be used after surgery to rid the body of remaining cancer cells. There are a number of different types of surgeries used in bone cancer treatment, all of which involve a "wide-excision." A wide-excision is when a surgeon attempts to remove a cancerous tumor from the bone. To ensure that every single cancer cell is removed and killed, the surgeon will remove both the tumor and additional surrounding tissue that appears to be healthy.
Amputation: Amputation is a type of surgery often used to treat bone cancer. More specifically, amputation involves removing the tumor, an area above it, and everything below it. As a result, amputation leaves the patient with a lost limb (arm or leg). While amputation used to be the surgery of choice for bone cancer treatment, the appearance of limb-salvage surgery has significantly lowered the need for such a surgery. Before the surgery, the pathologist and surgeon will utilize MRI scans and examination of the tissue to determine how much of the limb must be removed. After the surgery, the patient will often be fitted with a prosthesis, or an artificial limp.  Using this prosthesis will require months of rehabilitation.
Limb-salvage Surgery: This type of surgery has been the surgery of choice of recent times. In this procedure, the surgeon's goal is to remove all of the cancer from the body while still allowing the patient to retain his or her limb. Now, the overwhelming majority of bone cancer patients requiring surgery can have their limb salvaged. Limb-salvage surgery is not simple, however, and requires specially trained and skilled surgeons. The challenge for this type of surgery is to preserve the tendons, vessels, and nerves surrounding the cancerous growth. During the procedure, a wide-excision is done to remove the cancerous bone tumor. Afterwards, the surgeon will replace the missing bone with either a bone graft or an internal prosthesis (usually made out of metals or other materials). This type of surgery carries much more risk of infection or complications. Many patients may require surgery in the following years, and will be required to undergo very intense rehabilitation.
Reconstructive Surgery: Reconstructive surgery is often required after the two surgical procedures listed above. Each type of reconstructive surgery involves the surgeon attaching a healthy joint to a removed joint. For example, if the upper arm is removed during surgery, reconstructive surgery will reattach the lower arm, leaving the patient with a shorter, but functional arm.
Curretage: Curretage is a procedure that is commonly used when traditional wide-excision is impossible. In curretage, the surgeon will remove the tumor through a hole in a section of the bone. Often times, cryosurgery will be used. More specifically, the surgeon will pour liquid nitrogen into the small hole to kill and remove the tumor.
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