Diagnosis
There are a variety of diagnostic tools to determine availability and type of cancer. Some include:
- X-rays- show the location, size, and shape of a bone tumor. If x-rays suggest that an abnormal area may be cancer, the doctor is likely to recommend special imaging tests. Even if x-rays suggest that an abnormal area is benign, the doctor may want to do further tests, especially if the patient is experiencing unusual or persistent pain.
- Bone Scan- which is a test in which a small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it then collects in the bones and is detected by a scanner.
- Computed Tomography (CT or CAT) Scan- a series of detailed pictures of areas inside the body, taken from different angles, that are created by a computer linked to an x-ray machine.
- Magnetic Resonance Imaging (MRI)- uses a powerful magnet linked to a computer to create detailed pictures of areas inside the body without using x-rays.
- Positron Emission Tomography (PET) scan- a small amount of radioactive glucose is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body.
- Angiogram- an x-ray of blood vessels. Blood vessels near bones are analyzed.
- Biopsy (removal of a tissue sample from the bone tumor)- helps to determine whether cancer is present. The surgeon may perform a needle biopsy or an incisional biopsy. During a needle biopsy, the surgeon makes a small hole in the bone and removes a sample of tissue from the tumor with a needle-like instrument. In an incisional biopsy, the surgeon cuts into the tumor and removes a sample of tissue. Biopsies are best done by an orthopedic oncologist. A pathologist examines the tissue to determine whether it is cancerous.
- Blood tests- helps to determine the level of an enzyme called alkaline phosphatase. A large amount of this enzyme is present in the blood when the cells that form bone tissue are very active—when children are growing, when a broken bone is mending, or when a disease or tumor causes production of abnormal bone tissue. Because high levels of alkaline phosphatase are normal in growing children and adolescents, this test is not a completely reliable indicator of bone cancer.
- Follow-up treatment IS necessary: Bone cancer sometimes metastasizes, particularly to the lungs, or can recur, either at the same location or in other bones in the body. Because red blood cells are also grown in the bone marrow, bone cancer metastasizes rather quickly because the red blood cells made abnormal by the cancer flow into the bloodstream (therefore many people with bone cancer also tend to get leukemia if the bone cancer isn't treated quickly enough). People who have had bone cancer should see their doctor regularly and should report any unusual symptoms right away. Follow-up varies for different types and stages of bone cancer. Generally, patients are checked frequently by their doctor and have regular blood tests and x-rays. People who have had bone cancer, particularly children and adolescents, have an increased likelihood of developing another type of cancer, such as leukemia, later in life. Regular follow-up care ensures that changes in health are discussed and that problems are treated as soon as possible.