| Bone CancerThere are two types of bone cancer; primary and secondary
                            cancer.
                Primary bone cancer develops in the bones and is fortunately
                very rare. Secondary cancer is more common and is the result
                of cells
              becoming detached from a cancer elsewhere in the body. 
                         Primary Bone Cancer                           Two main types of primary
                          cancer occur in bones; cancers of the bone marrow (myeloma,
                          lymphoma or
                              leaukemia - not dealt with here) and cancer of
                          the bones themselves, normally called sarcomas.  There
                          are a number of different types of malignant bone tumours
                          - Osteosarcoma,
                              Ewing's sarcoma, Chondrosarcoma and Spindle cell
              sarcoma.                           How can bone cancer be diagnosed?                           The cancer can usually be
                          seen on an Xray, but an isotope bone scan, MRI (Magnetic
                          Resonance Imaging) scan or CT (Computed tomography)
                          scan may
                          also be used. Blood tests
                              will indicate the level
                    of calcium
                  or any problems with bone marrow.                           How is it treated?                           Primary bone cancer can be treated by an appropriate
                              combination of radiotherapy, chemotherapy and surgery
                              depending on the
                      type of tumour.                               Secondary Bone Cancer                           The cells travel in the
                          blood or lymph and become lodged in the bone, most
                          frequently in the central part of the skeleton
                            such as the spine, pelvis or hip.
            Almost any cancer can spread to bone but the most common are lung,
            breast or prostate cancer. When cancer cells spread like this to
            another part of the body it is called metastasis.  What are the symptoms?                           The most important symptom
                          is pain - a dull ache in the bones
            which gets worse at night. In addition there may be raised calcium
            levels which cause tiredness, nausea and confusion.If the cancer
                          causes localised bone destruction, broken bones (fractures)
                          can occur. If the cancer affects the bone marrow, the
                          production of new blood cells may be
            affected causing anaemia.                           How can bone cancer be diagnosed?                           The cancer canusually be
                          seen on an Xray, but a bone scan, MRI scan or CT scan
                          may
                          also
                          be used. Blood tests will
                          indicate the level of calcium
            or any problems with bone marrow.                           How is it treated?                           The treatment of secondary
                          bone cancer partly depends on the site of the primary
                          cancer, if this is not already
                          known tests will be
            carried out to identify it.  Treatment will be an appropriate
              combination
              of hormone therapy, chemotherapy an/or radiotherapy
              depending on the site and severity of the cancer. Bisphosphonates
                          are also frequently given, by mouth or by intravenous
                          drip, to reduce bone
                          pain and to lessen the chances of high blood levels
                          of calcium and broken bones. Bisphosphonates work by
                          reducing the number and action of the osteoclasts,
                          thus slowing down the process of bone breakdown. Lost
                          bone cannot be replaced but bisphosphonates can strengthen
                          existing bone and reduce the damage caused by secondary
              bone cancer. More information               NHS
              Direct - bone cancer Cancer Research UK
 Cancerbackup
 American
              Cancer Society - bone metastasis
 American
              Cancer Society - bone cancer
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