bone cancer [AS, ban + Gk, karkinos, crab] , a skeletal malignancy occurring as a sarcoma or in an area of rapid growth or as metastasis from cancer elsewhere in the body. Primary bone tumors are rare; the incidence peaks during adolescence, decreases, and then rises slowly after 35 years of age. In adults, bone cancer is linked to exposure to ionizing radiation. Paget’s disease, hyperparathyroidism, chronic osteomyelitis, old bone infarcts, and fracture callosities increase the risk of many bone tumors. Most osseous malignancies are metastatic lesions found most often in the spine or pelvis and less often in sites away from the trunk. These are referred to as cancers of the primary site and not bone cancer. See also chondrosarcoma, Ewing’s sarcoma, fibrosarcoma, multiple myeloma, osteosarcoma. ▪ OBSERVATIONS: Bone cancers progress rapidly but are often difficult to detect. Alkaline phosphatase levels are elevated in osteoblastic tumors, and serum calcium and urinary calcium levels are increased in highly destructive lesions. X-ray films, radioisotopic scanning, arteriography, and biopsy are diagnostic. ▪ INTERVENTIONS: Surgical treatment consists of local resection of slow-growing tumors or amputation, including the joint above the tumor, if the lesion is aggressive. Radiotherapy may be given preoperatively or as the primary form of treatment. ▪ PATIENT CARE CONSIDERATIONS: As with any malignancy a coordinated team approach is imperative to provide the best quality of life possible. Nursing care will often focus on the management of the medication regimen and the control of pain. There is evidence that maintaining a healthy weight and being physically active reduces the risk of developing other cancers and complications. Physical and occupational therapists should determine a safe exercise program based on the patient’s condition. Prosthetic and orthotic devices are often prescribed.
