Incidence

Bone cancer is the 24th leading site overall, 18th in males and 21st among females. In 1998, an estimated 769 new cases will be seen, 479 cases among males and 290 among females. Osteosarcoma is the most common of all malignant bone tumors. Incidence increases at age 60.

Risk factors

Areas of rapid bone growth, such as long bones in children and adolescents, as well as prolonged growth or overstimulated metabolism, such as chronic osteomyelitis and hyperparathyroidism. External radiation and bone-seeking isotopes have also been implicated.

Warning signals

Pain that is worse at night.

Early detection

Early detection is extremely difficult in asymptomatic patients. Patients with persistent and progressive bone pain should have an x-ray study of the bone.

Treatment

Although amputation has been the standard treatment of most bone cancer, limb-sparing surgery has been developed for both malignant and aggressive begin tumors. Advances in orthopedics, bioengineering, radiographic imaging, radiotherapy, and chemotherapy have contributed to safer, more reliable surgical procedures. Paralleling these advances, adjuvant chemotherapy has dramatically increased overall survival.