Second cancer: Bone cancer

What is bone cancer as a second form of cancer?

This page belongs to Second form of cancer. We recommend reading that information first.

Bones support the body. Together with the muscles, they help it to move and protect the organs. Bone cells are constantly broken down and replaced by new ones. Until approximately age 30, there is more bone formation than bone breakdown. From approximately age 40, this is reversed. The bones then slowly become less strong. In women, this happens faster after menopause than in men.

Sometimes bone cells begin to divide uncontrollably and form a malignant tumor. This is called a bone tumor. The chance of developing a bone tumor after childhood cancer is very small.

Do I have an increased risk of a bone tumor?

Everyone, including people who have not had cancer, can develop a bone tumor. However, some cancer treatments can increase the risk.

The following treatment can increase the risk of a bone tumor:

• Radiation: the irradiated part of the body has an increased risk of a bone tumor

You can see in your treatment summary whether you have received this treatment. If you do not have a summary, you can contact the LATER clinic or the hospital where you were treated.

A bone tumor does not always have to be caused by treatment. There may also be other causes.

What are the symptoms and signs of a bone tumor?

Certain symptoms and signs may indicate a bone tumor. Even if you do not have these symptoms now, it is important to recognize them in case they ever occur.

The following symptoms and signs may indicate a bone tumor:

• A (sometimes painful) lump

• Bone or joint pain (also at night), continuous or in waves

• A bone fracture after a minor accident

• Difficulty moving a part of the body

Often these symptoms have a different cause. However, rapid diagnosis and treatment of a bone tumor are very important. Therefore, contact your general practitioner immediately if you recognize any of these symptoms.

I have an increased risk of a bone tumor. What tests are necessary and when?

If you have an increased risk of a bone tumor, regular check-ups are not necessary. If you experience symptoms or signs, go to your general practitioner immediately. You will likely receive:

• A physical examination

• An X-ray or MRI

What happens if I (might) have a bone tumor?

If you (might) have a bone tumor, your general practitioner or LATER physician will refer you to an oncology team. This team consists of:

• Orthopedic oncologist (physician specialized in bone tumors)

• Oncologist (physician specialized in cancer)

The oncology team will conduct further tests and discuss treatment options with you if necessary.

What else can I do?

Living with an (increased risk of) bone tumor can be difficult. Talking with friends and family can help. Contact with people in a similar situation can also provide support, for example through a patient association such as VOX, part of the Dutch Childhood Cancer Association.

Above all, take good care of yourself. Although it is not certain whether it reduces the risk of a bone tumor, a healthy lifestyle is important. Also take care of your mental health. Small changes can already have a positive impact on your physical and mental wellbeing.

It is important that you know you have an increased risk of a bone tumor and that you recognize the symptoms and signs. If you have questions or are concerned after reading this information, contact your general practitioner or LATER physician.

Where can I find more information?

This LATER website also contains information about:

• Bone problems

• Healthy lifestyle

• Mental health

In the PanCare Plain Language Summaries you will find links to reliable information in English. You can search for information about bone tumors online, but keep in mind that it is not always up-to-date and accurate.

Disclaimer

This information is based on the plain language summary of the guideline below, created by the PanCare Plain Information Group, and has been adapted to the Dutch LATER guideline where necessary. If you experience symptoms and signs, do not rely solely on this information, but consult your general practitioner, LATER physician, or specialist.

```