About Bone Cancer
Cancer incidence is increasing throughout the United States, with an unprecedented 2 million new cancer cases predicted in 2024. According to the American Cancer Society, the following are some estimates for primary bone cancer in the United States in 2024:
- New cases: 3,970, including 2,270 in men and 1,700 in women
- Deaths: 2,050, including 1,100 in men and 950 in women
Bone tumors include osteosarcoma (OS), chondrosarcoma (CS), Ewing sarcoma, malignant giant cell tumor of bone (GCTB) and chordomas. The most common types are OS, CS and Ewing sarcoma, which make up 35%, 30% and 16% of primary malignant bone cancers, respectively. Chordomas and GCTB are less common, accounting for less than 5%1. Secondary bone cancer, also known as metastatic bone cancer, starts in another part of the body, such as the breast, lung, bladder or prostate, and then spreads to the bones.
Symptoms of Bone Cancer
- Pain
- Swelling
- Problems moving around
- Feeling tired
- High temperature (fever)
- Break in the bone (fracture)
- Weight loss
Causes of Bone Cancer
The risk of bone cancer increases with age. Exposure to high doses of radiation during radiation therapy can cause cancerous changes in the cells of bone. This is especially linked with radiation treatment in childhood. Treatment with alkylating chemotherapy agents is linked with osteosarcoma. Bone conditions, such as Paget's disease of the bone, can increase the risk of bone cancer. Some people inherit gene mutations from their parents that increase their risk of bone cancer: Li-Fraumeni syndrome and Rothmund-Thomson syndrome gene mutations. But the gene changes leading to bone cancer are usually acquired during life rather than inherited from a parent. People who had a rare type of eye cancer called retinoblastoma in childhood may be more likely to develop bone cancer because the same faulty gene can be responsible for both conditions. Research has also found that babies born with an umbilical hernia are three times more likely to develop a type of bone cancer called Ewing sarcoma2.
Alkylating agents used as chemotherapy and cancer also increase the risk of bone cancer3. Alkylating agents used in cancer treatments keep the cell from reproducing (making copies of itself) by damaging its DNA. These drugs work in all phases of the cell cycle and are used to treat many cancers, including cancers of the lung, breast, and ovary as well as leukemia, lymphoma, Hodgkin disease, multiple myeloma and sarcoma4.
Exposure to plutonium can increase the risk of bone cancer, especially for people who live or work near nuclear weapons factories or plutonium production plants. Some studies suggest that living within 1–3 kilometers (.62–1.86 miles) of industrial centers may increase the prevalence of bone tumors in children; metal production and processing plants, and urban waste-water treatment plants increase these cancer risks. Radium paint is used on the dials of watches and faces of clocks so that they glow. Workers who used their lips to bring the paintbrushes to a point have a high risk of bone cancer5.
Bone Cancer Prevention and Treatment in Functional Oncology
The gut microbiome can have a significant impact on human health, including bone cancer. The gut microbiome plays a role in nutrient absorption, immunomodulation and the gut–brain–bone axis, which regulates hormones. It's also known to influence cancer development and metastasis to distant organs, including bones, which is one of the most common sites of metastasis. The Gut-bone axis refers to the communications between the microbiome in the G.I. tract and skeletal system whereby microbes in the gut affect bone health. Accumulating evidence have revealed that gut microbiota is a critical factor in bone turnover6. The gut–brain axis serves as an interactive communication highway sending signals that influence multiple organs including the gut and non-gut organs, such as liver, brain and bone. The gut microbiota can affect cancer metastasis to distant organs, including bones, which is one of the most common sites of metastasis. Bacteria in the gut can induce TNF-α expression via tumor-associated natural bone marrow cells, which can mediate early tumor necrosis7. TNF-α is a cytokine that can trigger and worsen inflammation. Inflammation drives cancer growth. Bacteria can adhere to the colon mucosa and cause inflammatory responses that include TNF-α secretion, increased intestinal permeability, and cytokine secretion8.
In functional oncology, we use stool testing to identify the root cause of symptoms and disease and define the health of the microbiome. All patients are offered a research-based stool analysis to identify dysbiosis, inflammation, immune dysfunction, and diversity of microbes. Cancer prevention and ceasing cancer progression after it’s occurred is a priority for all cancer patients, and we know the role of probiotics can be essential in creating a healthy microbiome for all. All probiotics are not the same. Specific probiotics that have been found to be beneficial in cancer patients are Lactobacillus acidophilus, Streptococcus, Bifidobacterium, Propionibacterium, and Enterococcus, as well as beneficial yeasts such as Saccharomyces boulardii. But every cancer is different and not all probiotics work the same. Through stool studies, patients can have a well-defined microbiome to guide the provider in making prescription probiotic recommendations needed to optimize their gut. The probiotic prescriber needs to have knowledge of the type of cancer and use research defining the impact of bacteria in microbiota in the G.I tract for their cancer. In many cancers, probiotics have been shown to decrease cancer cell proliferation, decrease inflammation, induce cancer cell death, and produce important anticancer substances such as short chain fatty acids9.
Functional oncology utilizes supplements based on research to impact cancer in our patients. Melatonin has therapeutic effects when used for treating bone cancer such as osteosarcoma, it can halt cancer cell proliferation and trigger cell death, enhancing the effectiveness of chemotherapy. Furthermore, the antioxidative function of melatonin alleviates harmful side effects of chemotherapy that occurs from oxidative damage and aids in decreasing therapeutic toxicities10.
Contact Hyperion Functional Medicine to learn more about bone cancer.
1 https://www.cancer.org/cancer/types/bone-cancer/about/key-statistics.html
2 https://www.nhs.uk/conditions/bone-cancer/causes/#
3 https://www.cancerresearchuk.org/about-cancer/bone-cancer/risks-causes#
5 https://cancer.ca/en/cancer-information/cancer-types/bone/risks
6 Chen Y, Wang X, Zhang C, Liu Z, Li C, Ren Z. Gut Microbiota and Bone Diseases: A Growing Partnership. Front Microbiol. 2022 May 6;13:877776. doi: 10.3389/fmicb.2022.877776. PMID: 35602023; PMCID: PMC9121014.
7 Iida N, Dzutsev A, Stewart CA, Smith L, Bouladoux N, Weingarten RA, et al. Commensal bacteria control cancer response to therapy by modulating the tumor microenvironment. Science. 2013;342:967–70.
8 Mori T, Sato Y, Miyamoto K, Kobayashi T, Shimizu T, Kanagawa H, Katsuyama E, Fujie A, Hao W, Tando T, Iwasaki R, Kawana H, Morioka H, Matsumoto M, Saya H, Toyama Y, Miyamoto T. TNFα promotes osteosarcoma progression by maintaining tumor cells in an undifferentiated state. Oncogene. 2014 Aug 14;33(33):4236-41. doi: 10.1038/onc.2013.545. Epub 2013 Dec 16. PMID: 24336323.
9 Sankarapandian V, Venmathi Maran BA, Rajendran RL, Jogalekar MP, Gurunagarajan S, Krishnamoorthy R, Gangadaran P, Ahn BC. An Update on the Effectiveness of Probiotics in the Prevention and Treatment of Cancer. Life (Basel). 2022 Jan 2;12(1):59. doi: 10.3390/life12010059. PMID: 35054452; PMCID: PMC8779143.