Coping With Bone Cancer

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Table of Contents

People deal with the distress and uncertainty of cancer in different ways. One strategy that often helps is to learn enough about cancer to be able to ask questions about its treatment and about what the future may hold. Another is taking one day at a time and being sure to talk with friends and family.

Coping with bone cancer involves adjusting to the diagnosis, getting through treatment, making sense of life, and getting used to the 'new normal' thereafter.

Emotional

First, know that you don’t have to sort everything out all at once. It can take time to deal with each issue as it comes up, and that is both normal and necessary.

Osteosarcoma, Ewing sarcoma, and chondrosarcoma are the most common primary bone cancers.

The American Cancer Society has rich resources on many different cancers, including the bone cancers, and is a good place to start when trying to read up on your diagnosis.

But dealing with the diagnosis involves more than learning about bone cancer. Ask for help when you need it. Talking with professional counselors, clergy and cancer support groups also may be helpful. You can ask your doctor about support groups in your area or do some research online.

Physical

Your treatment for bone cancer may involve surgery, chemotherapy, radiation, or a combination of these therapies. Each treatment is associated with its own set of side effects, and so differing coping skills and strategies may be needed at different times in your cancer journey.

Coping With Surgery and Affected Limbs

Surgery is very common in the management of bone cancer. Any type of surgery can have risks and side effects, so you should not hesitate to ask the doctor what you can expect. And, if you have problems along the way, definitely let your doctors know about them. Doctors who treat people with bone cancer often will be able to help you with the particular problems that may come up. Typically this is an orthopedic surgeon—a surgeon who specializes in muscles and bones—and one who is further experienced or specialized in treating bone tumors.

It is common for bone cancer to affect the legs or arms. Today, many people who have surgery for bone cancer have what is known as ‘limb salvage’ procedures.

85 to 90 percent of patients with osteosarcoma of the appendicular skeleton (legs, arms, knees, and thighs) can undergo limb-sparing surgical procedures to help avoid amputation.

Limb preservation surgery can be complex and can include the placement of an artificial component entirely inside the body (an endoprosthetic device). Such devices can preserve the function of the limb, but there are drawbacks such as the risk of infection and, possibly, the eventual need for a revision surgery.

Less commonly, amputation may be required, which can result in the need for a distinct set of coping skills due to the loss of a limb. The loss of a limb can be challenging, and some people may feel hopelessness or grief afterward. The perception of one’s own body image can be affected.

It may be the case that coming to terms with the feelings around having an amputation may be just as important as getting used to the practical things and the “new normal” in life after having an amputation and/or prosthesis.

Whether you have limb-salvage surgery or amputation, for patients with bone cancer, the cancer journey continues after surgery.

Physical and occupational therapy play an important role in successful rehabilitation after surgery for bone cancer.

Both passive and active range-of-motion exercises are important in maintaining optimal limb function, and working hard to get better can be an important part of coping.

Coping With Radiation

Radiation can be used as part of the process of making sure no cancer is left after surgery. It can also be used if the bone tumor is particularly hard to remove or if it’s hard to remove the whole tumor surgically.

Common Side Effects of Radiation

  • Low blood counts
  • Feeling very tired
  • Skin changes at the site of treatment

The symptoms of radiation treatment can vary depending on which part of the body is receiving therapy. Most side effects get better after treatment ends, but some might last longer. Always communicate with your cancer care team about what you can expect as a result of treatment.

Coping With Chemotherapy

Chemotherapy may be used before surgery, after surgery, or both before and after.  The treatment has side effects, many of which resolve when therapy is complete.

Common Side Effects of Chemotherapy

  • Nausea and vomiting
  • Feeling tired and weak
  • Hair loss (which may be total)

Also, for many of the chemo-associated side effects such as nausea, there are effective treatments that can be used to address them, so if you have side effects, talk to your cancer care team so that they know what you are experiencing and can help.

Coping With Targeted Drugs

These are newer therapies that sometimes help when traditional therapies do not.  There are side effects, but they tend to vary depending on which drugs are used.

Common Side Effects of Targeted Drugs

  • Nausea
  • Diarrhea
  • Rashes
  • Headache
  • Fever and chills

Your care team will let you know what to look out for depending on the individual agent used and your personal health history.

Bone Cancer Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Man

Social

Friends and family can be extremely helpful, and although they may not always understand your thoughts and feelings in the way you want them to, it often helps to talk to someone else about your hopes and fears.

Opening up to others about your cancer diagnosis gives them the chance to learn how they can best support you.

Treatment requires some time away from your regular life, whether that’s school, college, or work. While there may be some concerns about “not telling the whole world” that you have cancer, it is important to tell at least those who need to know, and it’s likely that most people will be very understanding and supportive, perhaps even offering to help in any way they can.

Practical

Survivorship

Anybody who has ever had cancer will at some point worry about it coming back, and for some individuals, it can be extremely hard not to worry about cancer coming back. It may help to know that you are doing all you can to address that possibility.

You will be seeing your cancer doctor for years, long after you are treated. Be good about going to all of the follow-up visits. You will have exams, blood tests, scans, x-rays, and possibly some other tests to see if cancer has come back. The longer you’re cancer-free, the less often you will need to have follow-up visits and tests.

Nobody would ever ask to be diagnosed with cancer, but many people with cancer say it has changed their lives in positive ways, or that they would not be the same person today without having gone through that experience.

As noted by the American Cancer Society, “You can’t change the fact that you have cancer,” but you can always change the way you live the rest of your life.

This includes taking care of yourself physically, but also trying to avoid worrying excessively. The National Cancer Institute has an entire web hub devoted to survivorship, coping with cancer, and many of the issues that may come up along the way.

There is also a page by the American Cancer Society specific to living as an osteosarcoma survivor.

Caregiving

Both osteosarcoma and Ewing sarcoma can occur in relatively young individuals who are dependent on help from parents and others. Most osteosarcomas develop during adolescence, which is a very complex and delicate time in a person’s life. Similarly, the peak for Ewing sarcoma is between 10 and 20 years of age. 

In other words, parents act as crucial caregivers for many patients with bone cancer. And, like any major event affecting one family member, bone cancer and its treatment can have a profound effect on the whole family.

The American Cancer Society has developed resources for caregivers and for caring for children with cancer. There are also resources devoted to cancer caregiving, in general. Resources for caregivers often emphasize the importance of “care for the caregiver,” pointing out that hopelessness, guilt, confusion, doubt, anger, and helplessness can take a toll on both the person with cancer and the caregiver.

What is Caregiver Burnout?

Caregiver burnout is a serious issue that can compromise the quality of care the person with cancer receives. Recognizing the signs of burnout is important because there are resources available for caregivers.

The National Cancer Institute also has excellent resources on these topics—not only on coping with cancer and the issues that come with survivorship but also resources for family caregivers.

Sometimes after reviewing such materials about caregiving, people will come to learn that they have been “caregivers” for many years—it’s just that they don’t necessarily call themselves by that term or identify as such.

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Article Sources

  1. Surgery for Bone Cancer. American Cancer Society. Updated February 5, 2018.


  2. Primary Bone Cancer. National Cancer Institute. Updated November 20, 2018.


  3. Thornley P, Vicente M, Macdonald A, Evaniew N, Ghert M, Velez R. Causes and Frequencies of Reoperations After Endoprosthetic Reconstructions for Extremity Tumor Surgery: A Systematic Review. Clin Orthop Relat Res. 2019;477(4):894-902. doi:10.1097/CORR.0000000000000630


  4. Fauske L, Lorem G, Grov EK, Bondevik H. Changes in the body image of bone sarcoma survivors following surgical treatment--A qualitative study. J Surg Oncol. 2016;113(2):229-34. doi:10.1002/jso.24138


  5. Shehadeh A, El dahleh M, Salem A, et al. Standardization of rehabilitation after limb salvage surgery for sarcomas improves patients' outcome. Hematol Oncol Stem Cell Ther. 2013;6(3-4):105-11. doi:10.1016/j.hemonc.2013.09.001


  6. Radiation Therapy for Bone Cancer. American Cancer Society. Updated February 5, 2018.


  7. Chemotherapy for Bone Cancer. Memorial Sloan Kettering Cancer Center.


  8. Targeted Therapy for Bone Cancer. American Cancer Society. Updated January 3, 2019.


  9. Coping – Follow-Up Medical Care. National Cancer Institute. Updated July 18, 2017.


  10. Ewing Sarcoma. NORD (National Organization for Rare Disorders).


Additional Reading

  • Fauske L, Lorem G, Grov EK, Bondevik H. Changes in the body image of bone sarcoma survivors following surgical treatment—A qualitative study. Journal of Surgical Oncology. 2016;113(2):229-234. doi: 10.1002/jso.24138
  • Forni C, Gaudenzi N, Zoli M, et al. Living with rotationplasty--quality of life in rotationplasty patients from childhood to adulthood. J Surg Oncol. 2012;105(4):331-6. doi: 10.1002/jso.22088.
  • Grimer RJ, Aydin BK, Wafa H, et al. Very long-term outcomes after endoprosthetic replacement for malignant tumours of bone. Bone Joint J.2016;98-B(6):857-64. doi: 10.1302/0301-620X.98B6.37417.
  • Hinds PS, Billups CA, Cao X, et al. Health-related quality of life in adolescents at the time of diagnosis with osteosarcoma or acute myeloid leukemia. Eur J Oncol Nurs.2009;13(3):156-163. doi: 10.1302/0301-620X.98B6.37417.