5 Reasons Why Bone Scan is Important in Cancer Case

Cancer is one of the most dangerous diseases that can affect mankind. Thanks to innovative techniques and advancements in medical technologies, better diagnostic tests for cancer and treatment options are now available. Bone scan is one such diagnostic test that helps in evaluating structural integrity of bones. In cases of cancer, the investigative test has great utility. It can help to assess spread of cancer from elsewhere to bones. Also in case of cancer, which originates primarily in the bones, this investigative test helps in diagnosing the location and spread of cancer.

Bone Scan
Bone cancer occurs when healthy bone cells divide in uncontrolled manner and give rise to tumor which can be malignant or benign. Benign tumors are non-cancerous in nature whereas malignant tumors are cancerous. These malignant tumors spread to different parts of the body if they are not eradicated.

Bone scan is usually recommended if you are constantly suffering from following symptoms:

Bone infections
Intense skeletal pain
​Pain in areas like breast, pelvic region etc.
Pain while performing movements like walking, running, skipping.

Before we dig more into the topic of bone cancer, let us understand in short the composition and functionality of bones.


Let’s have a look at the structure and composition of bones in short!

Composition of bones:


Primary composition of bones comprise of inorganic bone mineral which is in the form of small crystals and collagen fibers. Bones also contain small amounts of inorganic salts and proteins. Honeycomb like matrix found in the internal part imparts rigidity to the bone.

Following are the types of bone cells which make up bone tissue –

Osteocytes and osteoblasts –

These cells are involved in forming basic mineral structure of the bone.

Osteoclasts –

These cells are responsible for systematic breakdown and re-absorption of degenerated bone cells which paves way to lay new bone cells.

There are several different types of tissues found in bone. These are – bone marrow, cartilage, endosteum, periosteum, blood vessels and nerves.

Functions of bones:

Following are the important functions of healthy bones:

  • Bones help in providing movement to the body by working in co-ordination with skeletal muscles, tendons, ligaments and joints. Bones provide movement and locomotion. They also provide shape and rigidity to our body.
  • Bones form a protective layer around delicate organs. For example, our brain is enclosed in skull and heart is protected by rib cage.
  • Blood cells are manufactured in bone marrow. Red bone marrow consists of hematopoietic stem cells which are blood forming stem cells.

What is a bone scan?

Bone scan is a nuclear medicine imaging test that uses tiny amount of radioactive dye known as tracer to diagnose bone problems. The test is completely safe.

Bone scan procedure:

Prior to undergoing bone scans, let your doctor know if you are allergic to any radioactive substances and about current medications you are put on. Medicines that contain elements like Bismuth or Barium may interfere with the results and provide inaccurate analysis. Hence, your doctor will tell you to discontinue these medicines for few days prior to the test. Women who are pregnant or may get pregnant and those who are breastfeeding should convey the information to the doctor. Apart form this, there are no major restrictions regarding food intake, physical activity etc.
Radioactive substance (tracer) will be injected into the vein located in the region of arm. Once, it is injected, tracer will flow throughout the body. You will not feel any movement of tracer. It takes approximately 2-4 hours for the bones to absorb tracer. During this waiting time, you need to drink lots of water in order to get rid of unabsorbed tracer. By frequent urinating, unabsorbed tracer will leave your body. After 4 hours, your doctor will ask to to lie down on an examination table. A large scanning camera will be positioned above your body. You should remain still so as the pictures do not come out blurry. Images will be captured from various angles for better evaluation or assessment.
You can bounce back to your normal routine immediately after bone scan test. Your doctor will advise you to drink lots of water in next 24 hours to flush out traces of tracer. It takes around two days for the tracer to be completely flushed out of the body.

What role does bone scan play in cancer cases?

Bone scan uses tracer (small amount of radioactive substance) to check prognosis of cancer. The part of body where tracer is absorbed shows presence of cancerous cells. Hence, the scan is extremely useful to check if the cancer has spread to the bones and assess effectiveness of current cancer treatment.

Reasons why bone scan is important in cancer case:

Below mentioned are five reasons why bone scan is important in cancer case:

1. To diagnose bone cancer

Bone scan is the confirmatory test conducted to check the spread of bone cancer or to know the status of ongoing cancer treatment. Primary bone cancer originates anywhere in bone itself.
Bone cancer may develop in different bone tissues like-

  • Osteosarcoma- Tumor of bone tissues
  • Chondrosarcoma- Tumor of cartilage
  • Multiple Myeloma- The tumor originates in bone marrow which is the site where blood cells are made.

The above types of tumors that originate in different types of tissues reveal symptoms like redness, swelling and pain at the site of tumor. Also, since healthy bone cells are replaced by cancerous cells, bones become weak and more prone to fracture. Since, the tumor consumes more of body’s energy, one gets tired too easily. Unintended weight loss is also another symptom produced by the above mentioned tumors.
Bone scan reveals parts of the body where the tracer has been absorbed. Places where tracer is absorbed indicates presence of malignant tissues. Further tests are then carried out to evaluate the stage of cancer and to determine other aspects related to metastasis of bone cancer.

2. To determine metastasis of bone cancer

In secondary bone cancer, cancer that has originated in other part of the body spreads to the bone. Metastasis is a medical term used to denote extent of spread of cancer in the  body. Bone scan reveals metastasis of cancer like how far the cancerous cells have spread in the body from the organ of origin. Degree of extent of metastasis can be determined through bone scan. Doctor is able to determine how far cancer has spread to other bones. Metastasis can also occur in case of bone cancers like in the case of long bones, such as femur (thigh bone). Cancer can affect a certain portion of the bone and then spread to another part of the same bone. Bone scan gives a clear idea to the doctor as how far the cancer has spread and thus, help in complete understanding.

3. ​Bone scan helps in deciding treatment approach for cancer patients

Bone scan reports are of immense help for doctors to determine treatment approach. The scan shows places where the tumor is present and how far it has metastasized. To treat most types of cancer, surgery, chemotherapy, radio-therapy or combination of more than two treatments are implemented to kill the malignant tumor.
In case of bone cancer surgery, prosthesis or bone graft (transplanting of bone tissues) implementation can also be used as along with other treatment options. Bone graft surgical procedures are more useful to preserve the affected bone. In this procedure, only the affected part of the bone and few surrounding healthy tissues are removed. The space which is left is then filled with bone graft (also called as internal prosthesis or endo-prosthesis). The bone that is used in bone graft can be either obtained from patient’s own body or from a donor or can be artificial. Autograft is a type of bone graft that is obtained from patient’s own body and can come from either hips, ribs, pelvis or wrist. Allograft is the bone graft that is obtained from donor. Bone grafts provide structural stability and help in filling void where bone is absent. Success of bone graft procedure is largely dependent on how well your body accepts it.
If the doctor feels after bone scan that the cancer is too far spread to be treated by any mode of therapy, palliative treatment can be started in order to relieve the patient of their symptoms. This does not get rid of cancer but helps in providing symptomatic relief thus improving the patient’s quality of life.​

4. Prognosis

Prognosis is the scope of recovery from a particular disease. The reports generated by bone scan help the doctors to understand how much scope is available for the patient to recover from the cancer treatment. Thus, results obtained from bone scan procedure form a base for cancer treatment approach. Depending upon the stage of cancer, treatment method is decided. It is comparatively easy to treat cancer which is in initial stage. But, as the tumor grows in size and kills healthy cells in the body, it becomes quite difficult for the oncologist to kill all the malignant tissues present in the body. Generally, two treatment methods like surgery and chemotherapy or radiation therapy are implemented in order to ensure that there is not even a single cancerous cell present in the body. Even a single cancerous cell is considered dangerous as it is going to increase chances of cancer recurrence.

5. ​ As a follow-up measure

Bone scan plays a vital role in follow-up post cancer treatment. It shows the outcome of the treatment and how well the patient is responding to it. Post cancer treatment, chances of cancer recurrence cannot be ignored. Hence, it is advised that patients undergo bone scan in order to assess if the cancerous tumor has re-grown or not. Your oncologist will chalk out follow-up measure for you and it is important that you follow it to the tee. By sticking to follow-up procedure plan, you will drastically reduce chances of cancer recurrence and it will add years to your life.
The importance of bone scan as a measure during treatment of cancer has been explained in the above article. Timely scanning at a good medical center or hospital will be very helpful in determining a treatment and follow up plan for patients suffering from cancer which has affected bones.

 

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