Chemotherapy, Radiation and Bone Loss Medication

Chemotherapy and radiation for bone cancer are treatment options that may be used instead of, or combined with, surgery to remove the bone tumor. This article specifically looks at bone cancer treatment and not treatment for bone marrow cancer (leukemia and multiple myeloma), although chemotherapy and radiation are also treatments for bone marrow cancer.

Chemotherapy for Bone Cancer

Chemotherapy for bone cancer is the use of powerful drugs to kill cancer cells. Various chemotherapy drugs are available, and the ones used depend on your cancer. According to the American Cancer Society (2010), chemotherapy is often used for Ewing sarcoma and osteosarcoma, but it is seldom used for other bone cancers.
Because the chemotherapy drugs enter your bloodstream, they also kill healthy cells and can have side effects, including nausea and vomiting, loss of appetite, hair loss and mouth sores. Chemotherapy can damage cells in the bone marrow and lymph nodes, leading to low blood cell counts. Low blood cell counts can lead to increased risk of infection, easy bleeding or bruising, fatigue or shortness of breath.
An alternative to conventional chemotherapy for bone cancer is fractionated-dose chemotherapy (also known as metronomic chemotherapy). In fractionated-dose chemotherapy, rather than receiving all the chemotherapy drugs in a single, large dose, you receive the total chemotherapy dose in smaller amounts over a longer period of time, perhaps three to five days. This approach may help reduce some of the unpleasant side effects of conventional chemotherapy.

Radiation

Radiation therapy for cancer uses high-energy rays to kill cancer cells. Various radiation bone cancer treatments are available:
  • External beam radiation therapy focuses a direct beam of radiation from outside the body on the cancerous bone tissue in the body. This conventional radiation therapy is rarely used for bone cancers other than Ewing sarcoma.
  • Intensity modulated radiation therapy (IMRT) is a three-dimensional radiation delivery system that uses an advanced computer program to plan a precise dose of radiation based on a tumor's size, shape and location. This technique is more accurate and precise than conventional radiation therapy, which means IMRT can treat difficult-to-reach bone cancer tumors while affecting less of the surrounding healthy tissue.
  • Three-dimensional (3D) conformal radiation therapy uses CT to produce an image of a bone tumor and surrounding tissue in three dimensions. This therapy uses multiple radiation beams shaped to match the contour of the treatment area.
  • TomoTherapy® is a new type of radiation treatment that uses an advanced type of IMRT combined with computer tomography (CT) scanning to deliver extremely precise radiation to a tumor.
The type of radiation you receive will depend on the type and location of your cancer, your history of radiation treatment and the treatment facility.

Bone Loss Medication

A complication of bone cancer and of bone cancer treatment is bone loss. To prevent the loss of bone or reduce the risk of fractures and decrease pain, your healthcare provider may prescribe a bisphosphonate drug. These drugs block or slow the breakdown of bone. The bisphosphonate drugs approved by the FDA to treat cancer-related bone loss include Zometa® (zoledronic acid) and Aredia®(pamidronate).

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