Bone Marrow (Trephine Biopsy) Tips

The human body has 206 bones and bone cancer can affect any of these bones. This condition starts when healthy bone marrow cells mutate and grow out of control to form a tumor. There are many different types of bone cancer. Treatment of bone cancer varies from case to case and depends on factors such as, type of cancer, stage at which it is diagnosed and the patient’s overall health amongst other factors.

Surgery, chemotherapy, and radiation are the three most common types of treatments favored for bone cancer. Surgery is usually used for low-grade tumors. This involves the removal of tumor and the surrounding healthy cells and tissues to ensure that that cancer does not recur. For high-grade tumors, surgery may be accompanied by chemotherapy, radiation or a combination of the two.

Chemotherapy involves the delivery of medication to destroy cancer cells orally or intravenously. Radiation involves the use of high energy X rays to kill cancer cells. This is often used to treat patients with a tumor that cannot be surgically removed.

Apart from these standard forms of treatment, bone cancer patients are often advised to take part in clinical trials for their treatment. This can be described as a research study to test the efficiency of new approaches to the treatment of bone cancer. A clinical trial can be used to treat the safety and efficacy of a new drug, the new dosage of standard drugs or a new combination of treatment types. As a member of a clinical trial, you may be one of the first few people to benefit from treatment even before it is available to the general public.

Some of the new options available through clinical trials are:

1. Immunotherapy: This is also known as biologic therapy. It is designed to boost the patient’s immune system to fight cancer cells. Mifamurtidesi one of the types of immunotherapy being tested. Immune checkpoint inhibitors such as monoclonal antibodies are also being tested for their ability to block specific molecules.
2. Targeted therapy: This type of therapy targets the genes and proteins that contribute towards the growth and survival of cancer cells. Targeted therapy limits the damage caused to healthy cells and tissues and only blocks the growth of cancer cells.
3. Myeloablative therapy: This involves an intense regimen of chemotherapy. High doses of chemotherapy aim at destroying all the cancer cells. Unfortunately, in the process, healthy cells may also be killed. This may be followed by introducing stem cells through a bone marrow transplant to the patient’s body to renew blood cells.
4. Intraoperative radiation therapy: These trials evaluate the use of radiation given inside the patient’s body during a surgery. In cases where tumor is in a distant location of the body, stereotactic body radiotherapy and radiofrequency ablation may be used.
    

We have more than 200 bones in our body and each of them is susceptible to bone cancer. However, long bones in the arms and legs are most susceptible to this condition. Bone cancer can be primary or secondary. Primary bone cancer involves uncontrolled and abnormal cell division within the bones while secondary bone cancer refers to cancer that originated somewhere else in the body and later spread to the bones. While children and adults are equally at risk for primary bone cancer, adults and elderly people are more susceptible to secondary bone cancer. If diagnosed early enough, bone cancer can be treated and even cured with surgery, chemotherapy or radiation.

Hence it is essential to recognize the signs and symptoms of bone cancer. Here’s what you should look out for.

1. Pain in Bones: Pain is one the primary symptoms of bone cancer. As the tumour grows larger, this pain can become more intense. In its early stages, the pain may be experienced as a dull ache inside the bone or the affected part of the body. It may also increase or decrease according to your activity level or may be experienced only at night. However, not all bone pains signify ‘cancer’ as this is also a symptom associated with osteoporosis.
2. Swelling: In some cases, the abnormal growth of bone cells can result in the formation of a lump of mass that may be felt through the skin. In other cases, the affected area may also show signs of swelling.
3. Breaking of the Bone: Cancer can weaken the bones and make them more brittle. This may make the bones more susceptible to fractures. A bone breaking in an area that has been painful or sore for a long period of time may be a sign of cancer. This is known as a pathologic fracture.
4. Reduced Flexibility: If the tumour is located near a joint, it may affect the range of movements possible and make simple actions uncomfortable. For example, a tumour around the knee may make walking and climbing stairs a painful exercise.

Other symptoms to look out for are sudden and drastic weight loss, tiredness, excessive sweating at night, fever and difficulty breathing in case cancer has spread to other organs. Since many of these symptoms are common to other medical disorders, you should conduct a doctor immediately if you notice any of them. A physical examination and a couple of tests along with a biopsy will be required to confirm a diagnosis of bone cancer.

Osteoporosis (meaning porous bones) refers to a medical condition in which the bones of an individual become thin and weak. The previous stage is called osteopenia (a precursor to osteoporosis). The bones become fragile and therefore start losing its strength. The medical researchers have reported that women are more prone to getting osteoporosis as compared to that of men, but that does not mean that men are completely immune to this disease. Where there are almost 50% women suffer from osteoporosis by the age of 60, there are about 30% of men who face the problem of osteoporosis.

Well, it has always been said that sooner you start taking care of your health especially bones, the better it is. Osteoporosis is a very common medical condition nowadays and major factors that are responsible for the increased prevalence of this disease is the lifestyle changes which include the living patterns and the diet changes.

What Causes Osteoporosis?

Osteoporosis happens when there is an imbalance between new bone formation and old bone resorption. The body may fail to produce enough new bone, or too much old bone may be reabsorbed, or both. If calcium intake is not sufficient or if the body does not absorb enough calcium from the diet, bone production and bone tissue may suffer. Thus, the bones may become porous, resulting in spongy and brittle, prone to fractures.

Other conditions that may lead to osteoporosis include overuse of corticosteroids (Cushing syndrome), thyroid problems, lack of muscle use, bone cancer, certain genetic disorders, use of certain medications, and dietary deficiency of calcium.

Risk factors for osteoporosis:

• Women above 60 years of age.

• Early menopause natural or surgical.

• Poor diet & lifestyle  i.e. Cigarette smoking, eating disorders such as anorexia nervosa or bulimia, low amounts of calcium in the diet, heavy alcohol consumption, inactive lifestyle.

• Rheumatoid arthritis itself is a risk factor for osteoporosis

• Family History of osteoporosis.

• Overuse of corticosteroids

• Hypothyroidism

• Chronic Emotional stress

Foods That Cause Osteoporosis

• Alcohol – Increases inflammation that can lead to more calcium being leached from bones.

• Sweetened / Aerated drinks beverages – The sugary drinks like canned juices and aerated drinks like cola are the most dreadful drinks for your health especially bones, as these drinks extract the calcium from the bones. Carbonated drinks contain a lot of phosphates which is responsible for leaching of calcium from bones. It has been proven in a Harvard Study that the women just 16-20 years young had already started loss of bones as they were consuming a lot of carbonated drinks. Sugar is also responsible for inflammations.

• Processed, red meat – A high intake of sodium and red meat may result in bone loss.

• Caffeine/Tea – Excessive caffeine intake can result in bone loss as it causes hindrance in iron and calcium absorption from food.

Natural Treatments for Osteoporosis:

1. Osteoporosis Diet

To help you get all the vitamins and minerals you need to build and maintain strong bones, it’s important to eat a varied diet with adequate calories to fuel all your body’s processes. Mainly calcium and vitamin D are important. Other Nutrients needed to prevent bone disorders include iron, vitamin C and magnesium. Iron deficiency (anaemia) is a risk factor for osteopenia and osteoporosis because iron is essential for collagen synthesis and vitamin D metabolism. Vitamin C plays a role in collagen formation. It also helps stimulate the cells that build bones, enhances calcium absorption, and helps vitamin D to work properly.

Foods that provide Calcium include: dairy products like yogurt, milk or paneer. salmon or sardines; dark leafy green vegetables; and other veggies like broccoli, Makhanas (puffed lotus seeds), sesame seeds, calcium.

Magnesium rich foods include: leafy greens like spinach, pumpkin seeds, yogurt, black beans, figs, banana, cranberries, sunflower seeds, dark chocolates and Almonds & Avocados.

Sources of vitamin C include: citrus fruits, papaya or guava, berries, peppers, kiwi, broccoli and Amla(Indian gooseberry), star fruit, phalsa ,tomato.

Collagen protein: collagen is one component of bone that helps to build its framework and provide a flexible structure that can withstand pressure. Collagen is found naturally in things like bone broth or can be taken in protein powder form or supplement form.

Foods that supply Iron (which can help to prevent anaemia) include: chicken, fish, eggs, nuts, seeds, spinach, kala chana , garden cress seeds, dates and raisins etc.

Alkaline diet that helps protect bones. This means eating lots of veggies, fruit, sea vegetables and plant foods. Wheat grass is highly alkaline food.

It’s also best to lower the amount of sodium in your diet by eating more unprocessed/whole foods. It also helps to avoid things like: processed meats, fast foods, fried foods, canned goods, salty condiments or sauces, frozen meals, ready to eat meals etc. In addition, try to limit your intake of sugary products, sweetened drinks, alcohol and caffeine.

2. Practice Exercises:

To help maintain skeletal strength, it’s important to stay active. Osteoporosis has greater risk of fractures, so be careful while Exercising. Avoid strenuous and jerky movements. Exercise helps your body reduce the decline in bone mass associated with aging. It has many others benefits, too, such as contributing to hormone balance and a healthy body weight. Exercise is needed to keep muscles strong. It also helps with coordination and balance.

Weight-bearing exercises are the most beneficial for your bones, although this term often confuses people. Weight-bearing exercises include any type that “forces you to work against gravity” and that you practice with an upright posture. This way your bones and muscles must support your body weight.

To prevent and cure osteoporosis, yoga and Pranayama will be a great addition in your lifestyle. It will fix up your hormonal balance which is the root cause of problem. Oxygenation by breathing techniques will make your body alkaline and will help you in reducing bone sponginess. Cool, Calm and Clean environment and yoga practice – a wows combination for your health.

3. Take Supplements That Can Help Protect Bones

• Calcium: It’s best to obtain calcium from foods in your diet. However, you can take a supplement for boost. Most adults need about 1,000 milligrams daily. Choose calcium citrate, take it before meals for better absorption in a divided dose of 500mg everyday.
• Vitamin D: Experts recommend that people who have a history of deficiency, elderly adults,take a vitamin D supplement daily. Dosage recommendations vary person to person.
• Magnesium: Magnesium is a mineral; your body requires for proper calcium metabolism. Aim to get between 300–500 milligrams daily. Epsom salt bath is super source to get it through skin.

Ayurveda perspective of osteoporosis is, when vata (air) element is vitiated in our body and affects our bones is called Asthi Majja Kashaya. Traditionally used medicines for Asthi-majja kashaya (osteoporosis):Asthi shrinkhala ghrita, Shatavari, Ashwagandha churna, Shuddha guggulu, Mukta pisti, Praval pisti, Shankhabhama. Oil enemas (basti) particularly work on Asthi Dhatu (bones) and Majja Dhatu (bone marrow) along with Abhyangam therapy.

4. Maintain A Healthy Weight: Obesity can increase inflammation and contribute to hormonal changes that damage bones. Maintaining a healthy weight makes it easier to exercise and stay active into older age.

5. Get Enough Sunlight: Vitamin D helps improve calcium absorption. It’s best to obtain it via natural sunlight. To allow your body to make enough vitamin D to protect your bones, aim to get 15–20 minutes of sunshine on your bare skin daily.

6 Get Enough sleep: A sound sleep of at least 7-8 hours per day helps in better assimilation and absorption of nutrients. Lack of sleep may lead to adrenal fatigue and associated symptoms.

Final Thoughts on Osteoporosis:

Osteopenia is a condition characterized by lower-than-normal bone density. It precedes osteoporosis and causes brittle, weaker than normal bones that are more likely to fracture on minor jerk.

Risk factors for osteopenia include: being a woman following menopause; dieting or calorie restriction; eating disorders; taking medications that interfere with mineral absorption; anaemia; smoking cigarettes; too little exercise; obesity and a family history.

Natural treatments and prevention include: balanced diet with enough calcium and vitamin D; getting regular & safe exercise; maintaining a healthy weight; not smoking; and preventing vitamin D deficiency by getting adequate sunlight exposure and sound sleep, maintaining alkalinity in body. In case you have a concern or query you can always consult an expert & get answers to your questions!

A healthy diet is crucial for healthy bones. Many people face problems like osteoarthritis and osteoporosis as they age. While there are many factors that lead to deterioration of bone health such as obesity, the foods that you consume has a bigger impact on your bone health.

For starters, two of the basic nutrients that your bones need are calcium and vitamin D. Calcium strengthens the bones while vitamin D helps the body absorb calcium. Deficiency of these key nutrients can set you up for bone ailments.

Here are some foods that will promote bone health –

1. Go nuts - Nuts like almonds and walnuts have omega 3 fatty acids, which prevent the rate of bone cells breaking down. Moreover, nuts are also rich in protein and other trace minerals that are essential for the musculoskeletal system of the body.

2. Leafy greens - Leafy greens like cabbage, spinach and kale are packed with calcium and vitamin K. We know what calcium does for the bones, but not much about the role of vitamin K in bone health. Vitamin K prevents calcium loss from urine. It also plays a critical role in forming essential bone proteins.  You can add leafy greens in your salad servings or in your sandwiches.

3. Dairy products - Most people give up on milk when they enter their teenage years. Milk is a powerhouse of nutrients, especially the ones that play a role in bone health, which is calcium and vitamin D. Ensure that the milk you drink is of the non-fat variety. Also, avoid certain products made from dairy such as ice cream and cheese as they are high in calories and contain very little vitamin D.

4. Seeds - Seeds like flax seeds and chia seeds are rich in magnesium. Not many people know this but 50% of your body’s magnesium reserves are in the bones.  So when your magnesium levels drop, your calcium levels too drop and this results in weak and fragile bones.

5. Fatty fish - Fatty fish like salmon are rich in vitamin and omega 3 fatty acids. In addition to eating these foods, you should also get sufficient sun exposure to naturally produce vitamin D. Remember to expose yourself to the early morning sun, as the sun can get unbearable during the middle of the day.

Moreover, you need to follow a daily exercise regimen to keep your bones healthy and strong. It will also keep your joints flexible.

Following a healthy lifestyle can help you keep your bones in good shape for a long time to come.

Did you know that in addition to your diet, exercise is one of the best ways to make sure that you never lie on a hospital bed with a surgeon treating you for a bone disorder? Medical expertise has constantly pointed out to the fact that regular exercise makes your bones less likely to suffer from wear and tear during old age.

As you exercise, your muscles become stronger, your bone density increases and your balance improves. Of course, it goes without saying that you need to follow certain precautions before you exercise to avoid certain injuries.

Before starting any exercise program, make sure that you prepare your body for exercise. A brief warm up helps you to get your muscles ready for exercise. It also makes sure that your chances of injury are drastically reduced.

Here are some tips to keep your bones healthy:

1. Weight lifting: Weight lifting is a type of exercise that, if done correctly, will be extremely beneficial for your bones. You can opt for simple bodyweight exercises such as pushups and squats, which build muscle as well as strength. Avoid using very heavy weights as it causes back-related problems such as slipped disk.

2. Yoga: Yoga is another method of exercise which is very beneficial for bones and joints. The premise of yoga is static strength building wherein you hold a pose or an exercise for a certain period of time; this helps in strengthening your muscles. Along with your muscles, your bones also become stronger as you get fitter. Yoga is repetitive stress which is good for flexibility and hence keeps your joints supple and muscles in good shape. There are certain asanas which are weight bearing and anti-gravity postures can strengthen your bones. 

3. Swimming: Swimming again is a good aerobic exercise and is good for back and overall fitness but doesn't strengthen bone per se. It is a way to keep you healthy. Swimming is a cardiovascular exercise, which is also known for its calorie-burning capabilities. It is also very effective is incinerating fat and keeping your skeletal system healthy. Whereas walking and jogging and running certainly build your bones as they are weight-bearing exercises.

4. Pilates: Pilates is a new form of exercise that has been gaining a lot of steam lately. It does not require much equipment, as you can get started with just a mat. It is very effective in working your spine and the hips, thus keeping your lower back strong. A weak lower back increases the chances of bone disorders drastically.

A bone fracture occurs when a strong external force is applied on the bones causing it to break. It is an extremely painful condition that results in days of immobility and rest.

There are several reasons which can result in bone fracture, some of them being:

1. Injuries caused in sports
Any sport requires and demands extreme physical exertion and participation. Being involved in any sport therefore automatically increases your risk of incurring injuries. Bone fractures therefore are mostly reported during sports.

2. Osteoporosis
Due to the deficiency of calcium, the bones of both men and women tend to get weak and more susceptible to fracture and breakage. It is one of the primary causes that lead to bone fracture.

3. Osteomalacia
This also refers to a condition wherein the bones become weak and brittle. Much like osteoporosis, osteomalacia too significantly contributes to instances of bone fractures.

4. Osteosarcoma
This is a rare form of bone cancer that most often develops either near the femur or near the shinbone. An instance of this form of bone cancer is most often found in children and weakens the bone, consequently leading to fractures.

Though there may be different causes of broken fractures, its symptoms remain similar. Some of them are-

1. Swelling
One of the most common symptoms of bone fracture is perceptible swelling. If any of your bone is fractured, that particular part will be visibly swollen.

2. Deformity
Bones give your body the shape it has, thereby, any fracture anywhere would inevitably manifest itself as a clear deformity of that particular part.

3. Extreme pain
It goes without saying that a bone fracture would entail excruciating and extreme pain. This pain sharply increases with mobility thereby necessitating complete rest.

4. Temporary loss of function
The part of the body where the bone is broken temporarily becomes dysfunctional. For instance, if the bone in your hand is broken, you will find it extremely difficult to move and do any work with it.

Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosis, osteomalacia, rickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopause induced bone loss.

Causes of Metabolic Bone Diseases:

1. Imbalance in the level of calcium : Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
2. Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
3. Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
4. Over or under secretion of the parathyroid hormone:The parathyroid hormone (PTH) stimulates the secretion of an enzyme, which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+), which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.

Symptoms of Metabolic Bone Diseases:

The symptoms of most of the Metabolic Bone Diseases are similar, such as 

1. A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time, but unlike muscular pain, the exact region of bone pain cannot be specified.
2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
4. Defects in the bones can cause bowed out legs and a bent backbone.
5. A general feeling of exhaustion is often caused by bone diseases.
6. Kidney stones are an associated complication of metabolic bone diseases.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Staying healthy involves a wholesome state of being where the mind and body are in perfect sync. A less than properly functioning body can leave you in a state of potential depression after a certain point of time, while a depressive mind can leave you feeling less than stellar where you end up imagining and experiencing pain. The health of your bones and joints is one such area that requires even more care as you start growing older. Wear and tear is just one of the reasons for degeneration while fractures and injuries can lead to a sudden halt of normal functioning of the bones and joints too. So how can you ensure bone and joint health in the long run? Follow our tips!

1. Eating Right: Pick calcium rich food like dairy products that have a low fat content, including milk and yogurt. Also, have a daily dose of green, leafy vegetables and plenty of citrus fruit and juices for your fill of calcium. Further, food like eggs and soya beans which have lots of vitamin D can also help in retaining good bone and joint health. Vitamin C rich fruit like watermelon, oranges, squash and tomatoes also help in natural tissue and cartilage repair. And finally, get plenty of Vitamin K to retain good bone density for a prolonged period with ingredients like leafy green vegetables, eggs and cheese.
2. Exercise: This is the key to good bone and joint health. Much like machinery and tools, the bones and joints of your body can also wither with disuse and prolonged inactivity. Make sure that you indulge in exercises like long walks and muscle strengthening exercises which will give your joints and bones good amount of strength as well. Remember to speak with your doctor before you start a new exercise regime so that you avoid anything that may be harmful in case you have any other ailment. Low impact exercises will strengthen the spine, while fat burning and weight loss exercises will ensure that there is less pressure on the knees and lumbar area. Swimming and resistance building exercises can also be practised for these purposes.
3. Abstinence: A major factor in promoting better bone and joint health is abstinence from all those things that can create problems in the long run, like smoking, drinking excessively and even too much consumption of caffeine and fatty food. All these things can create depletion of the natural bone mass. Also, switching to a lower heel for everyday wear footwear and changing your position during your time at your work station are a few things that will go a long way.

Take care of your bones and joints the right way today, for a healthier tomorrow. If you wish to discuss about any specific problem, you can consult an Orthopedist.

A bone fracture occurs when a strong external force is applied to the bones causing it to break. It is an extremely painful condition that results in days of immobility and rest. There are several reasons which can result in bone fracture, some of them being:

1. Injuries caused in sports
Any sport requires and demands extreme physical exertion and participation. Being involved in any sport therefore automatically increases your risk of incurring injuries. Bone fractures, therefore, are mostly reported during sports.

2. Osteoporosis
Due to the deficiency of calcium, the bones of both men and women tend to get weak and more susceptible to fracture and breakage. It is one of the primary causes that lead to bone fracture.

3. Osteomalacia
This also refers to a condition wherein the bones become weak and brittle. Much like osteoporosis, osteomalacia too significantly contributes to instances of bone fractures.

4. Osteosarcoma
This is a rare form of bone cancer that most often develops either near the femur or near the shinbone. An instance of this form of bone cancer is most often found in children and weakens the bone, consequently leading to fractures.

Though there may be different causes of broken fractures, its symptoms remain similar. Some of them are-

1. Swelling
One of the most common symptoms of bone fracture is perceptible swelling. If any of your bone is fractured, that particular part will be visibly swollen.

2. Deformity
Bones give your body the shape it has, thereby, any fracture anywhere would inevitably manifest itself as a clear deformity of that particular part.

3. Extreme pain
It goes without saying that a bone fracture would entail excruciating and extreme pain. This pain sharply increases with mobility thereby necessitating complete rest.

4. Temporary loss of function
The part of the body where the bone is broken temporarily becomes dysfunctional. For instance, if the bone in your hand is broken, you will find it extremely difficult to move and do any work with it.

Broken bone is commonly known as bone fracture a d it occurs when an exorbitant amount of force is applied causing the bone to split or shatter. While some minor fractures lead to cracks and crannies, others may lead to complete breakage of the bones. Despite being hard, bones are formed in such a way that they can absorb pressure to only a certain extent, beyond which they break. Statistically, the incidence of broken bones are most common in children and in old age people.

Causes of Bone Fracture
Bone fracture can be caused due to a number of reasons; both intentional and accidental. Some of them include:
1. Accidents and injuries: Sports injuries, being hit by a car and tripping and falling are some of the typical episodes.
2. Old age: Diseases such as osteoporosis and brittle bone disease are common in aged people. As bones tend to become more fragile among the aged, they are at a greater chance of bone fractures.

Type of bone fractures
Primarily bone fractures are of four types, based on the way the bone splits. They are:

1. Complete fracture: This type of fracture refers to a complete breakage of the bone wherein the fracture may occur at various parts of the bone.
2. Incomplete fracture: In this type of fracture, the bone partially breaks instead of splitting entirely.
3. Compound fractures: This is a type of a fracture wherein the bone breaks past the skin. It is also known as an open fracture.
4. Simple fracture: In this type of a fracture, the bone breaks without causing an open wound on the skin.

Treatment of bone fractures
In case of a broken bone, the immediate course of action would be to reach for the first aid box. This can be done to stabilize the bone prior to hospitalization. Icing the injury, elevating the injured area to prevent further swelling and covering the wound with bandages are common measures. In many cases, people also make household splints (made of newspapers) to keep the bone stabilized. Hospitalization and especially surgery, can be also opted for in case of severe fractures.