Contents
What is bone cancer?
bone Cancer are malignant tumors of various parts of the human skeleton. The most common form is secondary cancer, when the oncological process is caused by metastases that grow from neighboring organs.
Primary cancer, when the tumor develops from the bone tissue itself, is much less common. Its varieties are osteoblastoclastoma and parosteal sarcoma, as well as osteogenic sarcoma. Bone cancer includes malignant tumors of cartilage tissue: chondrosarcoma and fibrosarcoma. As well as cancers outside the bones – lymphoma, Ewing’s tumor and angioma.
In the structure of oncological morbidity, bone cancer occupies a small share – only one percent. But due to the symptoms that are not expressed at the initial stages and the tendency to rapid growth, it is one of the most dangerous types of oncology.
Symptoms of bone cancer
The first sign of developing bone cancer is pain that appears when you touch the place under which the tumor is located. At this stage, the neoplasm can already be felt: this is the middle stage of the course of the disease.
Then the pain is felt without pressure. At first weak, sometimes arising from time to time, gradually it becomes stronger. Appears unexpectedly and quickly disappears.
The pain occurs intermittently or is present constantly, in a dull or aching form. It concentrates in the area of the tumor and can radiate to nearby parts of the body: if the shoulder is affected, the arm may hurt. The pain does not go away even after rest, aggravated at night. As a rule, analgesics do not relieve the pain symptom, and the pain intensifies at night or during vigorous activity.
Other common symptoms of bone cancer include limited movement and swelling of the limbs and joints. Bone fractures may occur, even if the fall was very slight.
Abdominal pain and nausea are often noted. This is the result of hypercalcemia: calcium salts from the diseased bone enter the blood vessels and cause unpleasant symptoms. At further stages of the development of the disease, other common signs of bone cancer are observed – a person loses weight, his temperature rises.
At the next stage of the malignant process, usually two to three months after the onset of pain, regional lymph nodes increase, joints swell, and soft tissue edema develops. The tumor is well palpable – as a rule, it is a fixed area against the background of moving soft tissues. In the affected area itself, an increased temperature of the skin may be observed. The skin in this place becomes pale, thinner. If the size of the tumor is significant, a vascular, marble pattern is noticeable.
Weakness appears later. A person begins to quickly get tired, becomes lethargic, he is often haunted by drowsiness. If the cancer metastasizes to the lungs, breathing problems are observed.
The main symptoms of bone cancer:
pain;
limitation of joint mobility;
an increase in regional lymph nodes;
swelling of the limbs and joints;
swelling of soft tissues at the location of the tumor;
pain even after rest, worse at night;
increased skin temperature over the tumor;
thinning, pallor of the skin, pronounced vascular pattern;
weakness, lethargy, fatigue, drowsiness;
respiratory disorders.
The symptomatology of bone cancer, not obvious and mild at the initial stage, leads to the fact that a person does not attach importance to ailments until the disease has gone far enough.
The main risk group is children and young people under thirty years of age. Mostly bone cancer affects men between seventeen and thirty. Elderly people rarely get sick.
Causes of bone cancer
One of the provoking factors in the development of bone cancer is considered to be radiation in doses above sixty Grays. Including intensive irradiation during the treatment of other types of tumors. Ordinary X-ray does not have such an effect on bone tissue. The ingestion of radioactive strontium and radium can increase the tendency to form cancer cells.
Bone marrow transplantation can also provoke malignant processes in bone tissues.
A predisposition to the development of malignant neoplasms is observed in people with certain hereditary pathologies. Thus, Li-Fraumeni syndrome is determined in the anamnesis of some patients diagnosed with breast cancer, brain cancer, and sarcoma. Genetic diseases that can affect the appearance of cancer today include Rothmund-Thomson and Li-Fraumeni syndromes, Paget’s disease, and the presence of the RB1 gene.
According to doctors, the cause of the development of oncological neoplasms can be DNA mutations, as a result of which oncogenes are “launched” or genes that prevent tumor growth are suppressed. Some of these mutations are inherited from parents. But most tumors are associated with mutations acquired by a person already during his own life.
The risk of developing bone cancer is slightly higher in smokers and those who have chronic diseases of the skeletal system.
Main causes of bone cancer:
injuries of bones and joints;
radioactive radiation;
hereditary predisposition;
DNA mutations;
bone marrow transplant operations;
chronic diseases of the skeletal system.
Stages of bone cancer
At the first stage bone cancer is limited to the affected bone. In stage IA, the tumor is eight centimeters in diameter. In stage IB, it becomes larger and spreads to other parts of the bone.
The second stage The disease is characterized by malignancy of neoplasm cells. But it still does not go beyond the boundaries of the bone.
At the third stage the tumor captures several sections of the affected bone, its cells no longer differentiate.
Sign of the fourth stage – “intervention” of cancer in tissues adjacent to the bone: the formation of metastases. Most often in the lungs. Later – to regional lymph nodes, as well as to other organs of the body.
The rate of transition of the disease from one stage to another depends, first of all, on the type of malignant tumor. Some types of neoplasms are very aggressive and progress quickly. Others develop slowly.
One of the fastest growing types of bone cancer is osteosarcoma. He is also the most common. Typically seen in men. It is located on the long bones of the legs and arms, near the joints. An x-ray shows a change in the structure of the bone.
Another type of bone cancer, chondrosarcoma, can grow at different rates, either quickly or slowly. It occurs mainly in people over forty years of age. And it is usually located on the bones of the hips and pelvis. Metastases in such a tumor can “migrate” to the lymph nodes and lung tissues.
One of the rarest types of bone cancer is chordoma. It affects in most cases people over the age of thirty years. Localization – the spine: either its upper or lower section.
Bone cancer with metastases, prognosis
Most patients get an appointment with an oncologist when the bone cancer has already gone far. As a rule, metastases are diagnosed at this stage. Therefore, the complex treatment of malignant tumors of the skeletal system usually includes the entire set of anti-cancer techniques. In the later stages of the disease, it is often necessary to resort to amputation of the limb.
The effectiveness of treatment in oncology is measured by the survival rate: the time that a person lives from the moment of diagnosis. With bone cancer, the five-year milestone reaches seventy percent of patients. Both children and adults. The most common bone tumor in adult patients is chondrosarcoma, with it eighty percent of patients live longer than five years.
The cause of death in this form of oncology is usually not the bone cancer itself, but osteogenic tumors in other places of the body caused by metastases from the bone focus.
Treatment of bone cancer
The key condition for effective treatment of bone cancer is the earliest possible diagnosis. A timely X-ray or MRI can detect a malignant process in the initial stages and provide a high chance for the patient to recover.
Tactics of treatment in each case is selected individually. The main methods: surgery, radiation therapy, chemotherapy are used either in combination or separately from each other.
When choosing methods and their combination, the oncologist focuses on several factors: the localization of the tumor, the degree of its aggressiveness, the presence or absence of metastases in nearby or distant tissues.
Operative intervention
Surgery is performed in the vast majority of cases. Its goal is to remove the tumor and healthy bone tissue adjacent to it. If earlier the affected limb was often amputated, today more gentle methods are used when only a malignant neoplasm is removed. The damaged area is repaired with bone cement or bone graft from another part of the body. Bone bank tissue may be used. If a large area of bone has been removed, a metal implant is implanted. Some models of implants are able to “grow” with the body of a child or teenager.
Before surgery, chemotherapy may be prescribed: the introduction of drugs to stop the growth of malignant cells. This reduces the size of the tumor and facilitates the operation. After the tumor is surgically removed, chemotherapy is used to kill any cancer cells that may still be in the body.
Radiation therapy
Radiation therapy also aims to kill malignant cells. High-energy x-rays affect only the area of tumor localization. Long-term treatment: every day, several days or months.
Low Intensity Electro Resonance Therapy
Among the modern methods of treating bone cancer, the NIERT method (Low Intensity Electro Resonance Therapy) can be noted. In conjunction with autohemochemotherapy and the intake of calcium preparations, it is used to treat metastases of various sizes in bone tissues. Conducting several courses, experts say, gives a good analgesic effect, partial regression of metastases is achieved (in 75% of cases).
Rapid Arc
Rapid Arc is positioned as the latest development in the field of cancer treatment. This is radiation therapy that uses visual control and changes in the intensity of radiation. The technology uses high-precision linear accelerators and computed tomography. The device moves around the patient, “attacking” the tumor from a variety of angles. Irradiation is ten times more powerful than that of devices of older generations. Treatment time is reduced by up to eighty percent.
cyber knife
CyberKnife is considered an innovation in the surgical treatment of malignant neoplasms. Affected tissues are removed using stereotactic radiosurgery. This complex device combines the latest advances in robotics, radiation surgery and computer technology. The operation takes place without pain and blood, and the intervention in the patient’s body is minimal.
Brachytherapy
In brachytherapy, a radioactive source is implanted inside the tumor. This limits the area of radiation exposure and protects healthy tissue.
Proton beam therapy
A promising area in the radiological treatment of cancer is proton beam therapy. Malignant cells are exposed to beams of charged particles moving at great speed: heavy carbon ions and hydrogen protons. The method is more accurate than existing methods of cancer treatment.