Bone cancer is a group of malignant tumors that affect the bone system. This oncological illness is probably the most rare. Tumors of bones are most often found in adolescents and children, and very rarely in the elderly. In adults, bone defects are usually associated with metastases from another tumor (lungs, mammary gland, etc.).
The most common bone tumors are sarcoma Iving, osteosarcoma, chordoma, chondrosarcoma, fibrosarcoma, malignant fibrous histiocytoma.
Sarcoma iwing It is considered to be the most aggressive tumor of the bone, which occurs in the age range of 4 to 15 years. Men are most susceptible to the development of this oncological disease. Sarcoma Iving in people over thirty years is found in isolated cases. The main localization of this tumor is the middle part of the long bones of the legs and arms. The prognosis of three-year survival is about 65%, but it is significantly worsened in the case of the spread of cancer cells to other organs and tissues of the human body.
The most common primary bone cancer is Osteosarcoma, Which affects most men in the age range of 11 to 24 years (elderly people are very rare). In children, osteosarcoma often develops in areas of intense growth near the knee and shoulder joints, as well as in the long bones of the legs and arms. This type of cancer is very aggressive and can spread to the lungs. The forecast of five-year survival is about 65%.
Chordoma - rarely occurs, develops in people over thirty years old (twice as common in men). Most often affects the upper and lower parts of the spine.
Chondrosarcoma in its prevalence is second (25%) of the total number of recorded malignant bone tumors. These tumors develop from cartilage cells and can grow as a relatively slow and be very aggressive. Chondrosarcoma is most common in adults over forty years (mostly men) and tends to spread to the lymph nodes and lungs. The main sites of the localization of this tumor are thighs and pelvic bones. Prediction five-year survival with slow-growing tumors is about 90%, while aggressive forms less than 30%.
Fibrosarcoma Is a very rare form of bone tumor, which is most common in men 35 to 55 years of age (in men more often). The main places of localization are the back of the knee and soft tissue of the legs.
Malignant fibrous Histiocytoma Is the most common tumor of soft tissues in the elderly (over 50 years old), which affects fatty deposits, tendons, ligaments and muscles. The severity of the course of histiocytoma may be different. The five-year survival outlook is between 45% and 60%.
Also, in humans, two more common types of bone cancer can be observed: multiple Myeloma and Lymphomas. Multiple myelomas, although developed in bones, are not, however, classified as bone marrow tumors, since they are tumors of the bone marrow and not bone cells. Lymphoma - a cancer that begins its development, usually in the lymph nodes from the cells of the immune system, but can also begin to appear in the bones.
In addition to malignant tumors of the bone, various types of benign tumors can be observed: osteoblastoma, osteoma, osteochondroma, chondromyxoid fibroma, angondroma, osteoblastoclostoma (most often transformed into a malignant tumor).
Symptoms of bone cancer
The most common symptom of all bone tumors is pain. As disease progresses, symptoms become more and more difficult. In the early stages of the development of the tumor, pain is most often observed at night, or during active activity.
Being directly dependent on the rate of growth of a malignant tumor, symptoms can be observed from several weeks to several years before a person turns for medical assistance.
Sometimes the tumor can be felt both on the bone itself and on the surrounding tissues. These manifestations are characteristic of fibrosarcoma and histiocytoma, but can also occur with other tumor bones. Due to the development of malignant neoplasms, bones may be weakened, which, even with minor injuries (or even their complete absence), leads to fractures.
In addition, symptoms such as chills, fever, weight loss and night sweats may occur, but they are less common, as they appear after the spread of the malignant process into other organs and tissues of the body.
The primary diagnostic method for cancerous bone defects is an X-ray examination. The presence of bone tumor gives a radiograph a rather characteristic picture in the form of dark spots on the affected areas of the bone, or white spots in those areas where the result of the tumor process is the formation of calcium deposits. A more sensitive method than an X-ray examination is scanning bones, which allows you to detect even very small hearths that are not visible on the X-ray.
If the origin of the primary tumor is already known, in the secondary cancer, a biopsy is usually not performed. If the exact localization of the primary lesion has not been established, for the final diagnosis the obligatory conduct of the biopsy, which consists in the investigation of suspicious cells under a microscope, is indicated. In these cases, most often resort to a puncture biopsy carried out under local anesthesia. In some cases, an open biopsy is required, which is a surgical intervention that is performed under general anesthesia.
Other studies are conducted to determine the distribution of cancer cells (in the primary tumor), or to identify the primary lesion (the primary tumor is not localized, and the experimental tumor is secondary). Research includes: scanning by MRI, ultrasound of the liver, CT scan of the chest.
Treatment for bone cancer
The choice of tactics for treating bone cancer primarily depends on the degree of prevalence and the histological structure of the tumor.
Basic methods of treatment:
- Surgical (radical) intervention;
- Radiation therapy;
These methods are used both independently and in combination.
The most common method of treating bone cancer is surgery Whose purpose is to remove the entire tumor and the adjacent part of a healthy bone. Obtained after removal of the material is subject to thorough study, the purpose of which is to determine if there is a normal bone tissue around the tumor. In case of detection of cancer cells, further treatment is required.
Not so long ago, the only option for operative treatment of bone cancer was amputation, but modern treatments have reduced its need for a minimum. To date, in most cases, the tumor is removed from the normal bone without amputation. Based on the volume of the removed bone, bone cement is used to restore the damaged area, or bone marrow transplantation from the bone marrow or from another site of the body is performed. In the event of significant damage, implants from the metal are used, which can be prolonged during the growth of children.
Radiation therapy Is most often used for preoperative irradiation. When it is used, high total cell doses are used. The expediency of the combination of radiotherapy with diomodiffictive effects (hyperbaric oxygenation, turnstile hypoxia, hyperthermia) has been proved.
Chemotherapy When bone cancer is performed prior to surgical intervention for its relief and tumor reduction in size. It can also be used after a surgery to destroy cancer cells.