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Bone cancer first symptoms. Diagnosis of bone cancer: symptoms and manifestations of a tumor at an early stage

- These are malignant various parts of the human skeleton. The most common form is secondary cancer, when the oncological process is caused by tumors growing 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. 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 cancer incidence, bone cancer occupies a small share - only one percent. But due to its unexpressed symptoms in the initial stages and its tendency to grow rapidly, 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 area under which the tumor is located. At this stage, the neoplasm can already be felt: this is the middle stage of the disease.

Then the pain is felt without pressure. At first weak, sometimes occurring from time to time, it gradually becomes stronger. Appears unexpectedly and quickly disappears.

The pain occurs periodically or is constantly present, dull or aching. 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, intensifying 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 minor.

Abdominal pain and nausea are often noted. This is the result of hypercalcemia: calcium salts from the diseased bone penetrate 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 enlarge, joints swell, and soft tissue edema develops. The tumor can be easily palpated - as a rule, it is a stationary area against the background of moving soft tissues. In the affected area itself, increased skin temperature may be observed. The skin in this area becomes pale and thins. If the size of the tumor is significant, a vascular, marbled pattern is noticeable.

Later weakness appears. A person begins to get tired quickly, becomes lethargic, and is often haunted by drowsiness. If cancer metastasizes to the lungs, breathing problems occur.

Main symptoms of bone cancer:

limitation of joint mobility;

enlargement of regional lymph nodes;

swelling of the limbs and joints;

Bone marrow transplant operations can also provoke malignant processes in bone tissue.

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, or sarcoma. Genetic diseases that can influence the appearance of cancer today include Rothmund-Thomson and Li-Fraumeni syndromes, Paget's disease, as well as the presence of the RB1 gene.

According to doctors, the development of cancerous tumors can be caused by DNA mutations, as a result of which oncogenes are “triggered” or genes that prevent tumor growth are suppressed. Some such mutations are inherited from parents. But most tumors are associated with mutations acquired by a person during his own life.

The risk of developing bone cancer is slightly higher in people who smoke and those who have chronic diseases of the skeletal system.

Main causes of bone cancer:

injuries to 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. At stage IA, the tumor reaches eight centimeters in diameter. In stage IB, it becomes larger and spreads to other areas of the bone.

The second stage of 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 invades several areas of the affected bone, its cells no longer differentiate.

Sign of the fourth stage– “intervention” of cancer into tissues adjacent to the bone: the formation of metastases. Most often - to the lungs. Later - to the 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. It is also the most common one. Typically observed in men. Located on the long bones of the legs and arms, near the joints. X-rays show changes in bone structure.

Another type of bone cancer, chondrosarcoma, can grow at different rates: both fast and slow. It occurs mainly in people over forty years of age. And it is usually located on the bones of the hips and pelvis. Metastases from such a tumor can “migrate” to the lymph nodes and lung tissue.

One of the rarest types of bone cancer is chordoma. It affects people over the age of thirty in most cases. Localization - spine: either its upper or lower section.

Bone cancer with metastases, prognosis

Most patients see an oncologist when bone cancer is already advanced. As a rule, metastases are diagnosed at this stage. Therefore, complex treatment of malignant tumors of the skeletal system usually includes the entire range of anti-oncological techniques. In later stages of the disease, it is often necessary to resort to amputation of a limb.

The effectiveness of treatment in oncology is measured by the survival rate: the time a person lives from the moment of diagnosis. With bone cancer, seventy percent of patients reach the five-year mark. Both children and adults. The most common bone tumor in adult patients is chondrosarcoma; eighty percent of those affected live longer than five years.

The cause of death in this form of cancer is usually not bone cancer itself, but osteogenic tumors in other places in the body, caused by metastases from a bone lesion.

The key to effective treatment of bone cancer is early diagnosis. A timely X-ray or MRI can detect a malignant process in the initial stages and provide a high chance of recovery for the patient.

Treatment tactics are selected individually in each case. The main methods: surgery, radiation therapy, chemotherapy, are used either in combination or separately from each other.

When choosing techniques and their combination, the oncologist focuses on several factors: the location of the tumor, the degree of its aggressiveness, the presence or absence of metastases in nearby or distant tissues.

Surgery

Surgery is performed in the vast majority of cases. Its goal is to remove the tumor and adjacent healthy bone tissue. If previously the affected limb was often amputated, today more gentle techniques are used when only the malignant neoplasm is removed. The damaged area is repaired using bone cement or bone grafting from another area of the body. Tissue from a bone bank 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 administration of drugs to stop the growth of malignant cells. This reduces the size of the tumor and makes surgery easier. After surgical removal of the tumor, chemotherapy is used to destroy any cancer cells that may still remain in the body.

Radiation therapy

Radiation therapy also aims to kill malignant cells. High-energy X-rays affect only the area where the tumor is located. Treatment is long-term: every day, several days or months.

Low intensity electro-resonance therapy

Among the modern methods of treating bone cancer, one can note the LIERT method (Low Intensity Electro Resonance Therapy). In combination with autohemochemotherapy and calcium supplementation, it is used to treat metastases of various sizes in bone tissue. Carrying out several courses, experts say, gives a good analgesic effect, and 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 guidance and changes in radiation intensity. 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

“Cyber Knife” is considered an innovation in the surgical treatment of malignant tumors. The affected tissue is 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 intervention in the patient’s body is minimal.

Brachytherapy

In brachytherapy, a radioactive source is implanted inside the tumor. This limits the area exposed to radiation and protects healthy tissue.

Proton Beam Therapy

A promising area in radiological cancer treatment is proton beam therapy. Malignant cells are exposed to beams of charged particles moving at enormous speed: heavy carbon ions and hydrogen protons. The method is more accurate than existing cancer treatment methods.

Education: completed his residency at the Russian Scientific Oncology Center named after. N. N. Blokhin" and received a diploma in the specialty "Oncologist"

Bone cancer is not the most common cancer, but due to its mild symptoms it is one of the most dangerous diseases. It is often diagnosed at a late stage, which makes treatment much more difficult. Bone cancer manifests itself in the appearance of neoplasms on bone tissue, cartilage and soft tissues (tendons, muscles, fat, ligaments), often these are benign or have degenerated into malignant, metastatic tumors.

What is bone cancer

The human skeleton often becomes a haven for malignant neoplasms. Cancer can affect bone tissue, cartilage, muscles, joints, ligaments, and fiber. Exists primary a type of bone cancer, such as rib cancer, but more common is metastatic a type of cancer when a malignant tumor in bone tissue is a consequence of cancer in other parts of the body, for example, breast, esophagus, etc.

Symptoms of bone cancer

The disease has no clear signs of progression, which makes it difficult to recognize. Bone pain due to cancer can be similar to arthritis or gout. Often, patients consult a doctor already in a late stage disease, which makes it difficult to cure. The main symptoms of bone cancer:

pain that intensifies after exercise or at night;
swelling of the affected area;
weakening of the bone structure, which leads to frequent fractures;
poor health, fatigue, loss of appetite, fever.

Hands

Oncology localized in the bones of the hands is not observed so often, especially in the primary form. These are mainly metastases from breast, prostate and lung cancer. In this situation, bone tumors are detected on CT and MRI. Primary tumors on the bones of the hands rare, but they do occur In this case, you should pay attention to the following symptoms:

swelling, hardening and discoloration in the affected area;
pain in the joints of the hands;
general deterioration of the body – weight loss, fever, fatigue;
increased sweating, especially during sleep.

Legs

A malignant tumor on the leg bone is uncommon (approximately 1% of the total number of cancers). There are primary lesions of the bone, cartilage and soft tissues of the legs and secondary, that is metastases for certain types of neoplasms (breast and prostate glands, lung cancer). How does leg bone cancer manifest?

pain in joints and local areas of the legs;
the color of the skin above the tumor changes – it seems to become thinner;
decreased immunity, fatigue, sudden weight loss;
lameness may appear, the swelling interferes with movement.

Hips

Ewing's sarcoma, or osteogenic sarcoma, is located in the pelvic region, the junction of the pelvic and femur bones. Symptoms in this case Very greased Therefore, cancer is often diagnosed in the final stages. Clinical signs of the disease are:

Codman's triangle is a special shadow that doctors see on an X-ray;
skin pathology – it becomes thinner, color changes and lumpiness appears;
alternation of osteolytic (foci of bone tissue destruction) and osteosclerotic zones (seals);
problems in the functioning of the pelvic organs, nearby vessels and nerve endings.

Causes

The exact reasons for the development of bone cancer have not yet been clarified, but doctors identify several risk factors:

heredity - Rothmund-Thomson disease, Li-Fraumeni syndrome, the presence of the RB1 gene, which causes retinoblastoma;
Paget's disease, which affects bone structure;
precancerous neoplasms (chondroma, chondroblastoma, osteochondroma, ecostosis of cartilage and bone, and others;
exposure to radiation rays on the body, prolonged exposure to ionizing radiation;
injuries, fractures, bruises.

Types of bone cancer

There are several types of disease, some of them may be primary, but mostly it is secondary form of the disease:

osteosarcoma is a common form, more common in young people and adults under 30 years of age;
chondrosarcoma - malignant formations in cartilage tissue;
Ewing's sarcoma - spreads to the bone and soft tissues;
fibrous histiocytoma - affects soft tissues, bones of the extremities;
fibrosarcoma is a rare disease that affects the bones of the limbs, jaws, and soft tissues;
giant cell tumor - develops on the bones of the legs and arms, responds well to treatment.

Stages

Exists four stages of the course of bone tissue oncology, doctors distinguish additional substages:

first stage - the neoplasm is localized on a bone site, low degree of malignancy;
1A – the tumor grows, it puts pressure on the bone walls, swelling forms and pain occurs;
1B – cancer cells affect the entire bone, but remain in the bone;
second stage - cancer cells begin to spread into soft tissues;
stage three – tumor growth;
the fourth (thermal) stage is the process of metastasis to the lungs and lymphatic system.

Diagnostics

The signs of bone cancer are similar to the symptoms of many diseases; the most accurate diagnosis is clinical tests and functional diagnostics:

blood test for tumor markers - it will reveal an increase in thyroid-stimulating hormones, alkaline phosphatase, calcium and sialic acids in the body and a decrease in plasma protein concentration;
X-ray - visual analysis of the image can reveal the affected areas;
CT (computed tomography) - determines the stage of the disease and the presence of metastasis; a contrast agent is used to improve diagnosis.

Can be used to clarify the diagnosis MRI(Magnetic resonance imaging) using contrast, which shows the presence or absence of accumulation of cancer cells in the affected area. PET (positron emission tomography) determines the nature of the tumor. Today this is the most modern method of functional diagnostics.

A biopsy gives a 100% accurate result of diagnosing the nature of the tumor, whether it is primary, secondary and its type. For bone tumors, three types of biopsy are used:

Fine needle aspiration - a syringe is used to remove fluid from the tumor area. In difficult cases, the process is combined with CT.
Thick-needle – more effective for primary tumors.
Surgical – performed by making an incision and taking a sample; it can be combined with tumor removal, therefore it is performed under general anesthesia.

Treatment

The treatment system includes both traditional methods and latest developments by scientists:

NIERT - the technique is used for metastasis to reduce the pain effect and slow down the growth of cancer cells.
“Rapid Arc” is a type of radiation therapy, when the tumor is intensively exposed to a directed beam, treating it at different angles.
Cyberknife is a high-precision device that removes tumors with minimal impact on the body.
Brachytherapy – an implant with a radiation source is placed inside the tumor, which gradually kills cancer cells.

Chemotherapy

Standard chemotherapy involves the introduction of certain drugs into the body that destroy malignant tumors. Success is more noticeable in treatment at the initial stages of the disease. In addition, the metastatic process is prevented, the base for the development of new cells is destroyed. Chemotherapy is carried out under strict medical supervision, the drugs completely kill the immune system and have many negative side effects on the body (hair loss, nausea, mouth ulcers, slow growth in a child).

Surgery

Various operations to remove malignant tumors are the most common measure in the treatment of bone oncology. Often the intervention is prescribed simultaneously with taking a biopsy. When removing a tumor, it is important not to leave cancer cells in the body, so a wide excision is used, when nearby healthy tissue is also removed and their edges are analyzed for the presence of cancer cells. This type of operation is used for cancer of the hip area and extremities, if the affected area is small.

There are cases when wide excision cannot guarantee the desired result. Extensive lesions of the limbs and jaw bones require amputation. In the case of jaw bones, it is carried out tissue transplantation or the use of a bone graft. For tumors of the bones of the skull and spine, operations are performed to scrape out the affected areas from the bone, while preserving the bone.

Radiation therapy

Treatment with ionizing radiation, otherwise known as radiation therapy, is the exposure of cancer cells to radiation rays in doses that are safe for humans. However, the disease is resistant to radiation therapy and requires high doses of radiation, which negatively affects the body, especially the brain. It is often used for Ewing's sarcoma; radiation is used as an addition to chemotherapy and for prophylactic purposes in the postoperative period. Effective use of modern beam technologies: remote therapy, exposure of cancer cells to protons.

How long do people live with bone cancer?

The survival prognosis depends on many factors - the stage at which the patient went to the doctor, the type of cancer, the method of treatment and the age of the patient. With prompt access to an oncology clinic, patient survival reaches 70 percent. This means the likelihood of surviving the first 5 years after discovery and treatment of the disease. Unfortunately, when treated in late stages and with secondary metastasis, the chances of a successful cure are very low.

Video

Bone cancer (or bone cancer, or bone tumor) is a general definition used to address neoplasms of benign (with the possibility of degeneration) and malignant types. Bone cancer, the symptoms of which vary depending on the specific type of cancer, in the early stages may be accompanied by minor symptoms, and therefore is often ignored by patients. What is noteworthy is that bone cancer pathology itself is diagnosed quite rarely (about 1% of tumors), however, due to the formation of a tumor in a specific organ or system, and metastasis to the bones, certain types of cancer are classified specifically as bone cancer.

general description

Bone cancer is one of the most rarely diagnosed types of cancer. This disease mainly affects children and adolescents; much less often, bone cancer is diagnosed in older people. Bone damage mainly occurs due to metastasis from cancer in other areas (breast cancer, lung cancer, etc.). Depending on this, the disease is designated as primary or secondary. Primary bone cancer develops independently. Secondary bone cancer (or, as it is also called, metastatic bone cancer) develops in the previously mentioned variant, that is, in cases where cancer cells enter the bone tissue from other areas.

Let us remind our readers what metastasis is. Metastasis refers to a process in which secondary foci of tumor growth, that is, metastases, begin to form. Metastases begin to form due to the proliferation of cells to other areas and tissues from the area of the primary (main) location of the tumor. It is on the basis of a process such as metastasis that there are reasons to indicate the malignant nature of the tumor disease. At the same time, metastasis excludes the possibility of curing the existing tumor without removing the metastases themselves. Often, precisely because of damage to a number of internal organs (brain, liver, etc.), caused by metastases, tumors become incurable.

The disease that we will focus on today develops when bone cells begin to divide uncontrollably and randomly. Cancer cells grow directly in bone tissue. When uncontrolled division continues, that is, when there is no need for new cells, but they still continue to divide, a growth is formed - this is a tumor. Also, neoplasm cells can grow into tissues in close proximity to them, as well as spread to other parts of the body. This picture corresponds to a malignant tumor formation; if the tumor is benign, then such spread to other organs does not occur.

Depending on the characteristics of the lesion, the corresponding types of bone cancer are distinguished; we will consider them below.

Bone cancer: types and features

As we have already indicated, bone tumors can be benign and malignant. In listing the options, we will not dwell on their characteristic symptoms, but will only highlight their inherent features for a general idea.

Benign tumors include:

In this case, the tumor, as already indicated, is benign. It is characterized by a favorable course, it grows very slowly, is not predisposed to malignancy, does not grow into nearby tissues, and is not prone to metastasis. It is mainly diagnosed in children and young people (the general age group is patients 5-20 years of age). Osteomas have certain types of forms; their difference is the area of localization and structure. In particular, these are hyperplastic osteomas formed on the basis bone tissues (osteoid osteomas, osteomas), as well as heteroplastic osteomas formed on the basis connective tissue(osteophytes). Tumors are mainly localized on the external bone surface with localization in the area of the flat bones of the skull, on the humerus, femur and tibia, on the walls of the frontal, ethmoid, maxillary and sphenoid sinuses. The vertebral bodies may also be affected. As a rule, osteomas are single in nature of manifestation, but exceptions are allowed. As such it is considered Gardner's disease, accompanied by the formation of multiple tumor formations, as well as congenital osteomas with damage to the bones of the skull. The latter develop due to a disturbance in the development of mesenchymal tissues and appear in combination with a number of other defects. Osteomas themselves are not painful, their presence is not accompanied by any symptoms, however, until the nearby anatomical formations begin to be compressed - this can already cause the manifestation of a wide variety of symptoms, ranging from visual impairment and ending with the development of epileptic seizures. Osteomas are treated only through surgery.
Osteoid osteoma (also known as osteoid osteoma). This neoplasm is mostly single, its diameter does not exceed 1 centimeter. Its contours are clear, the localization area is possible in any of the bones of the skeleton (exceptions are the sternum and skull bones). Based on statistics for this type of tumor, they are diagnosed on average in 11% of cases of the formation of benign tumor formations. In most cases, the femur is affected, followed by the tibia in terms of frequency of detection of osteomas, and, finally, the humerus. Difficulties in diagnosis arise due to the small size of the tumor formation, as well as the lack of specific symptoms. Because of this, treatment of osteoid osteoma is often carried out on the basis of an incorrect diagnosis, and, accordingly, is unsuccessful. The only treatment option is surgery; its volume is determined based on the area of localization and the specific type of tumor process. Such a formation after removal, as a rule, is not subject to recurrence.
Osteochondroma (aka ectostosis). In this case, we are talking about a tumor formation that manifests itself as an outgrowth based on bone tissue, which is, as it were, covered with a “cap,” this time based on cartilage tissue. Osteochondroma has the appearance of a colorless mass in its structure. It is mainly detected in patients aged 10-25 years. A similar type of neoplasm, which can be designated as an osteophyte, has nothing in common with the tumor formation in question in terms of the characteristics of its pathogenesis (features of the course of the disease, what happens during it). Osteophytes form near the affected joint due to a disease such as osteoarthritis. In other words, it is incorrect to associate osteophyte with osteochondroma; they are not synonyms. As for the areas of localization, the picture here can be different, although in about half of the cases, damage to the lower part of the femur, damage to the upper part of the tibia and damage to the upper part of the humerus are diagnosed. Detection is also allowed in other bones, except for damage to the facial bones of the skull. The feet, hands and spine, however, are rarely affected. The diameter of the tumor can reach 14 centimeters; with the maximum period of observation of patients, there were no cases of malignancy of the process; the probability of this option, meanwhile, is 1-2%. Recurrence is also possible and is mainly observed during the first 26 months after surgical removal of the tumor. A similar option is possible in case of incomplete removal of the tumor or incomplete removal of its cap. Treatment of osteochondroma is carried out only with radical treatment, that is, with surgical removal of the tumor.
Chondroma. Chondroma can also be referred to as a cartilaginous tumor or cartilaginous tissue, which, as you can understand, determines the structural features of such a tumor - it is based on cartilage tissue. Based on the location of the bone, enchondroma and ecchondroma are distinguished. Enchondroma forms directly in the bone, which is accompanied by practical expansion of the latter as the tumor grows. Echondroma grows from the bone, towards the soft tissues, that is, beyond the bone to which it belongs. Chondromas in their localization most often affect the bones of the feet and hands; flat and long tubular bones are somewhat less likely to be affected. Symptoms are scanty, pain, as one of the symptoms, appears mainly as a result of injuries or as a result of pathological fractures caused by the growth and presence of a tumor process in the bone (which is important when localized in the area of the distal extremities). Treatment of chondromas requires surgery, during which the tumor is removed and plastic surgery of the defect is performed. Malignancy of the process occurs mainly with large tumors, concentrated in the pelvic bones and long tubular bones. In general, the prognosis is favorable.
Chondromyxoid fibroma. This type of tumor formation is quite rare and is benign. Mostly long tubular bones are affected, although other skeletal bones cannot be excluded. As a rule, the course of the disease is characterized as favorable, although the possibility of recurrence and even malignancy is possible. The manifestation of chondromyxoid chondroma is accompanied by the occurrence of increasing pain, which is noted where the tumor actually appeared. In severe cases, muscle atrophy may develop in the area of the affected limb, and the mobility of the joint located in close proximity to the tumor may also be limited. Often the tumor is found in the tibia and calcaneus. It can affect the pelvic, humeral bones, ribs, skull bones, sternum, and vertebrae. The most aggressive tumor growth occurs when the spine is affected. Chondromyxoid fibroma, the symptoms of which are detected with equal frequency in both men and women, develops in patients of any age. Particularly severe symptoms and the fastest growth of the tumor are detected in children. In approximately 15% of cases, the course is characterized by the absence of symptoms as such, while the detection of a tumor occurs by chance, during an X-ray examination in the direction of an orthopedist or traumatologist.
Chondroblastoma. This type of tumor formation is similarly benign, however, there are certain deviations for this statement. To begin with, let us indicate that such a tumor is formed due to cartilage tissue, focusing in the epiphyseal region of long tubular bones. The distal epiphysis of the femur is in first place in terms of damage, the proximal epiphysis with damage to the tibia is in second, and, finally, the proximal epiphysis with damage to the humerus is in third place. Chondroblastomas are somewhat less frequently detected in the proximal epiphysis of the femur, in the bones of the foot and pelvis. In practice, there are also cases of chondroblastomas appearing on the ribs, sternum, spine, scapula, clavicle, patella, wrist bones, phalanges of the fingers, as well as in the cranial vault and lower jaw. Most often, this disease is diagnosed after the age of 20, somewhat less often - in adulthood and in old age. For various age groups, there is data on chondroblastoma, indicating that it is diagnosed on average in 1-4% of cases of possible benign tumor formations. There is also a predisposition of men to this type of tumor - it is diagnosed in them on average 2 times more often than, accordingly, in women. It should be noted that chondroblastoma can be not only benign, but also malignant. Benign chondroblastoma can manifest itself either in a typical form or in a mixed form. There are also some variations of both types of tumors. Thus, benign chondroblastomas can manifest themselves in the following varieties: cystic chondroblastoma, chondromic chondroblastoma, chondroblastoma with chondromyxoid fibroma or with osteoblastoclastoma. In turn, malignant chondroblastomas can manifest themselves in the following varieties: clear cell chondrosarcoma, primary malignant chondroblastoma or malignant chondroblastoma (in the latter variant, its transformation into chondrosarcoma or osteogenic chondroblastic sarcoma is also possible). Malignant forms of chondroblastoma are diagnosed in approximately 7% of cases of chondroblastoma in general (that is, including benign ones). Malignancy mainly occurs against the background of several previous relapses of the benign form of the disease, which is in particular due to its incomplete surgical removal.
Giant cell tumor (also known as osteoblastoclastoma or osteoclastoma). This type of bone tumor is most often diagnosed. There are no particular differences in the susceptibility of men or women to this disease, therefore we can add that both sexes are equally susceptible to it. Hereditary predisposition is also relevant. As for age-related predisposition, in general the disease can be detected from 1 year to 70 years, however, in more than half of the cases of giant cell tumor detection, the age of 20-30 years can be designated as the peak age-related incidence. At the same time, we can add that in children under twelve years of age, the tumor is detected extremely rarely. Basically, the tumor formation is solitary; in some cases, its double concentration is detected and mainly in the bones located nearby. More often, long tubular bones are affected, which is true on average in 74% of cases; small and flat bones are affected less frequently. The localization of the tumor in long tubular bones is noted in the area of the epimetaphyseal region. Its growth into the epiphyseal and articular cartilage is not observed. In 0.2% of cases, which is quite rare, the localization is diaphyseal. A benign tumor can transform into a malignant one, in addition, osteoblastoclastoma can be primarily malignant. Malignant osteoblastoclastomas are localized similarly to benign tumor formations of this type. In this case, bone tissue is subject to destructive processes. The tumor consists of giant multinucleated cells, as well as single-celled formations, while giant cells play a less significant role in the development of tumor formation compared to single-celled ones. The cellular origin of tumor formation is generally unknown. The clinical course is characterized by its own slowness, pain appears late and is moderate. Bone swelling and deformation are observed in the later stages of the disease. The process of metastasis is accompanied by spread both to the surrounding veins and to distant veins, for example, to the lungs. Here they retain a benign structure, but at the same time they have the ability to produce bone tissue. Osteoblastoclastoma forms in areas that are designated bone growth zones. In particular, these are the neck and head of the femur, the greater or lesser trochanter of the femur. The tumor can completely affect the articular end of the bone, thereby promoting its swelling or destruction of the cortical layer, after which it extends beyond the affected bone. In some cases, bone destruction by a tumor occurs in an uneven manner; clinical and radiological features when examined indicate either its cellular-trabecular structure or the complete disappearance of bone under the influence of the growth of the tumor process - in this case we are talking about the lytic form. What is noteworthy is that the lytic form develops in pregnant women, and the process of tumor development is so rapid and vivid in its clinical picture that this form is diagnosed as malignant. Treatment in this case involves termination of pregnancy, although in practice there have also been cases of tumor detection in the final months of pregnancy, and therefore treatment began after birth. If previously this tumor was considered benign, now the prevailing idea about it has been revised, taking into account its possible primary malignant nature and tendency to malignancy. A number of questions about it, in addition, remain unclear.
Angioma. In this case, we are talking about a generalized definition for a group of vascular tumors formed on the basis of lymphatic or blood vessels. The localization of such neoplasms can be superficial (mucous membranes or skin are affected), in addition, they can be located in internal organs and muscles. The manifestations accompanying their existence are bleeding; they, in turn, can manifest themselves in varying degrees of their own intensity. Removal of such tumors is carried out using various methods (x-ray therapy, sclerotherapy, cryotherapy); surgery is also a possible measure. Various organs and tissues are affected, and angiomas can be either single or multiple. Sizes may also vary. If a case of hemangioma (an anomaly with damage to blood vessels) is considered, then the neoplasms are blue-red in color, and if lymphangiomas (an anomaly with damage to the lymphatic vessels), then such neoplasms are colorless. Angiomas are mainly found in children - they account for about 80% of cases of congenital forms of neoplasms. It is also necessary to indicate a predisposition to progression, and sometimes to very rapid progression. Angiomas are mainly found in the upper half of the body, on the neck and on the head. Somewhat less commonly, the orbits, eyelids, lungs, pharynx, external genitalia, bones, liver, etc. are affected. Basically, angiomas are congenital, and their increase is caused by the proliferation of blood vessels in the tumor itself. These vessels grow into the surrounding tissues, thereby destroying them, which is similar to the growth of malignant tumors.
Myxoma. Myxoma is an intracavitary tumor formation that affects the heart. This tumor is benign, and of all varieties of this type of tumor, it is detected in 50% of cases in adult patients, and in 15% in pediatric patients. Moreover, in 75% of cases, the localization of the tumor formation occurs in the left atrium, in 20% of cases - in the right atrium. A small proportion of cases occur in the valve apparatus or in the ventricles. The main age of patients is 40-60 years. Cardiac myxoma is more often diagnosed in women than in men. The tumor itself is formed on the basis of connective tissue, and it also contains a significant amount of mucus. In addition to heart damage, myxoma can also be detected on the extremities, in the area of intermuscular tissue, fascia and aponeuroses. Somewhat less frequently, the nerve trunks and bladder are affected.
Fibroma. Fibroma is a benign mature tumor based on connective tissue. It can form in any part of the body. May be diffuse or limited. The course of the disease and its symptoms directly depend on where the fibroma is located, as well as on the characteristics of the growth rate. The possibility of transformation from a benign formation to a malignant formation is allowed. Fibroids are treated surgically.
Eosinophilic granuloma. This disease is designated as a pathology of unknown nature, the course of which is characterized by the formation of granulomas (infiltrates) in the bones, while a feature of granulomas is the presence of a significant number of eosinophilic leukocytes in them. Some authors believe that the disease is of an infectious-allergic nature, some - that it is associated with trauma, some - with helminthic tissue invasion. The disease is diagnosed quite rarely, and mainly in children of preschool age. The main symptom of the disease in question is that it causes the formation of single or multiple tumor foci that affect tubular and flat bones. Most often the vertebrae, femurs, calvarial bones and pelvic bones are affected.

Malignant tumors include:

This type of tumor is malignant and affects the bone skeleton, mainly the lower part of the long tubular bones, collarbone, spine, pelvis, ribs, and scapula. Ewing's sarcoma ranks second in the frequency of diagnosis in children; in general, it occurs in children under 5 years of age, as well as in adults from 30 years of age. The main peak incidence is between 10 and 15 years of age. The causes of Ewing's sarcoma are currently still unknown, but 40% of cases of this disease are associated with previous trauma. In rare cases, Ewing's sarcoma develops as an extraosseous pathology, which is accompanied by damage to soft tissues, but mainly, as already noted, the bones are affected. The disease can be localized and metastatic in stages of development. The localized stage of Ewing's sarcoma determines its ability to spread from the primary lesion to soft tissues located in close proximity to it, while distant metastasis is not observed. As for the metastatic stage, here the tumor can spread to other parts of the patient’s body (bone marrow, bones, lungs, liver, central nervous system, etc.). In general, Ewing's sarcoma is the most aggressive of malignant tumors. What is noteworthy is that in approximately 90% of cases when any treatment measures are started, metastasis is already present for patients (the main areas are bones, lungs and bone marrow).
Osteogenic sarcoma. Osteogenic sarcoma is a tumor whose malignant cells are formed from bone tissue, and they also produce this tissue. Osteogenic sarcoma can be sclerotic (osteoplastic), osteolytic or mixed, as determined by x-ray. As is clear, such a sarcoma arises directly from bone elements; it is also characterized by rapid progression and early metastasis. Osteogenic sarcoma is detected at any age, but in approximately 65% of cases, the peak incidence occurs between the ages of 10 and 30 years. It is also noted that sarcoma mainly develops towards the end of puberty. As for gender predisposition, it is also relevant here: men get sick almost twice as often as women. The predominant localization environment for osteogenic sarcoma is long tubular bones, and in approximately 1 out of 5 cases of osteogenic sarcoma, they are localized in short or flat bones. The bones of the lower extremities are affected up to 6 times more often than the bones of the upper extremities, while about 80% of the total number of tumors affecting the lower extremities are concentrated in the knee joint. Also often affected are the femur, humerus and tibia, fibula and pelvis, ulna and shoulder girdle. In the radius, where giant cell tumors appear quite often, in rare cases they are accompanied by the growth of osteogenic sarcoma. Osteogenic sarcoma almost never grows from the patella. The skull is affected mainly in children; in addition, such damage is also relevant for elderly patients, but here it already acts as a complication of osteodystrophy. The development of a tumor is in some cases associated with rapid bone growth. In children who are diagnosed with osteogenic sarcoma, in most cases their height is higher (if we compare the general age norm), but the disease itself affects those parts of the skeleton that grow the fastest. Basically, the connection with trauma is also highlighted here as a predisposing factor to the development of sarcoma, but trauma is to a greater extent a factor that allows it to be detected almost randomly during an X-ray examination.
Parosteal sarcoma. This type of sarcoma is one of the variants of osteosarcoma. The frequency of its detection is on average 4% of the total number of osteosarcomas, that is, the tumor is quite rare. It develops directly on the bone surface, its peculiarity is a longer and, at the same time, less malignant in nature. The typical location is the area of the knee joint (the posterior surface of the femur or tibia), which accounts for about 70% of cases of this type of sarcoma. In rare cases, the skull, pelvic and spinal bones, scapula, foot and hand bones are affected (literally isolated cases). This tumor has a bone consistency, it is concentrated outside the bone, but is associated with the underlying bone and the periosteum. In frequent cases, it is located, as it were, in a capsule, which, however, does not exclude the possibility of its germination into nearby muscles.
Chondrosarcoma. This tumor is one of the most common tumor pathologies affecting the skeleton. It is based on cartilage tissue. Chondrosarcoma mainly develops in flat bones, although it is also possible to detect such a tumor in tubular bones. There are several possible scenarios according to which such tumors can progress. Thus, this may be a relatively favorable progression scenario, in which tumor growth is slowed down, and metastasis occurs at later stages, or an unfavorable one, in which tumor growth is rapid and metastasis begins early. These are two basic options, for which certain deviations are possible when considering the overall picture of the disease in each specific case. Treatment of chondrosarcomas consists of surgical intervention; the prognosis is determined by the specific course of the disease, as well as the possibilities of a relatively radical effect on the tumor. This tumor mainly affects the shoulder girdle, pelvic bones, femur and humerus bones, and ribs. On average, in 60% of cases, the disease is diagnosed in patients of the middle and elderly age group (age from 40 to 60 years). Meanwhile, this does not exclude the possibility of detecting chondrosarcoma in patients of other ages. Thus, statistical data indicate that the earliest case of this pathology was recorded at 6 years old, while the latest was at 90. Regarding gender predisposition, it can be indicated that men are twice as likely to encounter this disease compared to women. Chondrosarcoma can correspond to several degrees of malignancy of the process. So, 1st degree malignancy of chondrosarcomas is accompanied by the predominant presence of chondroid tissue in the tumor, the latter, in turn, contains chondrocytes, which contain small dense nuclei. There are still small numbers of multinucleated cells and no mitotic figures. For 2 degrees Characteristic is a predominantly myxoid intercellular substance, the number of cells is greater than within the 1st degree. An accumulation of cells occurs along the periphery of the lobules. The nuclei are enlarged, mitotic figures are present in single quantities, there are areas of destruction, that is, areas of necrosis. And finally 3rd degree, it is characterized by the myxoid composition of the intercellular substance, the arrangement of cells in it occurs in strands or groups. The presence of stellate or irregularly shaped cells in a significant volume is determined. There are many multinucleated cells, and there are also many cells with enlarged nuclei. There are mitotic figures, areas of necrosis are extensive. If we do not go into a detailed examination of this kind of changes, but rely only on knowledge of the degree of chondrosarcoma, then we can indicate that the higher the degree, the correspondingly higher the likelihood of early metastasis, as well as the development of relapse of the disease after surgical removal of the tumor formation.
Chordoma. This type of neoplasm can be designated both as a benign tumor and as a malignant tumor. Meanwhile, the benign nature of such a neoplasm is controversial. Considering the fact that the growth of tumor formation occurs slowly, and metastasis is rarely observed beyond its boundaries, it is considered to be benign. However, due to the fact that the tumor is located in a specific area, it is its location that causes the development of complications. The tumor itself can subsequently recur, that is, resume its development after the patient’s seemingly complete recovery. It is for this reason that, in accordance with the principles on which the international classification of neoplasms is based, it is more correct to classify it as a malignant tumor. Chordoma is rarely diagnosed (in approximately 1% of cases of tumor formations affecting bone structures); it is formed on the basis of the remains of the embryonic chord. Sacral chordoma is predominantly detected, in this case in patients 40-60 years old, more often in men. When a tumor is diagnosed in young people, it is usually a tumor at the base of the skull. It is these areas that are the main ones affected by chordoma. Tumors are divided into the following forms: chondroid chordoma, undifferentiated chordoma and conventional chordoma. Chondroid chordoma is characterized by the least aggressiveness. Undifferentiated is predisposed to metastasis and is the most aggressive of these forms. Sometimes difficulties arise in determining the specific type of tumor; in this case, it is often believed that chondrosarcoma has formed (due to the common location and structure). Here we are talking about an undifferentiated tumor, and, of course, about the need to differentiate a specific neoplasm. If we are really talking about chondrosarcoma, and not about chordoma, then there are grounds for a favorable prognosis for it. The fact is that chondrosarcoma is more sensitive to treatment using radiation therapy, which is the basis for such statements. Treatment of chordoma requires surgical intervention; its volume is determined individually depending on the nature of the pathological process.

Bone cancer: risk factors

Despite the fact that at the moment it has not been possible to determine the unambiguous cause of bone cancer, this does not exclude the identification of some factors that predispose to the development of this disease. In particular these are:

the presence of a benign disease affecting the bones, such as Paget's disease;
heredity (presence of this disease in close blood relatives in the past);
irradiation;
injury to bones (again, injury cannot be considered as a factor contributing to the development of cancer, however, it is with injury, as already noted, that the disease is identified).

Certain predisposing factors can also be identified for some individual types of bone cancer.

Osteosarcoma: male gender, age from 10 to 30 years, bone marrow transplantation, retinoblastoma (eye cancer, a fairly rare disease), the presence of hereditary cancer syndromes.
Chondrosarcoma: exostosis in a significant amount (a disease of hereditary type, as a result of which the bones are affected by characteristic bumps), age from 20 years.

In other types of cancer, a sufficient factor for the development of cancer is compliance with a certain age group, which, however, cannot be unambiguously determined due to the variability of options.

Bone cancer: symptoms

The clinical manifestations of the disease are based on the following symptoms:

Pain. Pain, as you can understand, if it appears, is in the place where the tumor has formed. The pain can be constant, and it intensifies during exercise and movement, and at night (a period of muscle relaxation).
Swelling. Swelling similarly occurs in the area where the tumor is located, in particular the swelling surrounding it. It is noticeable during the late stage of the disease, that is, when the tumor has already reached a significant size. In some cases, swelling may not be detected upon examination and palpation.
Difficulty in movement. Being in close proximity to the affected joint, the tumor, as it grows, leads to certain difficulties in its functioning. Limb movement may be limited because of this. If the joints of the legs are affected, this can cause numbness in the limbs, tingling in them, and lameness.
Deformation of the affected limb or body.
Weight loss, sweating, fever, lethargy are symptoms of a general “failure” of the body, whether due to cancer or any other type of disease.

The listed symptoms, as you can see, are relevant for many diseases, and this applies not only to the last point. Meanwhile, if the duration of the manifestation of a symptom such as pain in the limbs is more than two weeks, it is necessary to consult a doctor for a comprehensive examination to identify the specific cause.

Cancer of the leg and pelvis bones

In practice, primary tumors affecting the bone tissue of the pelvic bones are quite rare. In this case, osteosarcomas and chondrosarcomas are detected with equal frequency. Sarcoma of the hip joint is diagnosed even less frequently. Similar to many types of cancer, these pathologies are more often diagnosed in men (compared to women).

Let us dwell on the symptoms inherent in a disease such as pelvic bone cancer:

Blunt pain, occurring in the pelvis and buttock, in some cases such pain may be accompanied by a short-term increase in general body temperature.
Increasing pain sensations noted in particular during physical activity and while walking, the symptom is relevant with the gradual progression of tumor pathology.
Bulging, swelling, also detected in the future, as the disease progresses and the tumor acquires a significant size. The skin in the affected area becomes noticeably thinner, allowing a vascular pattern to be seen.
Spread of pain to the spine, perineum, groin, thigh, etc. This symptom is relevant for the later stages of the pathological process, when nerves and blood vessels are compressed by tumor formation.
Restricted mobility of the affected joint.

The next part of the symptoms that we will focus on corresponds to a type of disease such as leg cancer; its symptoms are diagnosed with equal frequency in both sexes, that is, in both men and women.

Pain in the legs, increased pain with exercise;
Restricted mobility of the affected limb;
The appearance of swelling on the skin, protrusion;
Deformity of the affected limb;
General symptoms of illness (fever, lethargy, weight loss, weakness, etc.).

Also, regardless of the type of cancer, a symptom such as bone fractures can be identified, which is more relevant for the later stages of cancer, when the tumor leads to significant damage to the joint to which it is directly related.

Diagnosis and treatment

Often, as we have already highlighted in the article, cancer is detected by chance, in the absence of symptoms and during an X-ray examination, for example, to check for the presence of injury. In the future, the doctor may prescribe a number of examinations, including the following:

a blood test (allows you to determine the level of current alkaline enzyme phosphatase; if it is elevated, then there is reason to suspect a bone tumor, which, however, is also relevant during the growth period of a completely healthy child);
X-ray examination;
scanning of skeletal bones (in this case we mean a test that can be used to determine where the tumor is located; to carry it out, a radioactive substance is introduced into the bloodstream, absorbed by bone tissue, after which, using a special scanner, the characteristics of its effect are monitored);
CT, MRI;
bone marrow biopsy.

As for such an issue as cancer treatment, it is applied differently in each case of this disease; its principles are determined precisely on the basis of the type, as well as on the basis of the stage of cancer, the area of localization of the tumor formation, the patient’s health status, the presence of metastases and other criteria. Surgical removal of the tumor is generally indicated, although treatment methods such as radiation therapy and chemotherapy can be used - they are mainly in addition to surgery in treatment.

If you have symptoms that may indicate cancer, you should contact an orthopedist or oncologist.

Bone cancer is one of the rarest diseases, occupying no more than 1% in the structure of oncopathologies. True, such statistics apply exclusively to a primary tumor of bone tissue, that is, to a disease in which the malignant process begins in bone cells. If cancer cells penetrate the skeleton from any other cancer that metastasizes, oncologists diagnose a secondary bone tumor. Medicine encounters this disease much more often.

A cancerous tumor is always a risk to the patient’s life, which means that every person should know about the causes of this deadly disease, its stages, signs and methods of treatment.

Cause of bone cancer

To date, scientists have not been able to establish the exact cause of bone cancer. However, it is known that the disease is typical for young people under 30 years of age, while it practically does not occur or is extremely rare in elderly people. Moreover, if in young people bone cancer mainly appears in the bones of the extremities, then in older people there is a much greater chance of encountering cancer of the skull bones.

In addition, it has been noted that representatives of the stronger sex are more likely to experience this disease, and long-term smokers are especially susceptible to bone cancer.

By the way, non-malignant tumors can also be found in the bones of the skeleton. Such neoplasms are spoken of when the growth that appears has smooth boundaries and is surrounded by healthy tissue, and its growth occurs very slowly. If the emerging growth is characterized by uneven boundaries, quickly progresses, spreading throughout the bone, and metastasizes into cartilage, ligaments and muscles, there is every reason to talk about the appearance of a malignant tumor.

Predisposing factors

By studying the stories of patients faced with this type of cancer, doctors were able to identify a number of pathological factors that provoke the development of this type of cancer. Among them are:

1. Skeletal injuries. According to statistics, more than 40% of oncological formations in bone tissue appear in the area of injuries and bone fractures. Moreover, practice shows that the focus of an oncological tumor can arise both immediately after injury to bone tissue, and ten years after this incident.

2. Exposure to ionizing radiation. This type of cancer is encountered by persons who, during treatment or in their professional activities, have been exposed once or periodically to ionizing radiation in high doses.

3. Genetic pathologies. According to doctors, people with Rothmund-Thomson syndrome, Li-Fraumeni syndrome and retinoblastomas are most likely to experience bone tissue oncology.

4. Paget's disease. With this disease, the process of bone tissue restoration is disrupted, which leads to a variety of bone abnormalities, including the appearance of tumors in them. In general, any chronic pathology of bone tissue increases the risk of cancer by 4 times.

5. Bone marrow transplant. It has been noted that in 20% of cases, this type of cancer appears in people who have undergone bone marrow surgery.

6. DNA mutation. Scientists say that in some cases, the cause of bone tissue cell degeneration may be DNA mutations that destroy the mechanism that prevents this process.

7. Hereditary predisposition. It is also known that some DNA mutations can be acquired, while others are inherited. The mutated RB1 gene can be passed on to such a patient from parents.

All of the above applies to primary cancer, i.e. a tumor appearing directly in the bone. As for secondary bone cancer, it is formed as a result of the penetration of metastases from tumors that appeared in the mammary glands, in the lungs, in the prostate, and many other organs.

Types of tumors

Bone cancer is usually differentiated by the location of the malignant neoplasm. Each type has its own developmental characteristics, and therefore its own approaches to treatment.

1. Ewing's sarcoma. This lesion can occur in absolutely any bones of the skeleton, incl. in the clavicles, shoulder blades and pelvic bones, but most often in the long bones. This type of cancer is considered very aggressive, since it grows rapidly and the tumor quickly metastasizes to surrounding organs and tissues. Often teenagers and young adults experience this disease.

2. Osteosarcoma. This is the most common type of bone cancer and is most often found in the pelvis and extremities. What is typical is that the tumor actively “attacks” the bone cells, and metastasizes only at the very end, when the entire bone is affected.

3. Chondrosarcoma. This type of oncology appears in cartilage, after which it begins to affect bone tissue directly. Most often, the disease affects flat bones of the skeleton and is practically not found in tubular bones.

Doctors note that such a disease can develop in two ways. The first is favorable, because the tumor develops slowly and actually does not metastasize. With the second development path, metastases appear already at the first stage of the tumor. A characteristic feature of this cancer is that it appears in people aged 40–60 years.

4. Fibrosarcoma. This malignant formation is detected quite often. Its peculiarity is that cancer cells originate in soft tissues, i.e. in tendons or connective tissue, and only then transfer to bone tissue. Most often, fibrosarcomas affect the bones of the legs, and the fair sex encounters this disease much more often.

5. Chondroma. This growth appears quite rarely and belongs to cartilaginous tumors. Scientists believe that chondroma begins its development from embryonic tissue. Most often it is found in the sacrum or at the base of the skull.

6. Fibrous histocytoma. People suffering from Paget's disease (pathological reorganization of bone tissue) are most often exposed to tumor formation. Very often, such oncology occurs as a result of bone fractures, and it has an aggressive course and quickly metastasizes, affecting mainly lung tissue.

7. Giant cell tumor. This growth also has another name – osteoblastoclastoma. It mainly affects adjacent tissues and the terminal parts of bones. The tumor rarely metastasizes, but after its removal there is a high probability of relapse.

8. Lymphomas and myelomas of bones. Lymphomas are tumors that initially arise in the lymph nodes and then spread to the bones, and the term myeloma refers to the rapid division of bone marrow cells. As a result of such processes, areas of osteoporosis appear in bone structures, which leads to their fractures.

Symptoms of the disease

The very first sign of a developing disease is pain that appears at the site of tumor formation. True, pain is temporary, and therefore a person is in no hurry to seek help from doctors.

However, if initially the pain is felt only with pressure, as the disease progresses, it begins to be felt constantly, having a dull and aching character. In this case, from the place where the growth appears, pain can radiate to nearby parts of the body, for example, to the arm, leg or shoulder. Such unpleasant sensations do not go away even at rest, disturbing the patient at night, and are not relieved by taking analgesics.

In addition, swelling may appear at the site of the malignant tumor. This area of skin becomes red and warm due to the increased temperature. The affected limb (or joint) itself loses mobility, which leads to difficulty in movements and the inability to perform any actions. If the tumor affects the lower extremities, the patient may experience tingling, numbness and pain, gradually leading to lameness. Moreover, such a bone can break even with a minor fall. In any case, if these symptoms are ignored, over time the tumor will begin to grow, leading to protrusion of the growth at the site of the lesion, as well as deformation of the limb or body.

Other symptoms characteristic of all cancer diseases include:

deterioration of general health;
the appearance of low-grade fever;
lethargy and decreased performance;
heavy sweating even at rest;
enlarged lymph nodes in the area of the affected bone;
lack of appetite and food rejection;
severe weight loss;
depression of the psychological state (nervousness and irritability).

Stages of cancer

Like other types of cancer, bone cancer has four stages of development.

Stage I. At this stage, the cancerous tumor is located within the bone. Moreover, this stage is usually divided into two, depending on whether the tumor exceeds or does not exceed 8 cm in diameter.

Stage II. The tumor is still located in the bone, but it is already prone to metastasis, because single cells are found on the surrounding soft tissue.

Stage III. Multiple growths are detected in different parts of the bone. Malignant cells can also be found on adjacent soft tissues, as well as in lymph nodes.

Stage IV. At this stage, the tumor is found not only in the bones. Malignant cells through the blood and lymph flow reach neighboring and even distant organs, for example, in the lungs, liver, kidneys, brain, stomach and others.

Diagnosis of the disease

It is worth noting that pain and other symptoms of bone cancer do not always appear in the first and second stages, and therefore very often the disease is detected by chance, during an X-ray examination. In any case, having suspected oncology, the doctor prescribes the following diagnostic measures to the patient:

– Blood analysis. It allows you to determine the level of alkaline enzyme phosphatase. A high level of this biological substance hints at the development of cancer. True, this substance is also increased in the case of intensive growth of the child.

– X-ray. On an x-ray, the doctor can clearly see a large tumor, whether it is malignant or benign. However, X-rays may simply not show small tumors.

– Computed tomography (CT) and magnetic resonance imaging (MRI). These types of diagnostics allow you to examine bones in cross section, which means you can study their structure in detail and notice small growths.

– Scanning. With this type of study, special substances are injected into the patient’s blood, which enters the bone tissue. At this time, using a scanner it is possible to detect even the smallest tumors.

– Biopsy. A piece of tumor tissue is sent for histological examination, after which the doctor, in fact, gives the patient a final diagnosis.

Bone cancer is a fairly rare occurrence (1% of all tumor cases). However, neoplasms present in the internal organs can gradually penetrate into the bone tissue itself. In this situation, we can talk about the presence of a secondary tumor. In modern medicine, such cases are diagnosed much more often.

General information

Bone cancer is one of the rarest forms of oncology. Young children and adolescents are usually at risk. This form of cancer is extremely rare in older people. In adults, so-called metastatic tumors are most often observed, which are formed due to the spread of malignant cells of the affected organs. Neoplasms that arise directly on the bones themselves are called primary.

Main reasons

Unfortunately, modern medicine currently cannot give an exact answer as to why bone cancer occurs. It is important to note that the number of cases each year is approximately the same. The exception in this case is secondary tumors caused by metastasized cells from previously affected internal organs. Here the clinical picture depends only on the type of primary neoplasm.

It is noteworthy that this disease “prefers” young people no older than 30 years. Among the smoking population, the incidence rate is slightly higher. Older patients are more likely to be diagnosed with cranial bone cancer.

Types of disease

Osteosarcoma is considered the most common type of malignant bone tumor. This disease is localized mainly in the area of the upper/lower extremities and pelvis. Osteosarcoma quickly attacks cells directly in the bone tissue itself. Most often it is diagnosed in children and young people under 30 years of age.
Chondrosarcoma is a special malignant neoplasm of cartilaginous structure. As a rule, it affects the bones of the pelvis, shoulder girdle and ribs.
Fibrosarcoma is one of the most common forms of tumors known in modern bone oncology. Initially, it forms in soft connective tissues, then moves to the bones of the lower and upper extremities, as well as the jaws. Cancer of this particular type is most often diagnosed in representatives of the fair half of humanity.
Chondroma is classified as a cartilage tumor. By nature, she is one of the least aggressive. Experts currently distinguish two types of this disease: ecchondroma and enchodroma.
Ewing's sarcoma can be localized absolutely anywhere in the body, but most often it affects the ribs, pelvic bones, shoulder blades and collarbones. Before systemic therapy is used, Ewing's sarcoma very often metastasizes. This type of bone cancer is predominantly diagnosed in young children.
Giant cell tumors can be not only malignant, but also benign. It is not prone to the formation of metastases, but is often recurrent in nature.

Symptoms

Mild pain is the primary clinical sign of bone cancer. Initially they are unexpressed and stop quickly. It is for this reason that many patients do not pay attention to the discomfort, and the disease only continues to progress.

As the disease develops, pain begins to appear regularly in the affected area, especially intensifying after sleep or physical activity. As a rule, objective signs of bone cancer are detected only three months after the onset of discomfort.

After some time, the following symptoms may occur:

deformation of the contour of the part of the body in which the tumor is located;
slight swelling of soft tissues;
a slight increase in skin temperature in the affected area;
varicose veins;
weight loss;
relatively quick fatigue;
pallor of the skin.

It is important to note that all of the above symptoms are not fully manifested in all patients. Take leg bone cancer, for example. The symptoms of this disease do not make themselves felt for a long time. That is why, if you suspect an illness, it is so important to consult with specialists.

Stages of the disease

The first stage is characterized by a relatively low level of malignancy.
Second stage. The existing neoplasm is still inside the bone, but its cells gradually begin to lose their differentiation.
The third stage is characterized by the spread of the neoplasm to several areas of the diseased area at once, the cells are not differentiated.
At the fourth stage, the tumor extends beyond the bone, metastases appear in the lungs, and then in the area of regional lymph nodes.

Timely staging of bone cancer is actually important. The thing is that it not only provides the opportunity to determine the exact extent of the spread of the tumor, but also to predict the final result of treatment.

Diagnostics

Today everyone understands how dangerous bone cancer is. Symptoms of this disease do not always appear immediately. That is why it is necessary to undergo a full examination regularly, at least once a year. On the other hand, when primary clinical signs appear, you should immediately seek advice from a specialist.

First of all, the attending physician must collect a complete medical history of the individual patient. It happens that close relatives already had this diagnosis, which significantly increases the risk of developing the disease. A detailed description of all accompanying symptoms gives a complete picture of the disease and also allows it to be differentiated. Only after this can we proceed to a comprehensive examination of a problem such as bone cancer.

Diagnosis also involves fluoroscopy. If the tumor appeared relatively recently, the tumor may not be clearly visible on the image. Distinct outlines subsequently help determine the type of tumor (benign or malignant). In the second case, it develops much faster and is characterized by “ragged” edges and the absence of bone tissue around the perimeter.

Another important diagnostic method is computed tomography. It allows you to scan a cross section of the bone. Thanks to this method, a specialist has the opportunity to identify the number of neoplasms and their approximate sizes, as well as study the bone itself in detail.

MRI is another diagnostic modality that provides cross-sectional imaging. In this case, on the monitor screen, the doctor directly examines the soft tissues for infection, which cannot be done with a computed tomography scan. For example, leg bone cancer, the symptoms of which do not appear immediately, can be detected and its presence confirmed using MRI.

Scintigraphy is considered one of the most effective diagnostic methods. It involves the process of identifying areas of the most intense bone growth and restoration. Very often, scintigraphy is used to examine the entire body to detect possible changes in other bones.

Importance of histological analysis

The importance of histological analysis is especially clearly confirmed when considering the material obtained during a biopsy. In the absence of additional clinical information, it is possible, based solely on microscopic criteria, to differentiate lesions such as giant cell tumor, chondroblastoma, or hyperparathyroidism based on biopsy findings.

Treatment

When choosing a specific treatment method, a specialist takes into account several factors. This includes the type of tumor, its aggressiveness, as well as its size and location. The age of the patient plays an important role in resolving this issue.

Treatment of bone cancer today is possible with the help of surgery, chemotherapy, and radiation therapy. It is important to note that all of these methods are effective both individually and together.

The surgical method involves removing the entire tumor (amputation of part of the bone). In this case, it is highly undesirable to leave the affected areas, since the remaining malignant cells may continue to develop. During the operation, some of the nerves and tissue surrounding the bone are also removed. The amputated bone is restored using special bone cement or a metal implant.

Radiation therapy involves destroying cancer cells using x-rays. If the latter enter the body in small doses, then the side effect in this case is almost minimal, and the primary signs of bone cancer quickly stop.

Chemotherapy use

Chemotherapy is prescribed by a qualified specialist, namely an oncologist. He selects the effective and at the same time the safest dose of a particular drug on an individual basis. Typically, doctors use several types of medications. They are introduced into the body by intramuscular injections, intravenous drips or in the form of tablets. After ingestion, the drugs are delivered along with the blood to the tumor and completely destroy it. Chemotherapy is most often prescribed in separate courses over specific periods of time. Some patients undergo treatment on an outpatient basis, while others require mandatory hospitalization.

Abroad, specialists combine chemotherapy and surgery to cure bone cancer. Before the operation itself, the patient takes medications to reduce the tumor, and after it - to prevent relapse.

Forecast for the future

It should be noted that the prognosis for the future is made individually for each specific patient. The thing is that several factors are taken into account at the same time. This includes the stage of the disease, the timeliness of therapy, and even the age of the patient. For example, cancer of the leg bone in a 15-year-old teenager and fibrosarcoma in a 50-year-old woman will be treated according to different schemes, respectively, and the result may not be the same.

The earlier the diagnosis is made, the higher the likelihood of a positive prognosis. It is important to note that isolated cancer (without metastases) is usually not a cause of death. Here the survival rate is equal to 80%. Patients often die from osteogenic tumors (60%), when “sick” cells are spread throughout the body.

What should be the prevention?

Unfortunately, modern medicine has still not come to a clear answer as to what exactly provokes this disease. Of course, a healthy lifestyle, proper nutrition, giving up bad habits and regular physical activity - all this one way or another is the prevention of cancer.

It is important to promptly seek qualified medical help when primary clinical signs of a problem such as bone cancer appear. Symptoms, as noted above, do not always appear at the first stage. That is why you should not neglect annual medical examination, which is a fairly effective preventive measure.