The bones in our bodies have several functions, as they form a framework that supports and protects the internal organs, such as: the bones of the skull to protect the soft tissues in the brain, and the rib cage protects the lungs. Bones are moved by muscles, and bone marrow works to produce blood cells in our bodies, and growth is called cancer
Primary bone cancer that originates in the developing bone tissue. Such tumors appear most often in the bones of the hands and feet, but they can occur in any type of bone in the body.
Bone cancer in children is rare, but in young adults and young adults it is the third most common after leukemia and lymphoma.
Types of primary bone cancer
Primary bone cancer is often called a sarcoma. There are several different types of sarcoma, each characterizing a different layer of bone. The most common are osteosarcoma, Ewing''s sarcoma, and chondrosarcoma.
1. Osteosarcoma
Osteosarcoma or also called osteogenic sarcoma is a malignant tumor of the bone originating in the osteogenic cells, and characterized by the formation of a substance called osteoid, which is the first stage of bone formation.
About 60% of primary bone tumors are osteosarcomas.
This tumor appears in young people, especially in the areas of rapid growth in the shoulder, knee, and thigh bones, and the best chances of recovery are in tumors in the extremities.
Osteosarcoma is defined according to the dominant cell type responsible for the swelling process, such as: osteoplast, chondrogenic cell (Chon last), fibroblast, and those related to dilated capillaries (Telangiectatic) that include spaces filled with blood in tumor cases .
There are multilocal conditions that do not respond to treatment in any way, and there are better neoplastic cases in which the tumor does not cause any damage to the bone cavity but to the bone itself.
The typical appearance of swelling appears in the form of local pain and swelling without the appearance of fever, and the patient may remain in this condition for more than half a year.
2. Ewing''s sarcoma
Ewing''s sarcoma was first described by James Ewing in 1921 as a bone tumor characterized by blue, round, radiosensitive cells.
It is the most common tumor type among bone malignancies in children and young adults, and each year four new cases are diagnosed for every million children under the age of 15.
Bone or soft tissue disease is more common in boys than in girls, and most cases are diagnosed in the extremities (53%), the thigh (25%), the pelvis (20%), and the spine and ribs (13%).
Patients will be paralyzed in 3% of cases as a result of tumor pressure on the spinal cord, and 28% of patients will have a fever similar to bone infection fever, and 26% of patients will have metastases at diagnosis, and the most common sites for metastases are the lung, bone, and bone marrow.
The odds of cure for children and adolescents with Ewing''s sarcoma depend on the size and location of the tumor, the stage of the disease and the presence of metastases.
The five-year survival rate for patients without metastases is 70%.
3. Chondrosarcoma
Chondrosarcoma is the most common of the malignant tumors of the chest wall, and the incidence of this type of sarcoma is greater in men in the third or fourth decade of their lives, and the tumor is usually concentrated in the anterior rib cage, and it may cause pain, but it does not cause a rib fracture.
Symptoms of bone cancer
Symptoms vary according to the type of cancer, as follows
1. Symptoms of osteosarcoma
Among the most prominent symptoms that the patient may encounter are the following
swelling around the bone
Pain in the bone and muscle area.
Bone injury for unknown reasons.
2. Symptoms of Ewing''s sarcoma
The most common symptoms that patients with Ewing sarcoma may experience are
Pain and swelling in the affected area.
bone pain
Unexpected tiredness.
Fever for no apparent reason.
Weight loss without striving towards it.
3. Chondrosarcoma symptoms
Chondrosarcoma disease worsens slowly, so the patient may not show any symptoms at first, but as the disease worsens, the following symptoms appear:
Increased pain.
A lump or swelling in the area.
Problems controlling the bowel and bladder if the cancer reaches the spinal cord.
Causes and risk factors for bone cancer
There are many causes and factors that lead to bone cancer, as follows
1. Causes of bone cancer
Despite the different types of bone cancer, the cause of the disease is unknown, and it often occurs due to a change in the genetic material, which leads to the multiplication of bone cells without the need for this, which causes the growth of the tumor.
2. Risk factors
Risk factors vary according to the type of cancer, as follows
1. Factors that increase the risk of osteosarcoma
The prevalence of osteosarcoma has been observed in patients with the following
Retinoblastoma.
Parts of the body that have been exposed to radiotherapy.
Patients over the age of forty.
People who suffer from Paget''s disease.
2. Factors that increase the risk of Ewing''s sarcoma
Among the most important factors that increase the risk of developing Ewing sarcoma
Children and adolescents.
European persons.
3. Factors that increase the risk of chondrosarcoma
Among the most important factors that increase the risk of chondrosarcoma
age.
The presence of other bone diseases, such as: Maffucci''s syndrome.
Complications of bone cancer
Complications of bone cancer include
The spread of cancer in different parts of the body, the most important of which are: the lung and healthy bones.
The need to remove the infected organ sometimes and install artificial organs that need time to get used to.
Long-term side effects of the medications used.
Diagnosis of bone cancer
Bone cancer is diagnosed of various types, depending on the symptoms that the patient faces, and then the following tests are performed:
1. Imaging examinations
Imaging examinations are initially performed to interpret the symptoms that the patient is facing, and the most prominent of these examinations are the following:
Computed tomography.
MRI.
Bone imaging.
2. Biopsy
The doctor takes a biopsy from the affected area and analyzes it, as the biopsy helps to know the type and grade of cancer.
Bone cancer treatment
The following are the most prominent treatment methods for bone cancer
Osteosarcoma treatment
Preoperative chemotherapy (neoadjuvant) improves the ability to preserve limbs without endangering the patient.
Chemotherapy depends on three of the following four drugs
Methotrexate - MTX.
Doxorubicin.
Cisplatin.
Ifosfomide.
IV medication is given in cases where side effects are severe, or not responding to other treatments. Resection of the tumor and ion of an artificial body in place of the bone is considered more acceptable today than the amputation that was common in the past.
60%-80% of patients without metastases at diagnosis recover without evidence of disease recurrence over the next five years, yet the cure rate for a tumor with metastases is only 20%.
Patients with stable tumors may be given radio-targeted therapy in addition to other medications, such as:
Gemcitabine).
Etoposide.
Carboplatin.
Ewing''s sarcoma treatment
Treatment of localized bone cancer is based on a high incidence of radiation of 45-65 radiation units, or resection, and this is related to the ability to perform surgery and to functional outcomes and risks of radiation-induced secondary tumors.
Radiotherapy is done for tumors in the pelvis and spine, and when there are remnants of the removed tumor, tumors in the extremities are surgically operated while preserving the limb.
The currently accepted treatment includes giving chemotherapy intravenously to reduce the tumor before eradication or radiation, and chemotherapy includes five drugs:
Vincristine.
Doxorubicin.
Cyclophosphamide.
Ifosfamide nated with etoposide.
Chondrosarcoma treatment
The tumor is removed with healthy tissue (Cutting away the cancer and some healthy tissue around it) as much as four centimeters of healthy tissue, in this extensive surgery significantly reduces the probability of tumor recurrence and the rate of metastasis, but as a result of extensive surgery, it is often required Reconstruction of the chest wall during surgery.
In some cases, chemotherapy or radiotherapy is used.
Prevention of bone cancer
Until now, there is no way to prevent bone cancer, but early diagnosis helps prevent complications.
