The structure of the iliac bone. The course of bone cancer, possible methods of therapy and the likelihood of recovery

Bone cancer is a cancer that affects the human skeleton. In the form of a tumor of the primary type, it is extremely rare (according to various sources, the share in the total number of cancers does not exceed 1-1.5%).

Primary bone cancer can develop:

From bone cells (osteogenic sarcoma, parosteal sarcoma, malignant osteoblastoma);
From cartilage cells (chondrosarcoma);
From fibrous connective tissue cells (fibrosarcoma);
From bone marrow cells (angioma, lymphoma, Ewing's tumor).

However, a secondary type of disease is much more often diagnosed. The cause of this form of bone cancer is metastases that penetrate into the skeletal system of the body from other previously affected organs.

The disease occurs mainly in young people under the age of 30 years (about 60% of all cases of cancerous tumors in the bones). Some varieties are found mainly in children and adolescents under 15 years of age (for example, osteosarcoma, the development of which is usually associated with active bone growth). In older people, cancer cells most often affect the bones of the skull.

Cancer can occur in absolutely any bones of the skeleton, but in the vast majority of cases, the tumor is localized in long tubular bones (femur, tibia, tibia, humerus), in 20% of cases - cancer in flat bones (ilium and rib bones).

Causes of bone cancer

Modern medicine cannot give an exact answer to the question of why bone cancer occurs, however, experts identify a number of factors that can increase the risk of developing this disease:

Limb injuries that preceded the disease (may contribute to the development of cancer, but the influence of this factor has not been definitely proven);
Chronic inflammatory bone disease (eg, Paget's disease);
Genetic mutations of a hereditary nature;
Ionizing radiation;
Prolonged contact with chemicals that have a carcinogenic effect (for example, with beryllium, radioactive phosphorus, cesium, strontium, radium, etc.);
Age (most often the disease occurs in children and young people aged 17-18 years);
Growth (some experts note the relationship between a child's height and the likelihood of developing osteosarcoma in him);
Umbilical hernia in childhood. According to statistics, Ewing's disease is three times more likely to develop in children born with an umbilical hernia. The reason for this relationship has not yet been precisely discovered;
The presence of retinoblastoma, a rare form of retinal cancer that develops in young children from tissues of embryonic origin (children with this form of cancer have a high chance of developing bone cancer);
Gender (in men, tumors in the bones are more common than in women);
Ethnicity (African Americans develop the disease less frequently than Europeans).

And, nevertheless, in most cases, the mechanism of occurrence and development of the disease remains unknown.

Symptoms of bone cancer

The main symptoms of bone cancer are pain in the area of the lesion, the formation of neoplasms in the area of the lesion, and a violation of the normal functioning of the limb.

Pain is one of the earliest signs of bone cancer. In the early stages of the disease, it has an unexpressed character, indistinct localization, occurs spontaneously and quickly disappears. With the progression of the disease, the pain becomes more and more prolonged and does not stop even in the case of complete immobilization of the limb. A characteristic feature of pain in bone cancer is that they increase at night, while affecting the quality of the patient's sleep.

Tumor growth gradually leads to deformities of the affected area of the body around it or to deformities of the contours of the limb. In most cases, there is swelling of the adjacent soft tissues. Probing the affected area allows you to identify a static neoplasm, which in some cases can be quite painful. As a rule, the temperature of the skin in the area of a cancerous tumor is higher than in other parts of the body. This is evidence of an inflammatory process. This group of signs of bone cancer usually appears 2-3 months after the onset of pain.

If the tumor reaches an impressive size, the skin over it becomes very thin and acquires a pale shade, a network of dilated blood vessels is clearly visible in it.

When the tumor is localized in the marginal zone of the tubular bone, the movement of the joint adjacent to it becomes difficult and, as a result, the process of muscle atrophy begins.

As a complication of the disease, pathological bone fractures can occur, which sometimes occur even due to minor injuries.

Other symptoms of bone cancer include signs that are common to all cancers:

Anemia;
Increased fatigue;
Decrease in working capacity;
Unexplained weight loss (up to cachexia);
Feverish conditions;
Increased sweating (especially at night);
Nausea, vomiting, the appearance of pain in the abdomen, confusion (these signs of bone cancer are the result of hypercalcemia - an increase in the level of calcium in the blood caused by the ingress of calcium salts from the bones into the bloodstream), etc.

Diagnosis of the disease

The following methods are used to diagnose bone cancer:

Biopsy;
MRI of the bone and adjacent tissues;
bone scan;
X-ray examination;
Determination of the level of calcium in the blood;
Test for determining the level of alkaline phosphatase isoenzyme;
Test for the determination of parathyroid hormone.

Treatment of bone cancer

Bone cancer has a number of distinctive features that are decisive factors in choosing the right treatment option.

First, tumors in the bones have a weak susceptibility to the effects of radiation therapy. Therefore, this method is rarely used in the treatment of bone cancer.

Secondly, the tumor begins to metastasize quite early and quickly. Therefore, before surgical treatment of bone cancer, the patient is prescribed a course of chemotherapy, which will reduce the number of cancer cells and reduce the size of the tumor. After the operation, a second course of chemotherapy is required.

The extent of surgical intervention directly depends on the stage at which the disease was diagnosed. In this case, very often it is not possible to save the patient's limb.

Bone cancer - prognosis

With bone cancer, the patient's prognosis depends on how quickly the disease is detected and how appropriate the treatment is.

Isolated, without metastases, bone cancer is not the cause of death of the patient. The survival rate at this stage is 75-80%.

Later, the disease is accompanied by a process of metastasis. At the same time, bone cancer metastases affect adjacent and distant tissues and organs, spreading throughout the body. At this stage of bone cancer, survival predictions for patients do not exceed 40%.

The bones of the pelvis belong to the formations of secondary ossification, i.e., bones passing through the cartilaginous stage. Until the end of the growth of the child, the cartilages of the sacroiliac joint, the pubic joint and the y-shaped cartilage of the acetabulum remain uncalcified. All this is the cause of fairly frequent cartilaginous lesions in the pelvic bones. Various kinds of bone lesions (tumors and dysplasia) are localized in the pelvic bones in 6% of all neoplasms and borderline processes in the bones, and 4% are cartilaginous formations.

The pelvic bones often suffer from various kinds of cartilage dysplasia. An exceptionally characteristic radiographic pattern of the iliac wing in the form of a fan-shaped arrangement of cartilaginous foci occurs with dyschondroplasia, or Olier's disease. Teardrop-shaped foci of cartilage can also be observed in other pelvic bones. These changes are usually not clinically evident, but help in recognizing the disease and in dealing with large lesions in the bones of the extremities.

With exostotic chondrodysplasia, more often with multiple, less often with a single form, osteochondral growths are localized at the sacroiliac joint or in the region of the pubic bone. Exostoses are clinically usually larger than on the x-ray, as they are covered with a cartilaginous sheath that is not visible on the picture. Sometimes it is difficult to distinguish them from true chondromas emanating from the growth cartilages of the pelvis. The presence of exostoses in other parts of the skeleton allows you to clarify the diagnosis.

True chondromas can be localized in the sacroiliac joint. They are dense to the touch, palpable from behind and are distinguished by pain associated with compression of the roots. Clinical and radiological differential diagnosis of chondromas with chondrosarcomas can be difficult, since the pain factor complicates the usual painless course of benign chondromas. Chondromas originating from the y-shaped cartilage of the acetabulum are asymptomatic for a long time and are detected as a result of the appearance of subluxation or dislocation of the femoral head, which occurs under the pressure of the tumor.

Intra-articular removal of such tumors is not difficult. After a T-shaped opening of the hip joint, the head is dislocated from the Olier-Murphy-Lexer approach. After removal of the chondroma, the head is replaced and the bag is sutured. After 10 days, it is necessary to start passive movements in the joint lying down.

A rare tumor of the pelvis in children should include benign osteoblastoclastoma. It is localized at the base of the ilium and is observed in lytic and cystic forms. Arising in the region of the articular cartilage of the acetabulum, it spreads to neighboring bones without destroying it. Such lesions must be differentiated from the tuberculous process at the base of the ilium, which, due to the depth of the lesion, can be asymptomatic, clinically and radiologically imitating osteoblastoclastoma.

With a small spread of the tumor, an approach is possible from the side of the visor of the cavity above the joint from the Smith-Petersen incision, and with a widespread lesion, from an incision parallel to the pupart ligament with intrapelvic extraperitoneal access according to V. D. Chaklin. After resection of the affected areas, the defect is filled with grafts. The iliac wing and other pelvic bones are often the site of localization of eosinophilic granuloma, with its single or multiple form. According to our data, in a third of all observed cases of eosinophilic bone granulomas in children, there was a lesion of the pelvic bones. The characteristic clinical and radiological picture of this disease persists even with pelvic localization, most often asymptomatic or detected due to soreness, swelling and local increase in skin temperature. With large foci of rarefaction in the bone, there are clear boundaries and stamped many scalloped edges.

However, it is known that the X-ray picture of bone formations in flat bones is variable and diverse, therefore, with large single eosinophilic granulomas, diagnostic errors are possible. In this regard, our observation of a 2-year-old 8-month-old boy that we published is of interest. Clinico-radiologically, and then with confirmation by an experienced morphologist after biopsy, an extensive lesion in the iliac wing measuring 4x3 cm in a child was regarded as chondrosarcoma. The parents refused the operation, after X-ray therapy recovery occurred with complete sclerosis of the focus. After 3 years, a similar formation appeared in the scapula. When the focus was removed, an eosinophilic granuloma was found. A retrospective analysis of the first disease helped to regard it as an eosinophilic granuloma of the iliac wing.

In unclear cases of hard-to-diagnose single eosinophilic granulomas of flat bones, it is necessary to strive for an accurate diagnosis before prescribing treatment; a puncture or open biopsy is advisable. This is necessary for the correct choice of treatment method.

Eosinophilic granuloma can be cured with radiotherapy, but is undesirable in girls with a pelvic localization of the tumor. When localized in the pelvic bones, it is better to perform an operation - curettage without replacing the focus; if it turns out to be a giant cell tumor, then this kind of operation will not lead to success: a more radical intervention is needed - resection. In children with giant cell tumors, radiation therapy is even more dangerous. When diagnosing a malignant tumor, the tactics are also different: extensive resection, preoperative telegammatherapy or chemotherapy are indicated.

Malignant tumors of the pelvic bones as rare in children as in adults. They present great difficulties for the doctor in terms of treatment. Sacrococcygeal chordomas (discussed in the spinal tumors section) are more common than vertebral and cranial chordomas, but they are still very rare. They can mimic teratomas and chondrosarcomas originating from the sacroiliac joint. The latter are often secondary. Their radiodiagnosis is difficult. The diagnosis is usually decided by an open biopsy. You can count on a cure only after an early radical operation. Radiation therapy for this neoplasm does not lead to success.

The iliac wing can be affected by osteogenic sarcoma and Ewing's sarcoma. In the first disease, small children suffer, which are characterized by flat bone sarcoma. Due to the very difficult early diagnosis, these patients are admitted to hospitals in an incurable state with metastases to the lungs. In older children, osteogenic sarcomas are described that originate from the base of the ilium with the transition to the wing.

Radiation therapy can bring only a temporary effect. Rarely occurring reticulosarcomas of the pelvic bones are amenable to radiation exposure, so the histological diagnosis of these lesions has practical meaning.

Ewing's sarcoma in some cases can also be located in the iliac wing. Although there is an opinion in the literature that this type of neoplasm is most often localized in the diaphyseal parts of long tubular bones, nevertheless, there are descriptions of lesions of flat bones. So, according to R. Sherman and K. Soon, out of 111 Ewing tumors, 44 were affected by flat bones, including the ilium.

Treatment of Ewing's sarcoma is carried out by combined methods. None of the types of self-treatment - surgical, radiation and chemotherapy - can not give in all cases a lasting recovery. It is known that this tumor undergoes a reduction and temporary disappearance under the influence of radiation therapy according to the roentgenogram. This property is used as a preoperative therapy. The boundaries of the tumor at the same time become more contoured, the focus is somewhat sclerotic. Radiological changes of this kind should not serve as a reason for stopping treatment, since relapse is possible. Only after radiation therapy is shown a radical removal of the tumor within healthy tissues with the periosteum and part of the surrounding muscles. Surgical treatment must be combined with the appointment of sarcolysin to the patient. This drug has a good effect as a means of preventing metastases. If recurrences occur, repeated radical surgical treatment is indicated. Recurrent areas of Ewing's sarcoma are not amenable to radiation exposure.

osteosarcoma

This is the most common neoplasm that develops primarily and affects the bones of the upper and lower extremities. The risk group is made up of young people under thirty years of age. This form is rarely diagnosed in patients over forty years of age. It is characterized by an aggressive course, rapid development of metastases and an extremely low degree of differentiation of its own cellular structures.

Chondrosarcoma

This is an oncological neoplasm that originates from the cartilage tissue that is located on the articular surfaces of the bones. Its most common localization is the ribs, pelvic joints, upper limb girdle. The risk group in this case is the elderly. The development of this tumor is associated with constant trauma at the site of its occurrence. The spine and intervertebral discs, in turn, are extremely rarely affected. Despite the fact that there is a large accumulation of chondrocytes.

fibrosarcoma

It is the most commonly diagnosed pathology of bone tissue. Development originates from soft connective tissue structures, such as the periosteum, ligamentous apparatus, cartilage. The most typical localization is the region of the upper limbs and wings of the lower jaw. Most often, female patients between the ages of thirty and forty are affected.

Chondroma

Chondroma grows from cartilaginous tissue, they represent a fairly aggressive class of tumors. Both bones growing inward and outward are distinguished, which are called Ek- and En-chondromas.

Ewing's sarcoma

It can develop in absolutely any bone structure of the human body. The most typical place of its localization are the tubular bones of the lower or upper extremities, pelvic bones, collarbones. The prognosis for this disease is all unfavorable, because metastasis is very early due to its proximity to the lymphatic and blood vessels. Secondary damage to other organs and tissues develops even before the manifestation of characteristic clinical symptoms. The most common metastases are to the brain. The risk group consists of children and adolescents who have active bone growth zones.

Enostosis is a benign neoplasm, which in shape resembles a nodule that arises from bone tissue cells. As a rule, this tumor does not exceed two centimeters in diameter, however, specialists have described formations of much larger sizes. This medical problem is typical for children and young people.

With multiple tumors, a significant increase in the cortical layer of the bone occurs, which leads to partial or complete filling of the bone marrow canal, disruption of the normal functioning of its structures and the appearance of clinical symptoms.

Reasons for development

The causes of this bone disease are varied. One of the key factors in the appearance of enostosis is a genetic predisposition. Specialists of the World Health Organization have proved that in the presence of benign neoplasms in the bones of parents, the likelihood of this pathology in a child is 45-50%. In addition to burdened heredity, the reasons for the development of enostosis are:

prolonged inflammatory process in the bone tissue;
traumatic injuries;
infectious pathology (osteomyelitis);
insufficient intake of calcium into the body, impaired absorption in the gastrointestinal tract, increased excretion of the mineral;
congenital anomalies in the development of bone tissue;
chronic intoxication of the body with heavy metals (production factor);
systemic connective tissue diseases;
syphilis in the later stages;
various oncological pathologies arising both from bone cells and having a different localization.

Clinical picture

Backache

The severity of manifestations depends on the localization of the pathological process and the size of the neoplasm. It should be noted that enostosis is a disease that can be asymptomatic for a long period without disturbing the patient at all. In such cases, its detection is accidental. Most often this occurs during an X-ray examination or MRI. The absence of a clinical picture in such cases is explained by the insignificant size of the neoplasm. Symptoms:

Enostosis of tubular bones. The progression of the pathological process leads to the proliferation of oncologically altered bone tissue cells. In this case, the neoplasm increases in size, penetrating into the cavity of the medullary canal. Running enostosis of the femur or other tubular bones can cause a violation of the physiological process - hematopoiesis, or the formation and maturation of blood cells. In patients, this can be manifested by anemia, bleeding, frequent infectious diseases due to a decrease in immunity. This is dangerous in childhood, when the process of blood formation is most intense.
Spinal enostosis. The main symptom of spinal enostosis is pain. It occurs when the nerve roots are infringed by overgrown bone tissue. The intensity of the pain syndrome may be different, but in any case, it gives the patient certain inconvenience and is a reason to contact a specialist.
Enostosis of flat bones. Localization of a pathological formation in flat bones (iliac, ischial, pubic, ribs, shoulder blades) is rarely accompanied by complaints from the patient. In some cases, the patient notes swelling or dull pain at the site of the lesion.

How to confirm the diagnosis?

Instrumental methods are used to confirm the diagnosis. The most accessible and quite informative of them is x-ray examination. It can be used to determine:

localization and size of the neoplasm;
the form of the pathological process;
the presence of bone spikes is a characteristic radiological sign of the disease.

Also, the method allows for differential diagnosis of enostosis and malignant oncological diseases of bone tissue. Benign neoplasms always have clear edges and a fairly homogeneous structure.

If necessary, the patient can be performed magnetic resonance imaging. This technique does not carry radiation exposure. It is advisable to use it for accurate differential diagnosis and dynamic monitoring of oncological formation.

Treatment

Small neoplasms that do not affect the functional activity of the bone marrow and do not cause discomfort to the patient do not need treatment. Their condition must be periodically monitored radiographically or using a magnetic resonance method.

Treatment of enostosis of large diameter is carried out promptly. Removal of the neoplasm is carried out after all the necessary diagnostic procedures. Excision of the oncological nodule is performed within healthy tissue, that is, in addition to enostosis, a part of the unchanged bone plate surrounding the pathology is cut out. This technique eliminates the recurrence of the tumor. Medications are prescribed according to indications.

In the treatment of enostosis, it is important not only to remove the nodules, but also to conduct a full-fledged therapy for the diseases that caused the development of oncology, to exclude etiological factors. Timely diagnosis and high-quality treatment will allow the patient to quickly return to normal life.

Pain in the sacrum can be due to a bruise or fracture of the vertebrae of the sacrococcygeal spine. If the lower abdomen hurts after a fall, damage to the soft tissues is obvious. To detect damage to the skeletal system, a digital rectal examination of the sacrococcygeal spine (through the rectum) or x-ray of the spine is necessary.

After falling on a “soft spot”, the buttocks on the right or left may hurt. In general, there are many symptoms of the disease, but their severity depends on the characteristics of the damage to the sacrococcygeal region.

Pain in the sacrum with bruises is not manifested by high intensity and severity. Palpation of the sacro-lumbar region can reveal local pain. It is eliminated by the use of anti-inflammatory drugs - ibuprofen, diclofenac and kenalog. They disrupt the local blood supply and reduce the likelihood of bleeding after a bruise of the lumbosacral spine.

At the same time, some doctors prescribe aspirin to eliminate the formation of blood clots in the vessels.

With a bruise, pain in the sacrum can be on the right and left, radiate to the buttocks or appear in the lower abdomen. Symptoms of the pathology depend on the volume of the affected soft tissues and the severity of hematomas.

Of particular danger is damage to the sacroiliac joint. In pathology, a displacement of the pelvic bones is observed to cause cramps and muscle pain. The disease does not cause pain, but leads to dysfunction of the liver, stomach and intestines.

When the sacroiliac joints are damaged, pain in the sacrum also occurs due to concomitant gynecological diseases in women, which are aggravated against the background of pathology.

When the pelvic bones are displaced, constipation, increased urination and pain in the sacrococcygeal region occur. This pain is called sacrodynia. It is manifested by a whole symptom complex, which occurs due to the infringement of the lumbosacral nerve plexus.

Symptoms of a fracture

With a fracture of the sacrum, women often have pain in the lower abdomen. Symptoms are caused by damage to the organs of the reproductive system with instability or displacement of the sacral spine. There is a close relationship between the small pelvis and gynecological organs due to vascular and visceral disorders.

Thus, the term "pain in the sacrum" refers to a whole range of symptoms that occurs against the background of fractures and fissures of the vertebrae, accompanied by damage to the longitudinal ligaments, intervertebral joints and other anatomical structures of the sacrococcygeal region.

If it hurts at the bottom of the spine, it is impossible to explain the causes of pain only by pain syndrome. There are many structures, damage to which will provoke pain in the sacrococcygeal spine.

With problems with the sacrum, pain in the back can be very pronounced, but they may not show cracks or fractures on x-rays. Such sensations are formed due to irritation of nerve receptors located in the muscular-ligamentous structures of the spine.

Other causes of pain

Pain in the lower back does not always appear only after a fall on the buttocks. There are other reasons for which there is pain in the sacrum:

If the lower abdomen hurts with endometriosis or sprain of the sacro-uterine ligaments, doctors exclude the pathology of the sacrococcygeal spine. In this case, women experience an increase in discharge during the menstrual cycle.
With increased pain in the sacral region, the load on the pelvic organs (bladder and uterus) increases. Against this background, endometritis is formed with stretching of the recto-uterine ligaments. In this case, there is pain in the sacrum due to neuro-reflex irradiation.
Congenital anomalies of the spine lead to pain in the lower abdomen if the distance in the transitional lumbosacral segment of the spine is narrowed.
If the sacrum hurts against the background of the pathology of the spinal column, instability can be assumed - displacement of the 5th lumbar vertebra. The disease occurs against the background of disorders in the lumbosacral spine.
Thrombi in the iliac and pelvic veins lead to pain in the back and sacrum.
Pain in the sacrum and coccyx during pregnancy can occur when the fetus is in the posterior occipital position. In such a situation, the baby's head is located at the bottom right or left and presses on the sacral bone of a pregnant woman. A change in the localization of pain in the sacrum from left to right is observed when the child turns.
In women, stretching of the utero-rectal ligament appears on a hormonal background. The ligamentous apparatus contains many nerve receptors. They provide pain at the slightest movement.
In older men, sacral pains are formed due to inflammatory processes in the prostate or rectum.
Infectious, metabolic and cancerous lesions of the prostate, kidneys and thyroid gland in the initial stages are asymptomatic. However, with a large size of the formation, the pelvic organs can be compressed, which leads to pain in the sacral region.
Infectious conditions in the pelvic area irritate the musculoskeletal apparatus, which causes severe pain in the lower abdomen on the right or left (depending on the location of the damage) during movement.
In old age, pain in the sacrum occurs against the background of osteoporosis of bone tissue (decrease in calcium density in the bones).
Gynecological or urological causes of pathology lead to pain in the sacrum. For example, retroversion of the uterus compresses the pelvic veins on the right.
Uterine cancer or endometriosis (degeneration of the uterine epithelium) leads to a change in the position of the organ. In this case, pain sensations are localized in the projection of the sacral bone.
The expansion of the sigmoid colon against the background of colitis also leads to illness. Due to the accumulation of air in the iliac region of the abdominal cavity, the internal organs are displaced, which leads to pressure on the sacrococcygeal spine.

It is difficult to list all the causes of the disease. They should be identified by a qualified specialist. It is not recommended to treat the disease on your own, since it is not necessary to count on the positive effect of therapy, and the risk of negative consequences increases significantly.

When asked by patients what to do with pain in the sacrum, we answer - you need to see a doctor. Only a specialist will be able to deal with the true causes of the disease and prescribe the correct therapy for the disease. Do not self-medicate, especially when you do not know the causes of the disease.

- These are malignant various parts of the human skeleton. The most common form is secondary cancer, when the oncological process is caused by sprouting 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 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. In the 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:

limitation of joint mobility;

an increase in regional lymph nodes;

swelling of the limbs and joints;

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 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 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 thighs 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 eighty percent of patients living with it for more 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.

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 of a patient's recovery.

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.

Surgery

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 taking 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.

Education: completed residency at the Russian Scientific Cancer Center named after N.N. N. N. Blokhin” and received a diploma in the specialty “Oncologist”