Cancer legs - symptoms, treatment and forecast when cancer bones of legs. Symptoms and signs of bone cancer: diagnosis and treatment How to recognize bone cancer at an early stage

Bone cancer is malignant tumors of various parts of a human skeleton. The most common form is a secondary cancer, when the oncological process cause metastases, germinating from neighboring organs.

Primary cancer, when the tumor develops from the most bone tissue, occurs much less frequently. Its varieties - osteoblastoclastoma and steamed sarcoma, as well as osteogenic sarcoma. Bone cancer include malignant tumors of cartilage tissues: chondrosarcom and fibrosarcom. As well as cancer formations outside the bones - lymphoma, a ying tumor and anegose.

In the structure of the oncological morbidity, bone cancer takes a small proportion - only one percent. But due to the initial stages of symptoms and inclinations to rapid growth, it is one of the most dangerous types of oncology.

Symptoms of bone cancer

The first sign of the developing bone cancer is the pain that appears when touched to the place, under which the tumor is located. At this stage, the neoplasm can already be forgiven: this is the average stage of the disease.

Then the pain is felt without pressure. First weak, sometimes arising from time to time, gradually it becomes stronger. It appears unexpectedly and quickly disappears.

Pain occurs periodically or present constantly, in a blunt or new form. It concentrates in the field of tumor and can irradiating into the nearest parts of the body: if the shoulder is hit, a hand be hurt. The pain does not pass even after rest, intensifying at night. As a rule, the analgesics with pain symptom are not removed, and at night or during active activity pain is enhanced.

Among other common symptoms of bone cancer are a limitation of movements and swelling of limbs and joints. It is possible to occur bone fractures, even if the fall was completely insignificant.

It is often noted pain in the stomach and nausea. This is the result of hypercalcemia: calcium salts from the sore bone penetrate into the blood vessels and cause unpleasant symptoms. At the further stages of the development of the disease, other common signs of bone cancer are observed - a person loses weight, he increases the temperature.

At the next stage of the malignant process, usually two or three months after the appearance of pain, regional lymph nodes increase, the joints are sweeping, swelling of soft tissues develop. The tumor is well proved - as a rule, this is a fixed area against the background of movable soft tissues. In the very zone of the defeat, an increased skin temperature may be observed. The skin in this place becomes pale, thinning. If the tumor dimensions are essential, noticeable vascular, marble, drawing.

Later appears weakness. A person begins to quickly get tired, becomes sluggish, his sleepiness often pursues. If cancer gives metastases into lungs, respiratory disorders are observed.

Basic bone cancer symptoms:

restriction of the mobility of the joints;

an increase in regional lymph nodes;

swelling of the limbs and joints;

swelling of soft tissues at the location of the tumor;

pain even after rest, intensifying at night;

increase skin temperature over a tumor;

thinning, pallor skin, pronounced vascular pattern;

weakness, lethargy, fast fatigue, drowsiness;

breath disorders.

The symptoms of bone cancer, not explicit and weakly expressed at the initial stage, leads to the fact that a person does not attach importance to disadvantages until the disease goes far enough.

In the main risk group - children and young people up to thirty years. Mostly, bone cancer is striking men from seventeen to thirty. Elderly people hurt very rarely.

One of the provoking factors in the development of bone cancer is considered to be radiation in doses above sixty Gray. Including intensive irradiation in the process of treating other types of tumors. The usual x-ray of such actions does not have this action. Increase the tendency to form cancer cells can enter the organism of radioactive strontium and radium.

Trials in bone marrow transplantation can also provoke malignant processes.

The predisposition to the development of malignant neoplasms is observed in people with some hereditary pathologies. Thus, Lee Syndrome is determined in the history of part of patients with a diagnosis of "breast cancer", "brain cancer", "Sarkoma". Genetic diseases capable of influencing the appearance of cancer today include the Rothmund-Thomson syndromes and Lee-Fraumeni, PEDGET disease, as well as the presence of RB1 gene.

According to doctors, the cause of the development of oncological neoplasms may become DNA mutations, as a result of which the oncogenes are "launched" or are suppressed by genes that prevent tumor growth. Some of these mutations are inherited from parents. But most tumors are associated with mutations acquired by man already during their own life.

The risk of bone cancer is somewhat more than smoking people and those who have chronic diseases of the bone system.

The main causes of bone cancer:

injuries of bones and joints;

radioactive radiation;

hereditary predisposition;

dNA mutations;

bone marrow transplant operations;

chronic bone system diseases.

Stages of cancer bones

In the first stage, bone cancer is limited to affected by bone. At the stage of Ia, the tumor reaches eight centimeters in diameter. At stage I, it becomes more and applies to other parts of the bone.

The second stage of the disease is characterized by the malignation of the neoplasm cells. But it still does not go beyond the bones.

In the third stage, the tumor captures several sections of the affected bone, its cells are no longer differentiated.

The sign of the fourth stage is the intervention of cancer in the adjacent tissue with the bone: the formation of metastasis. Most often - in the lungs. Later - into regional lymph nodes, as well as to other body bodies.

The rate of transition of the disease from one stage to the other depends, first of all, on the type of malignant tumor. Some types of neoplasses belong to very aggressive and progress quickly. Others develop slowly.

One of the most rapid types of oncological diseases of the bones is osteosarcoma. He is the most common. As a rule, men are observed. Located on long bones of legs and hands, near the joints. X-ray shows the change in the bone structure.

Another kind of bone cancer, Chondrosarcoma, can grow different pace: and quickly, and slowly. It is found mainly in persons older than forty years. And usually located on the bones of the hips and pelvis. Metastases with such a tumor can "migrate" in lymph nodes and lung tissues.

One of the rarest types of bone cancer - chordoma. It is sick in most cases people aged after thirty years. Localization - spine: or its upper, or bottom department.

Cancer cancer with metastases, forecast

Most patients fall on the reception to the oncologist when the bone cancer came far away. As a rule, at this stage metastases are diagnosed. Therefore, the complex treatment of malignant tumors of the bone system typically includes the entire set of anti-corporal techniques. At 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 an indicator of survival: the time that the person lives since the diagnosis is established. When cancer bones of a five-year-old turn reaches seventy percent of patients. Both children and adults. The most common tumor of bones in adult patients - Chondrosarcom, with her longer than five years old live eighty percent of the sick.

The cause of death under 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 the effective treatment of bone cancer is the highest possible diagnosis. In time, the conducted X-ray or MRI is able to identify the malignant process at the initial stages and ensure high chances of recovering the patient.

Tactics of treatment in each case is selected individually. Main methods: Surgical intervention, radiation therapy, chemotherapy, are used either in the complex or separately from each other.

When choosing techniques and their combinations, an oncologist is oriented into several factors: the localization of the tumor, the degree of its aggressiveness, the presence or absence of metastasis into nearby or remote fabrics.

Operational intervention

Surgical operation is carried out in the overwhelming majority. Its goal is to remove the tumor and gently adjacent bone fabrics. If earlier the affected limb was often amputated, today there are more gentle techniques, when only malignant neoplasm is removed. The damaged area is restored by bone cement or bone tissue transplant from another body. Can be used fabric from the bone bank. If a large part of the bone has been removed, the implant from the metal is implanted. Some models of implants are able to "grow" together with the child's body or teenager.

Chemotherapy may be assigned before performing operational intervention: the introduction of drugs to stop the growth of malignant cells. This allows you to reduce the size of the tumor and facilitate the operation. After surgical removal of neoplasm, chemotherapy is used to destroy cancer cells that could still remain in the body.

Radiation therapy

Radiation therapy also pursues the goal to kill malignant cells. High-energy X-rays affect only the localization area of \u200b\u200bthe tumor. Treatment Long: Every day, a few days or months.

Low intense electro-resonance therapy

Among the modern methods of treating bone cancer, it is possible to note the NIERT method (low intensive electro resonant therapy). In conjunction with autohemochimotherapy and intake of calcium preparations, it is used to treat metastasis of different types in bone tissues. Conducting several courses, experts argue, gives a good analgesic effect, the partial regression of metastasis (in 75% of cases) is achieved.

Rapid Arc

RAPID ARC is positioned as recent developments in the treatment of cancer. This is radiation therapy at which visual control and change in radiation intensity is applied. Technology uses high-precision linear accelerators and computed tomography. The device moves around the patient, "attacking" tumor under the most different angles. Irradiation is ten times more powerful than that of devices more "old" generations. Treatment is reduced to eighty percent.

Cyber-knife

Innovation in the surgical treatment of malignant neoplasms is considered "cyber-knife". The affected fabrics are removed by the method of stereotactic radiosurgery. This complex device combines the latest achievements of robotics, radiation surgery and computer technologies. The operation passes without pain and blood, and the intervention in the patient's body is minimal.

Brachitherapia

When brachytherapy, a radioactive source is implanted inside the tumor. This limits the zone of exposure to radiation and protects healthy fabrics.

Proton radiation therapy

The promising area in the radiological treatment of cancer is proton radiation therapy. Malignant cells are exposed to beams of charged particles moving at a huge speed: heavy carbon ions and hydrogen protons. The method is characterized by higher accuracy compared to the already existing methods of cancer treatment.

Bone cancer is a malignant neoplasm, which is accompanied by a rapid and uncontrolled division of bone cells. The disease itself is mainly striking young men and women up to 30 years. It can be brought out of any place of the bone skeleton.

Often, education itself occurs in adolescents and young children. In this case, the cancer is low differentiated, very aggressive and growing rapidly. The neoplasia itself is very rare, among all oncological diseases.

Primary - arises from bone cells.
Secondary - metastases of the injected organ affected by the bone of the hematogenic or lymphogenic path.

NOTE! Malignant neoplasm itself can develop from any bone tissue: cartilage, periosteum and bones. Cancer develops in one scheme, the cells begin to unintebly share and capture the nearest fabrics that also in the nearest bones.

Benign The dice tumor is usually characterized by control growth, when the neoplasia itself is closed in bone tissue, which interferes with cancer growth.
Malignant It has uneven borders, growing rapidly and covers all the nearest fabrics, ligaments, muscles, other bones, etc. And after a while gives metastases.

Bone cancer legs most often occurs in young people. The elderly people damage the skull. Most often arises from avid smokers.

The reasons

There is still an analysis of patients and collecting general information, factors that affect the occurrence of this ailment, and there is no accurate information on risk factors yet.

Bone marrow transplantation - Usually done with leukemia. At the same time there is damage to bones that mutate.
Injuries, fractures - It does not matter how long it was. It happens when pathology begins to sit together a fracture of 15 years ago.
Pedgety's disease - One consequence of this oncology is that the restoration of bone cells is disturbed and pathology appear.
Radiation - Radiation adversely affects the DNA of bone cells and changes them.
Genetics - Rotmund-Thomson's retinoblastoma and Lee Fraumeni. Plus, in children whose parents suffered from this sore chance above.
Smoking - affects the occurrence of almost all oncological diseases and including oncology of bones.

If we talk about secondary cancer, metastases usually go from breast cancer, kidneys, prostate gland, lungs and leukemia.

Views

A variety depends on localization, aggressiveness and as a result of the type of treatment.

Myeloma, lymphoma

It occurs in the bone marrow, but initially grow out of lymph nodes, and later go to the bone. In this case, there is a violation of the bone structure, osteoporosis appears, and it becomes breaking.

Sarcoma Yinga (Iving)

Very fast and aggressive cancer, striking long tubular bones. The defeat is a middle part. A little less often appears in the ribs, blades, pelvic bones, etc. The age of the disease is young from 11 to 16 years. Metastasation occurs in the early stages of almost 95% of cancer.

Gigantaeer education

Or in another osteoblastoclastoma, which affects the tips of the limbs or bones. A benign flow at the beginning, but if you do not remove the new formation, it can metastasize. Often after surgical removal, a new thigh is formed in the same place.

Metastases in osteogenic sarcoma appear very early, and it develops from any bone elements. Localizes in the lower limbs. Children have active growth places in the elbows, knees and joints of the brushes. It may occur in the pelvis, shoulders and in the whole shoulder department.

Men sick more often than women. It often occurs in young people from 10 to 28 years. As statistics show, the cancer formations themselves arise in the places of rapid growth and in people who spoke very quickly in a short period of time.

Fibrous histiocytoma

It grows mainly in the methifes of tubular bones and is localized in the retroperitoneal space. It is also called the knee cancer since it is formed exactly there. It grows quickly and metastasis in lung tissue.

Chordoma

There is at a very early age, in children and grows from the residues of embryonic fabrics in the head and in the sacrats department. According to the structure of the cells, the very formation of benign, but due to difficult localization as a result of growth arises complications.

Fibrosarkom

Frequently formed in women on their feet. First, education occurs in soft muscle tissues, tendons etc. But then the cancer develops into the bone and amazes it.

Often, the defeat is very small bones in the trachea and laundry. Penetration is mainly in flat bone tissue, and not tubular cartilage tissues. Often appears in older people from 40 to 60 years. It may proceed both quickly aggressively and slowly - it all depends on the differentiation of cancer cells.

Spring from bone and connective tissue. Benignant tumor, without led causes and symptoms. True, pain may appear later, if the education itself will put pressure on the nerve or muscle. It is more likely to have adolescents and children from 10 to 15 years. Grows from the outer surface of the bone in the location of the head skull.

Osteoid Osteoma

Amazes the femoral, tibial, and shoulder bone. It is quite rarely found in 11% of cases. The tumor itself has a clear border and small sizes up to 1 cm. After removing the tumor, it almost never returns.

First signs

The symptoms and first manifestations are highlighted as ordinary pains in the bones and muscles during oncology, which are not localized. It is worth paying attention to the fact that later pain become only stronger.

Periodic pains at the localization site of cancer. May be given to the muscles, tendons. First, it is periodic, and later develops into a systematic and not stopped. The pain is stronger at night at the moment of complete relaxation or during day sleep. At the last stages, the pain is stronger and painkillers do not help.
Pain in the head.
Joint cancer can quickly lead to an immobilized place due to the rapid growth of the tumor. Tumor in the knee to severe pains for any movements.
Nausea and possible vomiting.
Fatigue and severe fatigue.
Inxication in the body.
Constant mood change.
Thread on any body area. The touch has a warmer temperature due to inflammation.
Flexing and extension of the damaged limb becomes difficult. And the more stage, the harder.
At the site of the pathology of the bone becomes fragile, fractures appear.
Anemia, elevated number of leukocytes in the blood.
Bone cancer legs greatly affects any movement with the development of the tumor. Subsequently, the patient will not be able to move normally.

Legs

Pain over the whole leg without accurate location.
It's hard to move, squat and perform physical. Load.
Also, cancer feet is accompanied by a chromota, difficulty in movement due to the defeat of the ankle and knee joint. Over time, it becomes worse and worse.
Redness, swelling around the tumor.

Hands

Pain like the one that feel athletes after loads.
They become stronger when the burden on the damaged area.
Shoulder, elbow or ray-tailed joint worse moves.

Plumber

The pelvic bone cancer is accompanied by a strong pain in the spine, the groove region and in the cochter region.
Difficult movement, squatting, slopes and any involvement of hip bone.
Redness next to the tumor.

NOTE! If the affected organs are somewhat, the symptoms will be more pronounced.

Stages

Diagnostics

Radiography - You can see the seal and character of some sites.

Contrasting - The substance is introduced into Vienna next to education. Next it passes into the bones. When scanning, you can see more detailed bone structure and the tumor itself.
MRI, Kt. - The most detailed examination, where the oncologist can see the tumor, as far as it sprout into the nearest fabrics, etc.
Biopsy - Take a piece of bone tissue and looks at histological examination. We look through as far as cancer cells differ from healthy, their aggression and the speed of development.

Therapy

Treatment of bone cancer, tactics, preparations and methods are selected only after complete diagnosis at all levels. It depends on the localization of the tumor, its diffincerer, size and stage.

The most basic method is surgical removal. At the first stages, the thief itself is removed along with the nearest affected fabrics. The bone itself is replaced with an implant of plastic, titanium or other metal.

Before the operation, can be used as chemotherapy and radiotherapy, to reduce the tumor itself, reduce its growth rate. After removal, similar exposure courses and chemical reagents are used to destroy metastasis residues.

If the cancer has metastases, it does not make sense before removal, it does not make sense and the main doctors is to extend the life of the patient and reduce the painful syndrome. To do this, also apply radiation and chemotherapy.

The proton cannon produces small particles of the proton of hydrogen and carbon ions. The meaning is that the defeat is only at maximum speed, after some distance. Because of which the radio is not such a detrimental effect on primary tissues and is aimed at a tumor.

NIERT

Low intense electroresonance therapy, plus autohemochemotherapy helps reduce recurrences and regress the tumor. In addition, the doctor prescribes the calcium rate.

Rapid Arc

First, the model of the tumor itself made on CT is used. Then the device calculates the power of each radiation stream at different angles. Treatment occurs pretty quickly, the device moves around cancer and attacks from different angles.

Cyber-knife

The device affects y destroys the tumor without cuts and opening. Impact minimum. The tumor is burned with a special stereotactic cannon. Unfortunately, this technology is not so common in Russia.

Brachitherapia

One way to irradiate the tumor. The radiation isotope is introduced inside, which for a long time acts only on tissue tissue.

Forecast

It should be borne in mind that survival depends on many factors:

Stage of cancer.
The general condition of the patient is whether there are accompanying diseases or other oncology.
The aggressiveness of cancer cells and growth rate.
Localization of the tumor.
Are there metastasis.
Benign or malignant education. It happens that even with a benign disease, patients live for long, due to the fact that the tumor in the process hits the vital organs.

That is why the most favorable forecast has cancer of any bones of stage 1 and survival of almost 85%. At the later less, 2 is already 65%. At 3 stages due to the presence of local metastasis, the value drops to 30%, and the last 4 stage is not curable, but the percentage of five-year survival is 5%.

Cancer bones - Malignant tumors that can develop in any part of the skeleton, more often - in the joints. In the people, cancer is called any cancer, but bone cancer (primary formation) is tumors only from cartilage and bone tissue, so-called sarcoma. They constitute only 0.2% of the total number of oncological diseases. Among them are the most common osteosarcoma and Sarkoma Yinga. In other cases, malignant processes are secondary formation, metastases of soft tissue tumors or other affected organs.

Most often, the sarcoma is affixed by the lower limbs - 80% of the neoplasms fall on the knee joints, 15% - on hip bones.

Men have a great predisposition to the bone cancer, while more often the pathology develops in a growing body than in old age - for the older generation there are no more than 2% of cases by Sarcom. This is due to the active division of the cells of the epiphyse, at the expense of which the bones in the children's and youthful age occurs.

Causes of bone cancer

Factors that can lead to the emergence of malignant neoplasms:

Skeleton injuries;
Complications after the operations on the bone marrow;
Precancerous neoplasms;
Genetic disorders and diseases (for example, Lee-Fraumen's hereditary syndrome);
The deforming osteite (Pagesis), which is associated with a disruption of the reduction of bone tissue during deformations, displacements, fractures. Most often arises in old age.
Radiation, ionizing, microwave and electromagnetic radiation. Upon radiation of children and adolescents with high doses in the presence of a primary oncological process, an increased risk of bone cancer occurs. A dose of more than 60 grad is considered risky, which can provoke oncology and in adults.

One of the sources of oncological processes in the bones is the rebirth of benign formations, such as: osteoma, chondroblastoma, chondroma, osteomoblastoma, osteoclastoma. Also, the malignant flow can take formation of connective tissue (lipoma, fibroma), neurofibrome.

Secondary bone cancer is a consequence of metastasis of malignant tumors of other organs, including thyroid or mammary glands, kidneys, lungs, etc. In a child, a skull sarcoma can develop a child when irradiating the retinoblastoma (eye oncology).

Symptoms and signs of bone cancer

The primary manifestations and symptoms of bone cancer can be the sealing of the skin, swelling over the neoplasm, periodic pain in the same area. These signs are a reason for compulsory visits to the doctor, without self-medication and ineffective procedures, in order to detect a malignant process in a timely manner and not to launch the disease until late step. In the absence of therapy, a person begins to feel constant fatigue, weakness, general ailment and absence of appetite, and pain becomes more pronounced and long. Sometimes the functioning of the joints, limbs is disturbed.

Subsequently, heavier bone cancer symptoms may appear:

the neoplasm is inflamed, the skin above it becomes lighter, the veins appear, the skin turns out to be hot;
there is a deformation of the bone, sometimes - a fracture;
pains grow, interfere with normal sleep and high-quality life;
due to nausea, the body's impaired is noticeably reduced;
if the tumor is localized in the chest area, metastases can go into the lungs that are manifested by difficulty breathing.

Cancer forms

Primary cancer bones - True sarcoma, which originates in the bones, periosteum, cartilage, in fibrous and fatty tissues, vessels.
Secondary cancer - Metastatic: cells behave like under primary form, but identical to the tissues of the "maternal" neoplasm.

Classification of malignant tumors

from adipose tissue (liposrak);
muscular (Leiomiosarcoma);
from connective (fibrous histiocyte);
from Notokhorda (Hordom);
fibroblastic (fibrosarcoma);
vascular (epithelioid hemangioendothelioma, angiosarcoma);
chance-forming (chondrosarcoma);
kosovo-forming (osteogenic sarcoma, osteosarcoma);
giantheal (osteoclastoma);
hematopoietic (myeloma, lymphosarcoma, reticulosarcoma);
bone skeleton tumor (Sarkoma Yinga);
other (neurinoma).

Common types of bone cancer

Sarcoma Jinga

It develops in long tubular bones, in the pelvis, blades, clavicle and ribs, sometimes formed outside the bones - in soft tissues. Its feature is in aggressive development and early metastases in the central nervous system, bone marrow, lungs, liver. The peak of morbidity comes to adolescent age from 10 to 15 years.

Osteosarcoma

Develops in the bones of the pelvis and limbs (more often - in the lower). Oncology is more susceptible to long tubular bones, while cancer more often appears in the knees, femoral and pelvic bones, a large berth bone, shoulder joints.

Cancer neoplasms develop from bone cells by spreading with metastases surrounding tissues.

Diseases are subjected to young people under the age of 30 (they account for up to 65% of cases), more often - adolescents during puberty.

Chordoma

After 30 years, it occurs after 30 years, while in adult patients turn out to be affected by the bones of the spine in the field of the sacrum, in young people - the disease is localized at the base of the skull. It is characterized by slow development, but after surgical removal, relapses often occur. Horde with minimal aggressiveness is called chondroid, aggressive shape, prone to metastases, is undifferentiated.

Histiocyte (FZG)

Mutations in the cells of the connective tissue (in bundles, tendons, muscles) can lead to the formation of fibrous malignant histiocyte. If the tumor develops in the joints, neighboring lymph nodes and organs are often affected.

Chondrosarcoma

Develops from cartilage tissue, so the tumor may occur in any part of the body, where there are cartilage (limbs, blades, hip joints, skull, trachea, larynx, etc.) in the risk group of middle and older people (this is 60% of cases) who have benign education, such as ostechondromes. The disease progresses slowly and rarely gives metastase, rarely reaches 3 degrees, so when the process is detected there are all chances of a positive outcome.

Chondrosarcom is three species:

Mesenchymal - It grows rapidly, but highly sensitive to chemical and radiation therapy.
Svetoklochoe - develops slowly, but after removal prone to relapse in the same focus.
Differentiated form - The most aggressive, with development has symptoms of osteo- and fibrospark.

Osteoklastoma (giant tumor)

This is the result of reborn neoplasms in the joints of the hands and legs, which rarely moves to neighboring tissues and organs or gives metastases. However, after excision, often arises in the primary focus.

Stage oncology

Defined on localization and the size of the tumor.

I Stage (Early) - The neoplasm does not go beyond the bone. Inside this stage, the IA stages are distinguished when the tumor does not exceed 8 cm in diameter. If the size is greater, the pathological process spread inside the bone is stage IB.
Stage II - The tumor is within the borders of the bone, but all signs of the rebirth of cells in malignant (disorders of differentiation and the growth of tissues) are already manifested.
III Stage - Multiple fabric damage.
IV Stage - The malignant process extends to the adjacent tissue, metastases are formed into lymphatic components and organs.

Diagnostics

The first sign of bone cancer is the growing pain, the appearance under the skin of painful swelling, which is increasing over time. It originally looks like a dense and static education, gradually becomes soft and movable. If the symptoms are similar, this is a reason for a complete integrated examination.

What studies are needed?

blood test on monackers and alkaline phosphatase;
biopsy (bone marrow, bone tissue);
x-ray in two projections (it helps to determine the localization, the degree of destruction of the bone shell, the presence of the sclerosis, periosal reaction zone);
Kt., MRI, angiography (determine the degree and nature of the spread of the malignant process);
scintigraphy (Bone scan to identify the primary focus and the presence of metastases).

For the correct formulation of the diagnosis and exclusion of inflammatory processes with the same symptoms due to injuries and benign tumors, a differential diagnosis is carried out.

Metastases in bone tissue

The malignant process, which goes beyond the primary focus and affects other fabrics and organs, is secondary cancer. Most often with metastases are affected by the skeletal zones with active blood supply (spine, pelvis, skull, ribs).

Symptoms of cancer metastases in the bones:

bouts of bone pain and violation of the function of the joints;
fractures with low loads and minor mechanical exposure;
numbness of the limbs (due to spinal compression);
violation of consciousness;
constant fatigue, reduced appetite, nausea and vomiting (manifestations of hypercalcemia);
the formation of an excessive amount of urine with impaired urination.

Detect metastases in the bones of the skeleton allows scintigraphy - a study in a gamma chamber with preliminary leading in the blood flow of marker isotope.

Treatment of bone cancer

The main methods of treatment are radiation therapy, chemotherapy and surgical excision of the tumor (along with a case, and when it is unavailable, together with the nearest muscles). In extreme cases, limb is removed.

Treatment is prescribed based on the type and stage of the cancer tumor, its sensitivity to drugs and procedures.

The sarcoma of Yinga is highly sensitive to radiation and chemotherapy, while the operational method is not the main one.

Chondrosarcoma, on the contrary, is treated through the operation, including the articular ends of tubular bones with subsequent endoprosthetics are removed. The beam and PCTs are not effective in cases of fibrosark - they are also removed surgically. FZH is also trying to treat during organophing operations - resection with the possibility of subsequent plastics. Leaving the organ, the tumor is cut together with muscle vagina and fascia.

Operations on the limbs are carried out with the removal of the affected bone and adjacent soft tissues.

"Light" and "Chemistry"

Exposure is used in the therapy of the Sarcoma of the Jinga and the reticulosarcomer, but now it has been refused to treat osteogenic sarcoma, angio and chondrosarcom. Dose of irradiation does not exceed 50 Gray.

Chemotherapy - a procedure that is performed before and after surgery. After resection, the same drug may be assigned as before the adoption of the neoplasm (if there was 3 or 4 degrees, and more than 90% of the tissue are mutated). The composition may vary with less damage to the cells.

The following treatment regimens can be assigned in complex radiation and chemotherapy:

For the primary hearth:

The first stage - irradiation for up to 6 weeks with soda up to 60 grades.
The second stage is chemotherapy for two years: in the first year they are conducted by courses every three months, in the second - once every six months.

For a secondary hearth:

The first stage is assigned chemotherapy for 4-5 courses each with interruptions of three weeks.
The second stage is carried out irradiation of the epicenter and all the affected bones with parallel gentle "chemistry".
Then repeated PCTs according to the first stage scheme.

Chemotherapy as an independent procedure effective with multiple metastases. If conservative methods do not help, resort to operation. In the fourth stage, the bone marrow transplantation with PCTs in high doses is carried out.

How treatment is carried out with cancer metastasis

Cancer, which "let" metastases requires comprehensive therapy:

reception of antitumor drugs (cytostatics);
hormonal drugs;
chemotherapy;
immunotherapy;
supportive therapy (reception of analgesics and bisphosphonates that suspend reduction of bone mass);
local treatment (Radio frequency ablation - exposure to the current on the tumor; cementoplasty, irradiation, operation).

Basic drugs for chemotherapy in metastases: "Methotrexate" (M), "Cyclophosphamide" (FROM), "Formuracyl" (F) "Doxorubicin" (A)

For I-II line Prescribe these funds in various combinations: CMF, CAP, CAF And others.

For III-IV line Combine "Navalbin", "Mitomycin-C", "Millomantron", combining all three drugs to the course or combining the first and third preparation.

With multiple metastases, together with PCT and hormonal treatment, the course irradiation of pathological foci is carried out.

Hormonal therapy

Surgical or chemical castration is carried out in parallel with the method of non-steroidal antandrogen ("Anandron", "Casodex", "Flucine") or steroid ("Megesterol Acetate", "Andokur"). Also in practice, hormones agonists are used, which allow you to do without orchectomy ("Zoladex", "Prostal" once in the prescribed dosage)

Life forecast for bone cancer

How many patient can live with bone cancer depends on how soon it was possible to detect pathology and start therapy.

Five-year patient survival:

sarcoma Yinga - 50.6%;
osteosarcoma - almost 54%;
fibrosarcoma - 75%;
chondrosarcoma - 75.2%.

After the operation and during remission, patients remain under the supervision of doctors: in the first year they examine every three months, in the second - once every six months, hereinafter - once a year.

Cancer is too serious illness to engage in self-medication or experience the effectiveness of folk remedies that can only ease the symptoms. At the first alarming signs, you need to turn to the oncologist.

The diaphysis of tubular bones is filled with a bone marrow, and at the edges they have roundings and expansion. There are compounds of joints - epiphysis. Diaphysis and epiphysis divides the metaphisis in the form of a plate. It contains cells that are constantly actively divided. With the ossification of metaphysis, the human growth is terminated, therefore bone cancer is more common in the younger generation, and only 2% cancellation of the older generation. The male population is subject to bone cancer to a greater extent than women.

Oncology of bone tissue: symptoms and treatment

The rest of the (secondary) types of formations include metastatic bone damage, which develop with or other types of cancer. More often the neoplasms on the bones of the leg are diagnosed, 80% falls on the knee joint. In the hip bone, the oncoprocess appears in 15%, in the field of skull in children - up to 3-5%.

Bone cancer: causes

True causes of bone cancer are not known. It is assumed that the risk factors of cancer are:

genetic diseases, including Lee Fraumeny syndrome;
structural change of DNA;
precancerous neoplasms;
pedge's disease. In the disease, Pedge is affected and thicken bones in older people, because they are fragile and often break. The bone cancer is noted during the disease of PEDGET in 5-10% of cases. With a large number of exostosis (bone growth), the risk of the perics of the oncoprocess increases;
radiation and the presence of a plurality of electrical devices from which ionizing irradiation occurs, affecting the development of oncology. An X-ray study does not belong to the risk factor. If high doses of irradiation are prescribed at a young age on the primary cancer of another organ, it can cause . Doses\u003e 60 grams for adults can also increase the risk of cancer development, for example, chest.When riding radioactive substances (radium and strontium) increases the risk of bone cancer. From non-ionizing radiation, which contribute to the development of tumors, is called electromagnetic and microwave fields (arise from electrical lines, mobile communications, microwave ovens and other household appliances);
bone injuries and bone marrow transplant operation.

The risk of bone cancer is happening when reborn benign formations in malignant processes. Among the precancerous neoplasms, it is possible to highlight: chondroma, chondroblast, chondromixoid fibromu, osteoom, osteoid-osteoma, osteomoblast (osteoblastoclast), giant meal osteoclast benign development.

With a multiple osteochondr, which forms bone-cartilage tissue, the development of chondrosarcoma is possible. Among other connective tissue formations, the fibromo is distinguished and, as well as neurofibroma from the cells of the shells of nerves, fibroblasts and perhipurium, prone to reborn into malignant neoplasms.

The reasons for the secondary cancer of the bones are to metastasize cancer from other organs: or, and. When detecting in children of hereditary (node \u200b\u200bin the eye), osteogenic sarcoma may develop. After the radiation therapy of the retinoblastoma may appear sarcoma skull.

Cancer Cancer: Symptoms and Manifestation

The symptoms of bone cancer begin with periodic pain in the affected area, appearance of swelling and sealing under the skin. Most often, the patients try to rub a problematic place with alcohol-containing means and do not turn to the doctor. Due to late diagnosis, cancer is detected in late stages.

Over time, the condition of a person worsens. There are symptoms such as general weakness, malaise, fatigue, lack of appetite. It is possible to increase body temperature. At the same time, pain syndrome becomes more pronounced and constant. The function of the limb is broken.

the skin in the epicenter brightens and becomes hot;
the inflammatory process begins at the site of the neoplasm, and veins are viewed;
deformed bone under the tumor, fractures are possible;
the mass of the body is sharply reduced due to the loss of appetite, nausea and vomiting;
the patient sleeps badly due to pain, becomes sluggish and nervous;
breathing is disturbed as a result of tumor metastasis.

Types, types and shapes of bone cancer

In the form of the primary cancer of the bones represents the true sarcoma. It begins to grow in fibrous, fatty and tissues of bones, periosteum, muscles, blood vessels, in the structures of cartilage.

Secondary bone cancer is metastatic. The cells of the secondary cancer behave like cells of primary distribution. And under the microscope, bone cancer fabrics are identical with tissues of maternal oncological education. Secondary malignant bone tumors require the same treatment as primary education in other organs.

Classification

Cancer and joint cancer include the following types of malignant tumors:

Chance-forming:
Kosovoiding:
- osteogenic sarcoma;
- osteosarcoma YuCstakortical.
Gigantaeer malignant tumor (osteoclastoma).
Hemopoietic:
- reticulosarcoma;
- lymphosarcoma;
- meloma.
Fibroblastic:
- fibrosarkom.
Sarcoma Jinga.
Vascular:
- angiosarcoma;
- epithelioid hemangioendothelioma.
Connectant:
- malignant fibrous histiocyte.
Notechord tumors:
- hordom.
Muscular tumors:
- leiomiosarcoma.
Tumors of adipose tissue:
- liposarcoma.

other onco-formations: Inspection (Svannoma, Nevnoma), non-classified and tumor-like lesions.

Consider the most common types of bone cancer.

Osteogenic sarcoma

Amuses the upper (40%) and lower (60%) limbs, pelvic bones. We are often found in long tubular bones. Less often localizes in short and flat. Most of the knees suffer, then the thigh, the pelvis, the tibia and shoulder. Less often cancer is localized in a small berth and radial bone, elbow, skull.
Cancer cells are formed in bone tissue, then they apply to surrounding tissues, as a result of rapid progression and early metastasis. Split sclerotic (osteoplastic), osteolatic or mixed forms of osteosarcoma. The peak of the disease is celebrated at the age of 10-30 years (65%), more often in men during sexual maturation.

Sarcoma Jinga

It takes the second step among bone cancer, is distinguished by aggressiveness. Localizes in long tubular bones of limbs, pelvis, ribs, clavicle, blades. The peak of the disease is celebrated at the age of 10-15 years. It can be formed out of bone in soft tissues, early metastasis in the lungs, liver, bone marrow, CNS.

Chondrosarcoma

Grows from cells of cartilagers. Localizes in the bones of the skull, pelvis, limbs, blades, cartilages of ribs, spine, larynx, trachea and in other elements where cartilage are available. They suffer more (in 60%) from the Hondrosarcoma, medium and elderly age groups of people.

The symptoms of chondrosarcoma are manifested when reborn benign formations: enhondromes and osteochondromes (in the form of bone protrusing, covered with a roaster).

It happens:

differentiated, with aggressive development and acquisition of the features of a fibrospar or osteosarcoma;
light-cell, with slow growth, but frequent recurrences in primary foci;
mesenchymal, with rapid growth, and high sensitivity to chemicals and irradiation.

Chondrosarcoma grows slowly, it disseminates little, and its malignant achieves 1-2 degrees, which improves the forecast of survival. It is rarely found oncoprocessions 3 degrees, with rapid distribution.

Frequent localization of chordomy - skull bones and spine in patients after 30 years. Development slow without germination to neighboring bodies, but are characterized by local recurrences after excision with incomplete removal of oncoclecks. The basis of its education can be the remains of embryonic chord. In adults, Hordom is striking the sacrons, the young people are the base of the skull. Distinguish the chord:

ordinary;
chondroid (with the smallest aggressiveness);
untifferentiated (aggressive, inclined to metastasis).

The development of fibrous malignant histiocytomes (FZH) more often changes the cells of the connecting tissues: ligaments, tendons, muscles, fat fiber. When localizing the bone fabric of the limbs, especially in the joints, captures near the underlying fabrics and lymph nodes. Metastasis achieve lungs and other important remote organs.

Bone giantheal tumor

Reborn from a benign neoplasm and striking the joints of the limbs. It makes little metastasis and almost does not germinate into neighboring organs, but often recurrences even after excision at the site of the primary epicenter.

From other neoplasms, bone tissue affects and, capable of spreading to bone marrow, long, short and flat bones.

Stages of cancer bones

As the bone cancer stage, the doctor can find out the volume of the neoplasm, assign a treatment regimen and make a preliminary forecast.

If education is within the borders of the bone, it is assumed to be 1 bone cancer stage, which is divided into:

iA stage - the size of formation up to 8 cm;
stage IV is the size of the formation of more than 8 cm, with the propagation of inside the bone.

Bone cancer 2 stages It is still developing inside the bone, with characteristic cellular malignation - a malignant change in violation of the differentiation and proliferation process.

With a low degree of cell differentiation and multiple bone lesion, it is assumed 3 Stage. If education is detected beyond the bones, diagnosed bone cancer 4 stages. Metastasation in the lungs, lymph nodes of remote organs, the intervention of neighboring tissues is a sign of the fourth stage.

Cancer Cancer: Diagnostics

Diagnosis of bone cancer is hampered because it has similar symptoms with benign formations and inflammatory processes. For the correct interpretation of clinical signs of the disease in the presence of injuries of the musculoskeletal system, it is necessary to pay attention not only to the symptoms of bone cancer, but also to carry out x-ray and morphological research. For the diagnosis, it is determined where the node is localized, as quickly it grows, what is its consistency and mobility, whether the functions of the nearest joint are violated.

How to determine bone cancer?

The first signal symptom is pain. Next, it should be awarded its constant strengthening and the appearance of the tumor component under the skin, inclined to increase in size. In this case, the initially dense, still education begins to move and soften. The function of the nearest joints is broken. These bone cancer symptoms are a good basis for a full survey.

Diagnosis of bone cancer includes the following research methods:

x-ray in 2 projections to determine the place of destructive focus. It is important to know how thinner and collapsed the cortical layer, whether the sclerosis zone is found around the formation. In the presence of a periosal reaction, I determine its nature and severity;
angiography, tomography, CT, MRI to establish the nature of the spread of a malignant process and determining the treatment regimen, including the volume of surgical manipulations;
radioisotope diagnosis: skeletal scintigraphy (89SR, M99TC) to clarify the localization of the primary focus and its prevalence, metastatic lesions;
morphological diagnostics (aspiration biopsy or trepalobioplation). It is often an open biopsy with bone cancer;
common and blood test (Trap with subimposes 5 A and 5B) and to determine the level of enzyme alkaline phosphatase. When it is increased, cancer is suspected.

In the study of biochemical analysis of blood, it is possible to reduce the concentration of protein in plasma and the increase in calcium, sialic acid, to which the Trap will indicate (acidic tartrastrescent phosphatase) or the bone isoenzyme of alkaline phosphatase (the remains, var - bone alkaline phosphatase). Oncomarker Trap 5A and 5B also indicates the metastases in the bones.

To eliminate inflammatory processes, diseases of the bone system associated with injury and benign neoplasms with similar symptoms, assign adequate treatment, the differential diagnosis of bone cancer is carried out.

Bone cancer with metastases

Malignant processes in other organs: thyroid, dairy and prostate gland, lungs, kidneys spread metastases in the bone and form a secondary cancer.

How to determine metastases in the bones?

Most often metastases are localized in organs with good blood supply, for example: on blades and ribs, in the skull, thigh, spine or pelvis.

Patients may complain about the following signs of metastases in the bones:

spinal compression with characteristic numbness of the limbs and the region of the peritoness;
impaired urination function, with excessive formation of urine;
violation of consciousness;
nausea, dry mouth, thirst, decline in appetite, increase in fatigue, belong to signs of hypercalcemia when metastasis;
pain attacks in the area of \u200b\u200bbones with mobility restriction;
fractures in problem places even with low loads, awkward movements.

At any stage of bone cancer, in advanced cases, radioisotope skeletal scintigraphy will allow you to detect metastases in any corners of the skeleton. For this, patients are injected with a sharp 99M TC - osteotropic radiopharmological agent 2 hours before the body examination using a gamma chamber.

Cancer Cancer: Treatment

The treatment of bone cancer is carried out surgical, radiation and chemotherapeutic methods. With radical crilent amputations, exacticulations due to the presence of large tumors, perform a complete removal of the limb or its part.

Radical resection of education is carried out with the removal of muscle vagina and fascia. If the border of the case is technically unavailable, tumor masses are excised with the layer of nearest muscles.

In the initial stages of the disease, a organ-powder operation is carried out. Combined bone cancer treatment with operations includes chemistry or irradiation. It takes into account the sensitivity of the oncuses to a certain type of therapy. For example, the oncoprocess in cartilage does not respond to chemistry. The sarcoma reticoculosk or Yinga tumor feels highly therapy with rays and PCTs, while the operation is considered not the main method of treating these types of sarcom.

Chondroshrcoms are removed operational. If there is no large soft component of the node, then the operation on the joint ends of the tubular bones or they are removed and the endoprosthetics is defective.

In the region of the blades and the pelvis, inter-opumen and intermediate and intermediate-abdominal resection. The fibrosarcom is removed operational, since the therapy of rays and chemistry does not give effect. The fibrous histiocytime is eliminated by organ-resistant operations, that is, by various types of resection with the use of plastic defect or without it.

When preserving the organ, malignant education and the muscular-fascial vagina are removed simultaneously. Operated on the overlying segment of hands or legs, and crossed the tumor above the attachment site of muscles, which go to a healthy segment from the affected.

The preserving belt is used by preserving inter-optic - breast operation. To the pelvic belt - intermediate-abdominal, to the legs and arms - excision of a whole segment with a bright and soft tissue. From the nearest pole, the resection line is carried out at a distance, which is equal to the length of education. When chondrosarcomes, paraensional sarcoma - at a distance of 1/2 of the node length, if endoprosthetics is assigned.

Radiation and chemotherapy

The treatment of cancer of bones by irradiation is used mainly in the reticulosar and sarcoma of the Jinga. Osteogenic, Chondrosarcom, Angiosarcoma is not irradiated now. When combined with chemistry and before operation, a total dose of irradiation is used by 40-50 gr.

Chemotherapy for bone cancer is performed before resection and after it. Adjuvant chemistry (after surgery) determine the degree of pathomorphosis due to drugs. If more than 90% of the tissue (III-IV degree) is damaged into a medicinal combination of the same drug as the resection. If less cells are damaged by another drug.

The following options are used to combine chemistry and irradiation:

To the primary hearth:

first stage - exposure: 55-60 gr - 5-6 weeks;
the second stage is chemistry - up to 2 years: every three months in the first year, every 6 months for the second year.

On the secondary hearth:

first stage: PCT from 4-5 courses (first stage) at the interval - 3 weeks;
the second stage: radiation therapy of the hearth and the whole bone (soda 55-60 gr) and gentle polychimotherapy;
third Stage: 4-5 courses of PCT, as in the first stage.

If conservative therapy is ineffective or there is no possibility to carry out in connection with complications (decay of bumps, bleeding) - perform operation. At the fourth stage of the malignant process, highly visible PCTs and bone marrow transplantation are performed. Chemotherapy, as an independent method of therapy, is performed in the presence of multiple metastases.

Metastase therapy

Antitumor therapy for metastases includes cytostatics, hormonal agents, immunotherapy, chemotherapy. Supporting therapy includes bisphosphonates and analgesics. The main local treatment is the operation, irradiation, radio frequency ablation, cementoplasty.

Chemotherapy for metastases in the bones (I-II lines) is carried out by four main drugs: cyclophosphamide, and doxorubicin. For the monodeps are prescribed.

Basic diagrams of PCT I-II line

In metastases, they use diagrams for the introduction of drugs into bone tissue. Therapy is carried out by administration:

Cmf -, methotrexate, 5-fluorouracil.
CA - cyclophosphane and doxorubicin.
CAF - cyclophosphane, doxorubicin and 5-fluorouracil;
CAMF - cyclophosphane, doxorubicin, methotrexate and 5-fluorouracil;
Cap - cyclophosphane, doxorubicin and.

Schemes III-ov

Make up for combination schemes from Mitomycin-C, Mavelina:

MMM - Mitomycin-C, Mitoksantron, Methotrexat;
MN - Mitomycin-C and Mavelbin.

In parallel with the hormone and chemotherapy, it is irradiated with multiple foci and the presence of micrometastases enlarged doses: the genus - 4-5 gr, soda - 24-30 GR for 5-6 days. When expulsion of all zones affected by metastases, this type of therapy is considered the main one.

Hormonotherapy

Maximum androgen blockades are carried out: surgical or chemical castration, combining antandrogen:

non-steroid - flutamide (flucine), Anandron, Casodex;
steroid - Andokur and Megestrolla acetate.

Agonists are currently used in practice: gonadotropin-rilizing hormones with a convenient form for use. Allows you to do without surgical orchectomy Chemical castration:

Zoladex 1 time per month - 3.6 mg;
Zoladex 1 time in 3 months - 10.8 mg;
Prostal 1 time per month - 3.75 mg.

Life forecast for bone cancer

The forecast for bone cancer depends on how early the disease was discovered and appointed adequate therapy. The five-year survival rate of patients, for example, with an osteosarcoma is 53.9%, with chondrosarcoma - 75.2%, the sarcoma of UNInta - 50.6%, with a reticulous sarcoma - 60%, fibrosarcoma - 75%. If metastases are found in the bones, the life expectancy is reduced to 30-45% or less.

Patients are observed oncologists and fully examine them in the first year after the completion of therapy, ferry radiography perform every 3 months. In the second year, they examine every half year, three more years and in the following years of life are performed according to one control examination, including the pulmonary x-ray.

Informative video

Osteosarcoma

This is the most frequently emerging neoplasm that develops primary and affects the bones of the upper and lower extremities. A group of risk is young people up to thirty years. The specified form is rarely diagnosed in patients after forty years. It is characterized by an aggressive current, the rapid development of metastases and an extremely low degree of differentiation of its own cellular structures.

Chondrosarcoma

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

Fibrosarkom

It is the most frequently defining bone tissue pathology. Development originates from soft connective tissue structures, such as periosteum, a binder, cartilage. The most typical localization is the area of \u200b\u200bthe upper limbs and the wings of the lower jaw. Most often amazed female patients aged from thirty to forty years.

Hondroma

Chondrom grows out the cartilage tissue, they are quite aggressive class of tumors. It is isolated both growing in the bone and outwards that are called ek and en-chondromes.

Sarcoma Jinga

May develop in absolutely any bone structure of the human body. The most typical place of its localization is the tubular bones of the lower or upper extremities, pelvic bones, clavicle. The forecast of this disease is unfavorable, because metastasis is very early in view of the relative location to the lymphatic and blood vessel. The secondary defeat of other organs and tissues is developing before the manifestation of characteristic clinical symptoms. Metastases are most often developed in the brain. The risk group consists of children and adolescents who actively work the bone growth zones.