Generally, bone cancer any 2 types. They are secondary and primary bone cancer. Secondary bone cancer is a cancer of the bone caused by cancer cells derived from other organs and spread (metastasize) to the bone, such as lung cancer that spread to the bone.
The types of cancer most common and can spread to the bones are lung cancer, breast cancer, and prostate cancer. While the primary bone cancer is cancer of the bone caused by cancer cells derived from the bone. Cases of primary bone cancer are less common than the secondary bone cancer. Until now, the causes of bone cancer cannot be known with certainty. The symptoms of bone cancer include pain in the bones, the presence of a mass or lump of the bone and surrounding tissue with cancer, fever, chills, night time sweats, and weight loss can occur.
Symptoms Of Bone Cancer Generally
- Pain on the bones
Pain on the bone is a symptom of bone cancer that most often appears, but not all bone cancers cause pain. Bone cancer that attacks the bone cells are generally preceded by symptoms of pain that is fairly consistent and lasts for 1-2 weeks.
The pain is persistent or unusual, or swelling of the bone or the surrounding area may be caused by bone cancer or other medical conditions. The main part of the back and neck accompanied by other symptoms such as aches and pains. The pain does not just stop at the spine, but gradually spread to parts of the body.
The deployment is affected by the abnormal growth. If the cancer cells only cause irritation and small inflammation, then the pain is generally only occur on the back of the body. But if the nerve is pressed by the cancer cells, then the pain will spread to parts into place spread of cancer cells. Therefore it is necessary to conduct examination to the doctor to determine the cause.
- Capabilities in doing activity is down
The cancer cells that suppresses nerve with powerful, can make a person’s ability to do activity is decreased. This was due to the disruption to spinal primarily on impulses. Because when cancer trigger a large inflammation, the brain’s ability to communicate with other members of the body can no longer be run with the maximum, so that the foot was difficult to wear walking, hands stiff to be used to hold or grab something, and other symptoms.
- Sensitivity descending
The sensation of touch is also weakened due to inflammation, the pressure and influence of spinal cancer, because the nerve center located in the spinal marrow. Because of this sensitivity decreasing the bone cancer is getting hard to be able to feel the temperature of hot or cold when you touch something, as well as the decreased ability of the brain when communicating with the other limb.
- Incontinence
Cancer of the spine can also cause incontinence. These symptoms are very similar to weakness, due to pressure on certain nerves in the spinal cord that is responsible for controlling the performance of the bladder and bowel. If the impulse is interrupted, can cause a person to lose control of their bladder, bowel, or both.
- Paralysis
Along with the cancer development of the spine, a person may suffer paralysis. Depending on the severity, paralysis be isolated to a single limb. The size and location growth to the amount. You may experience pain around the occurrence of cancer, and it will probably show swelling in the bone, lump or something in it.
- Weight Loss and Fracture
Undeairable losing weight and fatigue that accompanied by bone pain. Other symptoms, like as difficulty breathing. Cancer cells can weaken the bones, and it is sometimes causes a fracture, too. Bone damage may occur in the bone that previously hurt.
Symptoms of Bone Cancer by It’s types
Bone cancer arise because of a problem with the cells that form the bone. Every year, more than 2,000 people in the US diagnosed with bone cancer contracted. bone cancer usually occurs in children and adolescents, rarely experienced by adults. Cancer involving the bone in adults may result from the spread of a tumor to another. As for the types of bone cancer include:
A. Ewing’s sarcoma (4-5 years old)
This type is the most aggressive bone tumor and attack people who are younger with age 4-15 years old. Cancer is commonly experienced by men and rarely affects people over of 30 years. Ewing’s sarcoma usually occurs in the middle of the bones in the arms and legs. Symptoms of this type of bone cancer are:
Bone Cancer Symptoms of Ewing’s sarcoma type
- Pain and bumps
Pain and bumps are common symptoms in patients with Ewing’s sarcoma. This pain is the first symptom. At first, the pain can be intermittent and mild, but it can quickly become unwieldy and require anti-pain medication. In Ewing’s sarcoma, located in axial as in the spine, back pain can be a major complaint, urinary disorders and bowel movements depending on the area and location of the tumor in the spine.
- Swelling
Tumor growth is gradually causing swelling that can be visible or palpable on the affected area. It is tense, elastic, hard, there is tenderness, is growing rapidly and there is an increase in local temperature. The tumor mass itself may be unknown for long periods in cases of pelvic tumors, spine or femur is not palpable. Because of it, or in cases of Ewing’s sarcoma which extends only to the cancellous bone or along the canal cord long bone without extends beyond cortex. Rarely, pathological fractures in sarcoma Ewing that only 10-15% of cases at diagnosis.
- Other Symptoms
Other common symptoms include fever, anemia, and signs are non-specific inflammation such as increased erythrocyte sedimentation rate (ESR), leukocytosis, and increased serum lactate dehydrogenase (LDH).
The diagnosis of Ewing’s sarcoma
Diagnosis is often delayed because of a tumor mass located in or on the torso. Imaging is required from the plain to CT and MRI for the diagnosis well as staging. Diagnosis still requires histopathological examination which has now been supported by immunohistochemical staining specific. The histopathological examination can also be used to assess prognosis in the form of response to chemotherapy.
Treatment of Ewing’s sarcoma
The management of Ewing’s sarcoma requires systemic chemotherapy combined with surgery or radiotherapy for local tumor control. The protocol of chemotherapy for Ewing’s sarcoma continues to be developed for intensification using modalities supportive development. Local control on Ewing’s sarcoma is done with a combination of surgery and radiotherapy. Bone defect after reconstruction of local control can be done to improve the patient’s quality of life.
B. Osteosarcoma (10-25 years old)
It is the most common malignant bone cancer. Osteosarcoma is a malignancy of the bone in children and young adults. The incidence of osteosarcoma has a bimodal nature in children and young adults and the elderly over 65 years and more common in men than women with a ratio of 1:2:1.
The common predilection: upper arms, legs, knees because the border with osteosarcoma occurs primarily in the bone area is great with a rapid growth rate although did not rule can occur in any bone. This cancer usually strikes a men in aged of 10-25 years, but rarely attack people who are older. This type is often very aggressive with risk of spread to the lungs. Patients with osteosarcoma has a five-year survival rate of approximately 65 percent.
Bone Cancer Symptoms of Osteosarcoma type
A person who diagnosed with osteosarcoma will feel the pain and swelling appear on the arms and legs. This condition is a common symptom of patients with osteosarcoma shown. Here’re the full symptoms:
- Pain
Pain is the most common symptoms of osteosarcoma, initially most intermittent, hidden pain, increased after the event; As the disease progresses gradually become persistent, severe pain, aggravated at night, and even wake up at night in patients with or an inability to sleep. The higher the degree of malignancy of osteosarcoma, the patient’s pain occurred earlier and more intense. If the lower limb osteosarcoma can cause claudication.
- Massa
Massa appeared in the affected area, usually located near the joints, tumor size, hardness varies locally accompanied by tenderness, such as osteosarcoma perforation of the cortical bone, soft tissue mass may be repaired, the surface smooth or uneven, often short-form big lumps. If a small amount of osteosarcoma spread to the epiphysis, even break the articular cartilage, joint capsule invasion, which causes joint dysfunction.
- Fracture
Minor trauma can cause pathologic fracture, the fracture site swelling and severe pain. Spine sarcoma pathological fractures, spinal cord compression often resulting in dysfunction (such as paraplegia).
- Four systemic symptoms
Initial body in good shape, too late as fever, weight loss, anemia, organ failure and other symptoms. It can occur in patients with advanced lung metastasis coughing up blood, difficulty in breathing and other symptoms.
Diagnosis Osteosarcoma
Enforced by history (generally at young age, their pain is sick), physical examination (localization, large tumor), and investigations.
Treatment Osteosarcoma
Generally, the treatment is done with the surgery to remove the tumor as a whole. Surgery are divided into two types, namely: Limb Salvage, the affected bone grafting techniques with bone tumors taken from patients who had died. This technique can also be done by lifting the entire bone and kill cancer cells with radiation, and the bones are returned to the original position. The second is Limb ablation, which amputates bones have been affected by the tumor and can no longer be saved.
C. Fibrosarcoma (35-55 years old)
This type is less common than other bone tumors. usually occurs in 35-55 years old. Fibrosarcoma also affects the soft tissues of the leg behind the knee. Slightly more common in males than females.
Bone Cancer Symptoms of Fibrosarcoma type
Symptoms in fibrosarcoma often not visible or no perceived pain. The new tumor usually appears after the onset of symptoms and a palpable lump. In large lesions occur on the skin stretch and appear shiny purple. In a huge mass dilation of the veins. Signs and symptoms are indistinguishable from fibrosarcoma tumor tissue more so that the necessary examination under a microscope to obtain the grade and staging of fibrosarcoma.
Diagnosis to fibrosarcoma
Diagnosis can be done in two ways, physical examination and investigation. On physical examination is about tumor location and tumor description, include: Limit firm or not, size, surface, Consistency, Pain when pressed or not, whether regional lymph gland palpable or not. While investigations can be done through X-rays, ultrasound, CT-scan, and MRI.
Treatment to fibrosarcoma
Surgical resection with wide margins is the usual management. In low-grade fibrosarcoma with surgery is usually adequate, although local recurrence occurred in 11% of patients. While in high-grade fibrosarcoma with preoperative or adjuvant often require chemotherapy after surgery to meet survival. Chemotherapy is controversial but well chemotherapy is used in bone lesions.
D. Chondrosarcoma (40 years old)
This type affects the soft tissues, including muscles, ligaments, tendons, and fat. MFH primarily affects people aged 50-60 years old. MFH also generally affects the limbs such as legs and arms. The attack was estimated at two times more common in males than females.
Bone Cancer Symptoms of Malignant fibrous histiocytoma (MFH) type
The introduction of these tumors is often difficult. Often there are no symptoms for sarcoma swelling usually occurs in network compressible and can be quite large without causing complaints. Pain is often a sign of local infiltrative growth nerve located above the tumor.
Diagnosis to MFH
Important information about the area can be obtained with CT and MRI. The final examination is the examination of choice, which can provide reliable information about the large tumor and their links to various anatomic structures. The check should be done before all other procedures.
In planning the stab-surgical procedure, angiography may be useful to assess tumor vascularization, as well as the relationship of the important blood vessels.
An adequate biopsy is a procedure that needs to get a definitive diagnosis. Aspiration cytology or biopsy material with a large needle is generally not able to provide the determination of histological types trustworthy. Open biopsy material should be taken under the common narcotics. Only on small and superficial tumors (<3 cm) for excision biopsy can be done, by lifting a layer of healthy tissue around the tumor. Larger lesions should be treated with an incisional biopsy. To be able to make handling plans, assessment of tumor types and degrees malignity often very important
Treatment to MFH
On the handling of soft tissue tumors (including MFH) surgery fingering me a very important role. Sensitives to light are relatively small, guns irradiating only the additional but very important to reduce local. Surgery is almost always difficult and often impossible, and can even cause mutilation.
F. Chordoma (Over 30 years old)
Chordoma occurs in adults over 30 years old. This type is also twice as common in men than women. Chordoma affects the spinal column at the lower end or the upper end.
Bone Cancer Symptoms of Chordoma type
Clinical features of these tumors depend on the location and start time for the appearance of tumors. These symptoms can arise from several months to several years after it first appears.
- On Chordoma in the sacrum, the clinical presentation is impossible recurring back pain and / or lower extremities. In some patients with Chordoma can occur bowel disorders and urinary incontinence may occur. In some patients also sometimes palpable mass on rectal palpation and toucher.
- On sphenoid-occipital region, Chordoma symptoms that often arises is diplopia and headache. Symptoms of neurological disorders also occur in over 50% of patients. Paralysis that often occurs in the cranial nerve VI, the sensory branch of the V nerve and sensory branches of the nerve III.
- In patients with Chordoma located along the axis, the lower spine may show symptoms such as pain, lower extremity weakness.
- Patients with a tumor in the cervical location may present with dysphagia and sometimes bleed pharyngeal.
Diagnosis to Chordoma
The start time of onset of symptoms until the patient was diagnosed as Chordoma usually an average of 10 months. Diagnosis is based on clinical examination and investigations are radiology and pathological anatomy. With clinical examination is sometimes difficult to diagnose let alone distinguish between benign and malignant, because clinical symptoms are found depending on the location of the tumor, the speed of future growth of the tumor and the rapid onset of symptoms of high pressure intracranial as well as the effects of future tumor to the brain that can cause compression, invasion and destruction of brain tissue. radiological examination and anatomical pathology almost certainly be able to distinguish benign and malignant tumors
Treatment to Chordoma
Treatment with imatinib succeeded in stabilizing tumor growth (for 84%) or shrink the size of the tumor (for 16%) in a cohort of patients. Imatinib is a tyrosine kinase inhibitor targets multiple enzymes including platelet-derived growth factor receptor, which can be expressed in chordomas.
Adjuvant radiation therapy is used in cases where complete resection is suspected. Traditional chemotherapy has not proven effective. Surgical therapy Surgery is the preferred treatment for chordomas. The success of the treatment often depends on the extent and location of the tumor. Generally, a complete removal with wide excision delay time interval between surgery and eventually relapse.