How to recognize bone cancer?

Bone cancer is a rare malignancy and if not detected early can have serious consequences. So how to detect bone cancer? This article will give an overview of bone cancer and how to recognize this pathology.

Bone cancer is a disease that occurs due to the abnormal proliferation and destruction of bone cells. The disease is more common in young patients, when bones and cartilage are growing and maturing. There are two types of bone cancer: primary bone cancer (which comes from bone cells) and secondary bone cancer (from another organ cancer that has spread to the bone).
Any location of the bone is likely to have cancer, in which malignant cells in the long bones (arm bones, shin bones, ...) are found in more than 50% of patients with bone cancer. , the rest are found at the lower end of the femur, the top of the tibia, around the knee joint. In addition, bone cancer can appear on the top of the femur, the top of the arm bone, or flat bones such as the pelvis and shoulder blades.

A study has shown the frequency of occurrence of bone cancers, in descending order of frequency, as follows:
Bone sarcoma Cartilage sarcoma Ewing's sarcoma Spinaloma Fibroid sarcoma Vascular sarcoma

As mentioned above, bone cancer can be secondary to cancer spreading from other organs. As for primary bone cancer, the cause is still unclear. Several risk factors are thought to be associated with bone cancer.
3.1. Genetic factors Bone cancer usually occurs at a young age (about 12-20 years old), when bones grow strongly. Some bone cancer patients are associated with genetic factors such as:
Li - Fraumeni syndrome: People with Li - Fraumeni syndrome have an increased risk of cancers such as breast cancer, ovarian cancer, and cancer. bone,... Retinoblastoma: Children with retinoblastoma also have an increased risk of bone cancer. This can be explained by a disorder of the oncogene suppressor (P53), which makes the body unable to control the abnormal proliferation of cells and the formation of cancer. Rothmund-Thomson syndrome: This very rare syndrome is characterized by small stature, hair loss, rash and skeletal dysplasia, and an increased risk of bone cancer. 3.2. Ionizing radiation Long-term exposure to physical agents such as intense ionizing radiation may increase the risk of bone cancer. High-dose radiation therapy in the treatment of some cancers, especially in young patients, can cause bone cancer later in life.
3.3. Bone disease Several benign bone diseases can be a risk factor for bone cancer, including:
Paget's disease of bone: Some adults have Paget's disease of bone, a lesion with abnormal growth of the bones. new bone cells increase the risk of bone cancer. Bone and muscle dysplasia.

How to recognize bone cancer sometimes becomes difficult because the initial clinical manifestations are often vague and unclear.
Pain: Pain is a common symptom of bone cancer. Depending on the stage, the pain has different characteristics and pain characteristics. Patients with early-stage bone cancer may have vague onset of bone pain, sometimes transient pain that makes patients subjective or can be confused with benign bone and joint diseases such as osteoarthritis, osteoarthritis. ,... In the late stages, the pain becomes more severe, the patient may have constant pain and be less responsive to conventional pain relievers. Feel the bone tumor: Patients can go to the doctor and detect the disease by palpating the bone tumor. This symptom may appear before or after the patient has bone pain. Malignant bone tumors are often firm, irregular margins, and can invade surrounding tissues. Restriction of movement: The bone tumor gradually grows, affecting the movement of bones and joints. Pathological Fractures: Fractures spontaneously or after minor trauma can signal pathology in the body's skeletal system. Patients may find bone cancer after a minor injury that causes a fracture and hospitalization. Fatigue, weight loss: Bone cancer patients may present with systemic symptoms such as frequent fatigue, loss of appetite, fever, unexplained weight loss.

5.1. Osteoarthritis X-ray is the first basic test indicated to diagnose bone and joint diseases, including suspected cases of bone tumors (except for subjects with contraindications to X-rays).
X-ray allows to detect bone tumors and evaluate the location as well as characteristics and characteristics of the tumor:
Tumor border: Malignant bone tumors often have thin, weak, jagged edges, many places are destroyed, There may be bone loss or bone formation in the soft part. Signs of bone destruction: Patients with bone cancer may have bone resorption with bone cysts and rodent images on radiographs. Bone loss, bone loss can be the cause of pathological fractures due to bone cancer. In addition, radiographs of patients with bone cancer may show signs of bone formation interspersed with resorption, but no signs of bone death. Periosteal reaction: Bone cancer can break through the periosteum, but this symptom is not specific for the diagnosis of bone cancer. Some patients do not see the image of the periosteum because of the soft tissue invasion of malignant bone cells. 5.2. More modern imaging techniques If X-ray allows preliminary assessment of bone tumors, the following imaging techniques allow specific investigation and more detailed assessment of bone lesion characteristics:
Computerized tomography (CT Scan) Magnetic resonance imaging (MRI) PET/CT Bone Scan 5.3. Pathology Biopsies of bone lesions and histopathology (histopathology) allow a definitive diagnosis of bone cancer. The doctor can order other necessary tests on the patient sample (such as immunohistochemical staining, ...) to get the most accurate diagnosis and choose the appropriate treatment plan.

Bone cancer needs to be differentiated from other bone, joint and marrow diseases:
Osteoarthritis Osteoarthritis Osteomyelitis Osteoarthritis Bone tumor Benign tumor of bone Malignant lymphoma

Depending on the pathological characteristics, stage of the disease, the patient's condition, etc., the doctors will consult with many specialties to make treatment decisions.
7.1. Surgery Surgery at an early stage can completely remove the tumor, reducing the risk of disease recurrence.
limb-conserving surgery: This surgery removes malignant lesions both to avoid recurrence and to limit the impact on surrounding healthy tissues to preserve the patient's limb. However, not all patients can apply this method, but also depending on the location of the lesion, the degree of nerve invasion, surrounding blood vessels, the stage of the disease,... plan to graft to restore the removed bone or replace the prosthetic bone to restore movement for the patient. Amputation and joint dissection: This surgery is indicated when it is not possible to save the patient's limb. This can interfere with activities and daily activities, but without surgery, the disease will progress quickly. 7.2. Chemotherapy Chemotherapy may be prescribed before or after surgery to increase the effectiveness of treatment. In addition, chemotherapy is also indicated for distant metastases beyond the indication for surgery.
7.3. Radiation therapy Radiation therapy may be prescribed for cases of bone cancer to slow the rate of tumor growth. Late-stage bone cancer may have an indication for pain-relieving radiation therapy.
In summary, bone cancer is a rare type of cancer and can leave dangerous complications. Recognizing the signs of bone cancer is important to detect the disease and plan treatment in time. With the development of modern medicine, there are more and more new methods to help diagnose and treat bone cancer, increase the cure rate and improve the quality of life for patients.
Center for Orthopedic Trauma & Sports Medicine - Vinmec Times City International Hospital specializes in treating injuries and conditions related to the musculoskeletal system and ligaments.
The center can specialize in surgery and treatment of diseases:
Partial or complete replacement of artificial bones and joints; Replacement of hip, knee, elbow; The first and only reversible shoulder joint replacement in Vietnam; Arthroscopic surgery to regenerate and repair damage to ligaments and meniscus; Bone cancer, bone and soft tissue tumors of motor organs; Intensive Rehabilitation in Sports Medicine; Mobility analytics to diagnose, monitor, and improve performance for athletes; diagnose and support patient recovery. The center is applying modern and cutting-edge technologies to treatment such as 3D imaging and 3D printing of bones and artificial joints, 3D-printed and personalized assistive technology, manufacturing technology. Creation and application of artificial bones and joints with new materials and precise surgical techniques by Robot.