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Osteosarcoma
What does osteosarcoma feel like to the touch?
Osteosarcoma is a malignant tumor that consumes bone and typically shows no symptoms in its early stages. By the time symptoms are recognized, it is usually in the mid to late stages. There might be localized masses; upon discovery of such masses, a visit to the hospital for diagnostic imaging is needed. Radiological examinations reveal characteristic signs such as sunburst appearance and Codman's triangle on X-rays. Further investigation with MRI or CT scans is necessary, followed by a biopsy for confirmation. During physical examination for this type of osteosarcoma, a localized mass may be found typically around the proximal tibia or distal femur, mainly around the metaphyseal ends. The mass may be accompanied by localized heat and pain, with nocturnal pain being more pronounced. Additionally, patients might show varying degrees of weight loss. Generally, osteosarcoma can be diagnosed through physical examination and radiological findings, followed by a confirmatory biopsy. Early stages require surgical intervention. Furthermore, osteosarcomas have a high rate of early pulmonary metastasis. Using extensive chemotherapy can improve patient survival time. With rapid advancements in chemotherapy, the five-year survival rate can reach about 50%.
Osteosarcoma can exhibit which symptoms?
The symptoms of osteosarcoma, first of all, include pain. The severity of the tumor varies, and so does the accompanying pain. If the tumor significantly damages the bone, causing stimulation to the nerve endings of the periosteum, it will lead to increased pain; Secondly, there is a lump. A lump can be felt on the limb, but this lump also comes with significant tenderness. The growth rate of this lump depends on the condition; Third, there is limping. This limping is also due to limb pain, which causes progressive limping symptoms when walking, and prolonged limping can also lead to joint stiffness and muscle atrophy; Fourth, there are systemic symptoms. Any patient with malignant tumors will experience weight loss, anemia, and multi-organ failure, and may even suffer from pathological fractures.
Can late-stage osteosarcoma be cured?
For osteosarcoma in its late stages, it often metastasizes to other organs, with the majority of cases involving lung metastasis. In such cases, conservative treatment can be applied. However, if surgery is an option, it is the best approach as it can be complemented with postoperative chemotherapy and radiotherapy to extend the patient’s survival time. If there is distant metastasis and the body is in poor condition, unable to withstand surgery, then only conservative treatment and nutritional support are viable, along with the use of painkillers. In late stages, when the patient cannot tolerate surgery, only conservative treatment is available with no other alternatives. Typically, the conditions are divided into three stages. By stage three, there is usually lung metastasis. This stage often involves T which signifies intracompartmental or extracompartmental growth—T2 indicating extracompartmental, typically a marker of an aggressive tumor. Then M represents metastasis, with 0 for none and 1 for presence. So, in cases where distant metastasis occurs, it generally corresponds to stage three, phase B, which involves extracompartmental invasive metastasis. In such cases, even surgery provides poor outcomes. Early detection and treatment are best. If it progresses to later or final stages, treatment is often deemed unnecessary, limited to conservative management, as surgical outcomes are poor, and metastasis may occur elsewhere.
Will osteosarcoma cause the skin to turn red?
Patients with osteosarcoma will not have red skin. The early symptoms of osteosarcoma are generally not obvious, primarily involving localized swelling, with pain around the joints leading to limited joint mobility. As the condition progresses, this pain may shift from intermittent to constant, and the severity of the pain will increase as the disease worsens. The second patient will exhibit a noticeable lump that can be felt; this lump is usually accompanied by significant tenderness. The third symptom is intermittent limping, caused by pain from the tumor during walking, which prevents the patient from bearing weight for extended periods. The fourth aspect involves systemic symptoms common to patients with tumors, such as anemia, mild fever, and even pathological fractures.
Can patients with osteosarcoma have children?
Whether osteosarcoma patients can have children requires comprehensive consideration. One factor is that the patient's age should not be too old. Additionally, one must consider the individual's response after surgery and subsequent performance after treatment. Besides, regular check-ups should be conducted, and attempts to conceive can be made if there is no obvious abnormality or other pathological changes in the body. However, it is essential to conduct regular follow-ups and be mentally prepared. The possibility of various problems during pregnancy should not be ruled out, such as a decrease in immune response, which could trigger a recurrence of the bone tumor or other conditions, potentially leading to health issues for the child or the mother. Thus, a comprehensive and thorough evaluation is necessary.
Can osteosarcoma be treated with moxibustion?
Osteosarcoma is a malignant tumor of the bone, and the treatment effect of moxibustion is not very good. This disease develops quite rapidly, mostly occurring at the proximal end of the tibia, the distal end of the femur, the proximal end of the humerus, among others, typically at the metaphyseal ends. Clinically, the main symptoms include persistent pain, which becomes more pronounced at night, along with local swelling, restricted movement, increased local surface skin temperature, some may show prominent veins, and patients often appear emaciated, severely looking cachectic as the disease progresses with noticeable symptoms. Radiographic examination can reveal Codman's triangle or sunburst patterns. Early detection necessitates early treatment, including surgery such as inactivation reimplantation or prosthesis implantation to sustain operation. Additionally, amputation followed by extensive chemotherapy can effectively improve the patient’s survival time. Osteosarcoma has a high chance of early pulmonary metastasis, requiring systematic treatment at a hospital. Solely using moxibustion is not very effective and has limited usefulness, but it could still be worth a try if there are no better options available.
What tests are done to diagnose osteosarcoma?
The most accurate diagnostic method for osteosarcoma is biopsy, where live tissue is extracted and sent for pathological examination. The positive rate of this method can reach over 90%. Besides biopsy, there are several other methods to examine such conditions. For example, X-rays can be taken to observe significant damage to the bone structure. Secondly, CT scans and MRI can be used to determine whether the bone tumor has infiltrated surrounding tissues. MRI can also detect if there are metastases to organs outside the lungs. The third method is radionuclide bone scanning, which primarily aims to check for distant metastases of osteosarcoma.
Osteosarcoma etiology
Currently, in clinical practice, the pathogenesis of osteosarcoma is not fully understood. However, it may be related to genetics, exposure to radioactive materials, and viral infections. It can also be secondary to other deformative osteitis, fibrous dysplasia, and some benign tumors transforming into malignant bone tumors. Osteosarcoma primarily occurs in the metaphysis of long bones. The tumor spreads along the marrow cavity, extending towards both the metaphysis of the long bones and the diaphysis of the bones. Once the tumor breaks through the bone shaft, it rapidly destroys the cortical bone, spreads under the periosteum, and invades the surrounding soft tissues outside the eardrum, damaging the surrounding muscles and soft tissues.
How is osteosarcoma diagnosed?
Currently, the diagnosis of osteosarcoma in clinical settings primarily relies on a combination of clinical symptoms, imaging studies, and pathological findings. Clinically, osteosarcomas commonly occur in the distal femur, proximal tibia, and lower end of the humerus, manifesting as localized persistent pain, nocturnal pain, and swelling, often accompanied by superficial venous engorgement and increased skin temperature. Systemic symptoms of cachexia may appear, and even pathological fractures. Imaging is indispensable, revealing osteoblastic, osteolytic, or mixed osteolytic lesions, usually with a pronounced periosteal reaction, Codman's triangle (a common sign of malignancy), or sunburst patterns. Magnetic resonance imaging (MRI) is very important for diagnosing bone tumors as it can indicate the tumor's boundaries and the extent of erosion. Additionally, PET-CT and radioactive isotope scanning are considered crucial for tumor diagnosis. Pathological examination is currently regarded as the gold standard for diagnosing osteosarcoma. This involves a biopsy, usually taking a small part of the tumor for examination from a molecular biology perspective. However, when performing a biopsy, it is important to note two things: first, it is preferable to take the biopsy intraoperatively; second, if there is no plan for systematic treatment of osteosarcoma, it is best not to proceed with a biopsy to avoid potentially accelerating the spread or even hastening metastasis. Therefore, the diagnosis of osteosarcoma must be approached with caution, requiring a combination of clinical symptoms, necessary auxiliary examinations, and pathological analysis.
Characteristics of bone metastasis in osteosarcoma
Osteosarcoma, when it metastasizes to the bone, is very complex to treat. Surgery cannot fully excise the metastasized bone tissue. Currently, clinical treatments mainly involve a comprehensive approach using radiotherapy, chemotherapy, and traditional Chinese medicine. Most osteosarcomas show improvement in symptoms and an increase in patients' quality of life after radiotherapy and chemotherapy treatment. However, these treatments have their complications. For instance, while killing tumor cells, they can also damage normal cells, resulting in a decreased immune response and various related complications. Ultimately, this might lead to the cessation of radiotherapy and chemotherapy treatments. Therefore, current treatments for bone metastases from osteosarcoma involve using radiotherapy and chemotherapy in conjunction with traditional Chinese medicine. Traditional Chinese medicine may enhance the efficacy of radiotherapy and chemotherapy while also reducing their toxicity. (The use of medications should be under the guidance of a professional doctor.)