How to alleviate the pain of osteosarcoma?

Written by Guan Jing Tao
Orthopedics
Updated on December 12, 2024
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Pain in osteosarcoma patients is mostly caused by the cancer invading local bone tissue and other tissues, leading to pain, tenderness, and even sleeplessness. Therefore, the pain management follows a certain hierarchy, starting with non-steroidal anti-inflammatory drugs, followed by weak opioids, and finally strong opioids such as morphine. However, this only alleviates the pain and does not help with treatment. For early-stage osteosarcoma patients, pain management primarily involves surgery when necessary. For advanced-stage patients, it involves gradually increasing the dose of effective pain-relief medications to alleviate temporary pain. (Controlled drugs must be strictly used under the supervision of relevant physicians.)

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Written by Na Hong Wei
Orthopedics
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Osteosarcoma is a type of cancer.

Osteosarcoma is a relatively common type of malignant bone tumor in clinical practice. It mainly occurs near the ends of the humerus, including the area around the head of the humerus, and at the distal end of the femur, near the femoral condyles, as well as the proximal tibia, close to the tibial plateau. These are its common sites. It predominantly affects teenagers, generally those under 18 years of age. The main symptoms include: firstly, persistent and worsening pain that gradually intensifies and does not alleviate, with the notable characteristic being that the pain is more severe at night than during the day; secondly, the appearance of spindle-shaped tumors around the joints, particularly at the three aforementioned common sites, often accompanied by redness, warmth, pain in the superficial skin, and even prominent superficial veins; thirdly, osteosarcoma is a type of malignant tumor, classified as grade 2B among malignant tumors. Its main feature, apart from local symptoms, is its propensity for metastasis, with the lungs being the most likely site of metastasis.

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Written by Wang Cheng Lin
Orthopedics
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How long is the latent period of osteosarcoma?

In clinical practice, there is no such thing as a latency period for malignant bone tumors, because these tumors progress very quickly. So, if you experience symptoms such as swelling and pain in the affected limb, if you can feel a mass, and if the pain severely impacts your daily life, you should promptly go to a hospital to get an imaging test done to determine whether a bone tumor is present. Only through imaging and accurate diagnosis can early diagnosis and treatment be achieved, which is the best treatment approach for osteosarcoma. Therefore, in clinical practice, there is no concept of a latency period for malignant bone tumors.

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Written by Wang Cheng Lin
Orthopedics
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What is the metastatic pathway of osteosarcoma?

Osteosarcoma commonly spreads in three ways. The first is through hematogenous dissemination, meaning that tumor cells spread throughout the body via the bloodstream, a process known as hematogenous spread. The second method is called implantation metastasis, where tumor cells directly implant in the common sites of osteosarcoma, leading to localized disease. The third type is lymphatic spread, where tumor cells spread to multiple parts of the body through the lymphatic system, causing new tumor growth. These three pathways are the most common routes of metastasis seen clinically in osteosarcoma, with hematogenous spread being the most frequent.

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Written by Na Hong Wei
Orthopedics
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What are the symptoms of osteosarcoma?

The main symptom of osteosarcoma is localized pain, primarily at the distal end of the femur, the proximal end of the tibia, and the proximal end of the humerus. This pain tends to worsen continuously, with nighttime pain often more severe than during the day, which is a significant characteristic of osteosarcoma. The second symptom is the presence of a local mass, which is often spindle-shaped and generally located near a joint. This mass often leads to limited joint mobility, and the skin over the mass typically has a high temperature. Sometimes, it may also be accompanied by visible swelling of superficial veins. The third symptom involves systemic cachexia, which includes unexplained weight loss, generalized weakness, and even an anemic condition. The fourth point pertains to osteolytic osteosarcoma, which often leads to bone destruction, reduced bone strength, and consequently, even minor external forces can cause fractures. These are called pathological fractures. Thus, the symptoms of osteosarcoma generally include these four points.

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Written by Na Hong Wei
Orthopedics
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Is there a cure for bone metastasis of osteosarcoma?

Is there any hope for osteosarcoma bone metastasis? If osteosarcoma develops bone metastasis, there is still hope for treatment. However, once metastasis occurs, the treatment costs, difficulty, and prognosis tend to be relatively unfavorable. Additionally, osteosarcoma itself invades and damages the bone. As the disease progresses, it stimulates osteogenesis which eventually leads to both bone formation and damage. Generally, the appearance of osteogenic changes often indicates a shift towards a better prognosis for the bone. Therefore, if osteosarcoma has metastasized, while treating the primary lesion of the tumor, it is also crucial to actively treat the metastatic sites. Thus, the difficulty of the treatment and the prognosis might not be very optimistic, but it certainly hasn't reached a point where the disease is untreatable. Therefore, once osteosarcoma metastasizes, it is recommended to visit the oncology department of a reputable hospital for systematic treatment by a doctor.