Can hot compresses relieve pain for osteosarcoma?

Written by Guan Jing Tao
Orthopedics
Updated on November 09, 2024
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Osteosarcoma has very limited pain relief effects through simple or pure hot compresses. As the lesion progresses, hot compresses can become completely ineffective or have very unclear effects. Clinical manifestations include pain and swelling, with local formation of lumps or tumor-like appearances. It can also affect the joint mobility around it, and even cause atrophy of limbs and muscles. In terms of treatment, it still relies on early surgical excision, but the prognosis is still not very optimistic.

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Osteosarcoma mainly metastasizes through

The main metastatic pathways of osteosarcoma are generally divided into three types. The first is hematogenous spread, which refers to the dispersal of tumor cells throughout the body via the bloodstream, typically settling in areas with slower blood flow which facilitates the deposition of these cells leading to local changes. The second is direct implantation, which involves tumor cells directly establishing themselves in the vicinity of the tumor's common sites, eventually leading to local metastasis. The third type is lymphatic spread, where tumor cells migrate through the lymphatic system, spreading along lymphatic vessels or pathways. Therefore, the main metastatic pathways of osteosarcoma are these three types. The primary sites of metastasis for osteosarcoma are mainly the lungs, but metastases can also occur in the brain or through other mechanisms.

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What is osteosarcoma?

Osteosarcoma is a type of malignant tumor that occurs in the bones, generally classified as stage IIb. Common sites for osteosarcoma include the distal part of the bone, the proximal tibia, and the proximal humerus. It most commonly affects adolescents. Clinically, it primarily presents as persistent pain, including nighttime pain. Swelling and limited joint function typically occur around the common sites. Additionally, there are general symptoms associated with cachexia, such as malnutrition, anemia, mild or high fever, or weight loss. Fourthly, it is very prone to causing pathological fractures. Many osteosarcoma patients seek medical attention due to these fractures. Thus, osteosarcoma is a serious malignancy in the bones with a generally poor prognosis. Diagnosis and treatment of osteosarcoma are crucial; upon confirmation, timely treatment is necessary. The primary treatment approach is a combination therapy centered around surgery, typically involving preoperative chemotherapy, followed by surgical treatment and postoperative chemotherapy. Currently, the five-year survival rate for osteosarcoma has significantly improved, reaching approximately 70% to over 80%.

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Orthopedic Surgery
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What is the basis for the diagnosis of osteosarcoma?

Let's briefly describe osteosarcoma, which is a malignant tumor of the bone, most commonly found in adolescents and young adults, typically occurring near the proximal end of the tibia, the distal end of the femur, or the proximal end of the humerus, mainly growing at the epiphyseal ends. In the early stages, patients show no symptoms, with the most common symptom being pain, usually discovered in the middle to late stages. This pain tends to be persistent and is most pronounced at night. Some patients may also have a local mass. Osteosarcomas are highly prone to early lung metastases. Additionally, the surface skin temperature may increase, veins may become distended, and there may be a presence of cachexia as the disease progresses, leading to severe thinness and weakness in the body. The primary diagnostic basis is radiographic examination, which might show unique signs such as Codman’s triangle under sun-ray exposure, indicative of osteosarcoma. If the radiographic signs are not typical, further differentiation can be done using CT scans or MRI. The most crucial matter is surgical biopsy for a definitive diagnosis, mainly based on the postoperative pathology. Intraoperative measures like cryosurgery can be performed. Upon discovery, limb amputation is generally recommended, although limb-sparing surgeries can be considered, involving techniques like resection followed by reimplantation or prosthetic implantation. Overall, the prognosis is typically poor, but with the rapid advancement in chemotherapy, the five-year survival rate can improve somewhat, generally around 50%.

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Postoperative recurrence symptoms of osteosarcoma

Symptoms of recurrent osteosarcoma after surgery are generally consistent with the symptoms before the initial surgery. The main symptoms include: Firstly, localized pain, which is persistent, progressive, and does not alleviate, including pain that worsens at night. Secondly, localized swelling, which usually occurs around the surgical site if limb-sparing surgery was performed, or at the stump if amputation was done. Thirdly, the appearance of systemic cachexia and symptoms of metastasis. Systemic cachexia typically includes weight loss, anemia, fatigue, and loss of appetite. For osteosarcoma, metastasis primarily targets the lungs, where numerous cancerous shadows can be detected. Thus, the main recurrent symptoms of osteosarcoma after surgery include pain, swelling, and cachexia.

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Symptoms of osteosarcoma

The common symptoms of osteosarcoma include, first, pain which is often persistent, typically occurring at the distal femur, proximal tibia, and proximal humerus. The characteristic of this pain is that it worsens at night, more severe than during the day. Second, there is local swelling usually near joints, particularly at the three aforementioned common sites. The skin over the swelling often becomes warm and may even show redness, and some patients may have dilated surface veins. The swelling can frequently cause dysfunction of nearby joints, or restricted function. Third, systemic symptoms primarily include a persistent wasting syndrome, known as cachexia. Fourth, osteosarcomas can weaken the bone's load-bearing capacity and strength following cortical bone involvement, eventually leading to pathological fractures. Therefore, the main symptoms of osteosarcoma are localized pain, local swellings, systemic manifestations of cachexia, or pathological fractures.