Adult Osteosarcoma

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By Chris Ryan and Dr. Kevin Buckman

Sarcoma is medical jargon for a tumor of the connective tissue which is malignant or cancerous. We might think our bones being ‘dead’ components of our body but it is actually the opposite. Bones are quite alive and the proof being that fractures wouldn’t heal if they weren’t.

There are several kinds of tissues in bones like osteoid, cartilaginous, and fibrous (or connective) tissue. All of these types of tissues can be affected by both benign or malignant tumors. Bone tumors are classified on the basis of the origin tissue.

Bone sarcoma are of four major types – chondrosarcoma, fibrosarcoma, osteosarcoma, and lastly Ewing’s sarcoma. All these tumors have both malignant and benign variants.

Malignant tumors arising in the skeletal system usually seem to affect people within certain age ranges. Osteosarcoma (also referred to as osteogenic sarcoma) for instance is seen primarily in teenagers whereas Ewing’s sarcoma tends to affect children between the ages of 5 to 10 as well as young adults in their 20s. Middle aged people in their 50s or 60s are usually susceptible to Chondrosarcoma as well as fibrosarcoma. The prognosis for those patients who are over 40 years and suffering from osteosarcoma is usually not a very good one.

Around 2,500 cases of connective joints and bone cancers are detected and treated in the United States every year. This accounts for barely 0.2 percent of total new cancers cases. The vast bulk of these patients suffer from osteosarcomas. Leaving aside multiple myeloma (or multiple bone cancers), the most common type without doubt of malignant bone tumor is osteosarcoma. The treatment processes used to treat these tumors in children have subsequently been used in the treatment of other rare bone cancers in adults.

Bone sarcomas are in a sense still a mystery as the reason for their occurrence is unknown. However, it can be said with some confidence that osteosarcoma development increases with exposure to radiation. Patients who have been exposed to high-levels of radiation therapy in the past for the treatment of conditions like tuberculosis of the joints or thyroid disease can develop Fibrosarcomas. The days, of course, due precautions are taken and any excessive use of radiation has been avoided to a large extent. Radiation exposure is carefully controlled to minimize any possibility of radiation-related cancer.

It has been found that rapid growth of bones is a key factor contributing to the expansion of this disease, as the most common occurrence sites usually are those areas of where the bone divides more rapidly (for instance areas which are nearest to the ‘physes’ or ‘growth plates’).

Medical evidence also suggests that the prevalence of the polyomavirus, called SV40, is linked to osteosarcoma, although there is no conclusive proof even as the debate on this issue rages on. Various epidemiological studies have linked the fluoridation of water supply to a rise in the cases of osteosarcoma. Evidence also suggests there may be a genetic tendency to people getting bone cancer.


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