The course of bone cancer, possible treatment methods and the likelihood of recovery

One of the oncological diseases that is difficult to treat and can lead to the death of the patient is bone cancer. The disorder is often diagnosed in women and men with genetic pathologies of the skeletal system. At different stages of the disease, a different clinical picture appears, which, if not treated in a timely manner, only gets worse and leads to greater bone destruction. Cancer can be in the shoulder joint, bone structures of the arms and legs. It is important to see a doctor as soon as possible at the first signs of cancer.

Signs and symptoms of the disease

Before treatment for bone cancer can begin, the disease must be accurately diagnosed. To do this, specialists pay attention to the symptoms and signs of the disease. Bone cancer manifests itself as follows:

• Pain is the most common symptom among patients with cancer of the skeletal system.
• A tumor appears near the affected area.
• The bones weaken, causing them to be more likely to fracture.
• Patients often experience increased fatigue and sudden weight loss.

If the disease has already affected other areas of the body or organs, then other manifestations occur. They will depend on the affected area. In fact, all symptoms of bone cancer develop gradually, following each other. In the first stages, painful sensations appear only with physical impact on the place under which the tumor is located. If the tumor is already palpable, then the disease has entered the second stage. Then the pain begins to increase, often manifesting itself in sudden outbreaks. At the third stage, it is already constantly present: aching, pulling or sharp - it depends on the type of disease and the person’s pain threshold. A characteristic sign of pain from cancerous bone lesions is that it “radiates” to nearby parts of the body. It gets worse at night, and analgesics are not able to completely relieve pain. Often, people suffering from bone cancer experience pain in the stomach and constant nausea. This is a symptom of hypercalcemia: calcium salts from the affected bone enter the blood and cause pain in the gastrointestinal tract. By the fourth stage, the patient begins to lose weight, and if the cancer has metastasized to the lungs, disturbances in the respiratory system begin.

Symptoms signaling a problem

The first manifestations of the malignant process are edema and swelling in the affected area.
Pelvic bone cancer and oncology of other localizations are accompanied by different clinical signs. The initial stage of the disease may not make itself felt for a long time, which is why examination and treatment of cancer is not carried out in a timely manner. As cancer progresses, bone pain of varying intensity appears. The initial signs of a malignant tumor in the area of ​​bone structures are swelling and swelling of the affected area. Other common symptoms of oncology are:

• redness and inflammatory reaction in damaged structures;
• the appearance of a pathological growth or lump on the bone;
• frequent fractures even with mild damage;
• high body temperature - more than 38 degrees;
• weight loss;
• increased sweating at night.

Types of bone cancer

Bone cancer is a serious change with metastatic manifestations, when the tumor not only affects bone tissue, but can literally grow into another organ. Advanced cases cause the appearance of growths in the skeletal system. However, the lethality of bone cancer depends specifically on the metastasis of the disease in the lungs, liver or other vital organs. The manifestation of bone cancer depends on its type:

• Leukemia. This is also considered a type of bone cancer, since the disease develops from blood-forming particles in the bone marrow.
• Sarcoma (true bone cancer). It is formed in bone tissue, but can also develop from fat, muscle tissue or from the circulatory system.

Depending on the location of the tumor, the following types of bone cancer are distinguished:

• Osteoblastoclastoma. It can be either benign or malignant. It affects the bone tissue of the extremities, mainly localized in the knee area. This disease is usually diagnosed in young and middle-aged people. As a rule, it does not have metastases, but under some circumstances a relapse may occur with the appearance of a tumor in the same place. As a rule, it is easy to treat.
• Hodrosarcoma. This type of bone cancer usually develops in mature people. The usual location is any site where either cartilage or periosteum is present. Most often it appears on the bones of the hip joint or shoulder girdle. In advanced cases, this tumor begins to metastasize to the lymph nodes and lungs.
• Fibrosarcoma. It is formed either in the bones of the limb or in the facial bones. At an advanced stage, the neoplasm cells begin to spread beyond the boundaries of the bones.
• Diffuse endothelioma. It can form in any organ, but most often develops in the bones of the limbs, hip joint, ribs or spine. Most often diagnosed in young people or children.
• Osteosarcoma. The most common type of bone cancer, which is localized in bone cells. Formed in the bone tissue of the femur or tibia, near the joints. Most often diagnosed in adolescents.
• Fibrous histiciotoma. It usually affects the soft tissues of the body, but can develop in the bones of the extremities.
• Chordoma. A rare type of cancer that is diagnosed in people over thirty years of age. The usual location is the upper or lower spine.

Signs of bone cancer may include pain localized in the joints or ligaments, and fatigue. If the nature of the pain is unclear, it is better to immediately undergo an examination and, if necessary, donate blood for tumor markers. A disease detected at an early stage is easier to treat.

Malignant and benign form of pathology

Whatever the symptoms of bone cancer, all forms of the disease are divided into two categories: benign and malignant bone tumors. We can speak of a benign nature if the formed tumor is surrounded by healthy tissue. This means that pathological tissue growth will occur rather slowly.

Malignant cancer manifests itself as growths on the bones of various shapes and locations; the boundaries of the tumor are uneven and prone to rapid growth. The first signs of bone cancer in the form of visual deformation of bone surfaces become noticeable quite early. This is due to the fact that cancer tissue grows very quickly.

It has been noted that leg bone cancer occurs at a younger age. In elderly people, pathological growths of the skull bones are often found. The cancer process most often affects men. People over 40 with many years of experience as smokers are at particular risk.

Stages of cancer

The prognosis for treatment of this cancer depends on its stage. Each of them has its own characteristics.

• 1st stage. At this stage, the tumor has a lower degree of malignancy, and does not spread to nearby organs. The neoplasm is no more than 8 cm in diameter.
• 2nd stage. At this stage of cancer, the tumor still does not extend beyond the bone, but it is the most malignant.
• 3rd stage. The tumor forms in several areas of the bone. Cancer cells are dedifferentiated.
• 4th stage. At this stage of cancer development, the tumor begins to spread beyond the boundaries of the skeletal system. Most often the lungs and regional lymph nodes are affected.

The main danger and insidiousness of cancer is that this disease may not manifest itself until the 4th stage of bone cancer. Some people don't know they have it until the most obvious symptoms of bone cancer appear and the pain increases to the point where it becomes impossible to ignore. Therefore, doctors recommend undergoing a full examination once a year, which will identify the growth of the tumor disease even before it begins to manifest itself. In this case, bone cancer treatment will be most effective.

Characteristics of the oncological process in bone structures

Bone cancer is difficult to diagnose; patients themselves notice the symptoms and manifestations of the disease in the later stages. There are primary and secondary forms of the disease. If there is a cancer focus in the body, there is always a danger that sooner or later cancer cells will begin to travel throughout the body by lymphogenous and hematogenous routes.

Malignant elements can settle in the bones of the skeleton in any area. In this case we are talking about a secondary form of the oncological process. However, there will be no symptoms of bone cancer for a long time. If the primary focus of pathology is detected, all efforts will be aimed at eliminating it, and bone oncology will be ignored.

Primary bone cancer also causes visible symptoms at quite advanced stages of development. In this case, neoplasms are formed directly from the cells of the bones themselves. The basis for the oncological process can be anything: bone structures, cartilage, periosteum.

Atypical cells begin to grow rapidly, divide uncontrollably, and each new fraction of malignant elements has an abnormal structure and is unable to perform any functions. Over time, a growth forms. The first obvious symptoms of bone and joint cancer appear.

Diagnosis of the disease

Bone cancer has very specific symptoms that may prompt you to see a doctor. And during the initial examination, the therapist may suspect a malignant neoplasm. However, in addition to cancer, the same symptoms can be caused by bone infections that do not require long-term treatment with chemotherapy. Therefore, to diagnose the disease, it is necessary to give the patient a biopsy - take a sample of bone tissue. In addition to the biopsy, the patient must donate blood for window markers, undergo a CT scan, have an MRI and undergo other tests prescribed by the doctor.

Diagnostics

The signs of bone cancer are similar to the symptoms of many diseases; the most accurate diagnosis is clinical tests and functional diagnostics:

• blood test for tumor markers - it will reveal an increase in thyroid-stimulating hormones, alkaline phosphatase, calcium and sialic acids in the body and a decrease in plasma protein concentration;
• X-ray - visual analysis of the image can reveal the affected areas;
• CT (computed tomography) - determines the stage of the disease and the presence of metastasis; a contrast agent is used to improve diagnosis.

To clarify the diagnosis, MRI (magnetic resonance imaging) using contrast , which shows the presence or absence of accumulation of cancer cells in the affected area. PET (positron emission tomography) determines the nature of the tumor. Today this is the most modern method of functional diagnostics.

A biopsy gives a 100% accurate result of diagnosing the nature of the tumor, whether it is primary, secondary and its type. For bone tumors, three types of biopsy are used:

1. Fine needle aspiration - a syringe is used to remove fluid from the tumor area. In difficult cases, the process is combined with CT.
2. Thick-needle – more effective for primary tumors.
3. Surgical – performed by making an incision and taking a sample; it can be combined with tumor removal, therefore it is performed under general anesthesia.

Surgical treatment of bone cancer

Surgical treatment is the main type of therapy for osteosarcoma. The main goal of the operation is to completely remove the entire tumor. Removal of the affected bone fragment should be accompanied by the removal of a small amount of healthy tissue surrounding the primary lesion. This is called “wide excision”, and it is done to prevent the resumption of the tumor process - any unremoved malignant cells can cause a relapse - the recurrence of a tumor with the same or displaced localization. It is very important to take a biopsy during surgery. Unfortunately, treatment of some tumors on the extremities—hands, fingers, and others—may require amputation of the entire affected limb, as wide excision becomes impracticable. To avoid amputation, you can resort to prosthetics - replacing the removed bone fragment with artificial material. There are many types of plastics and alloys that are used for this purpose. Naturally, such an operation is much more complex and expensive, and not every clinic has sufficient material resources to perform it. Another option for prosthetics is to replace the removed bone fragment with the patient’s own bone tissue. This does not apply to the treatment of tumors on the spine and skull. To treat such lesions, curettage is performed. This operation leaves a cavity at the site of the tumor, but allows you to preserve the vertebra or the integrity of the cranial plates. Then, the resulting cavity must be treated so that there are no malignant cells left in it that are capable of growth. Most often, this is done using cryosurgery - treating a piece of tissue at extremely low temperatures, which are achieved by exposure to nitrogen. After treatment, the cavity can be filled with a special cementitious composition.

Treatment

The treatment system includes both traditional methods and the latest developments of scientists :

1. NIERT - the technique is used for metastasis to reduce the pain effect and slow down the growth of cancer cells.
2. “Rapid Arc” is a type of radiation therapy, when the tumor is intensively exposed to a directed beam, treating it at different angles.
3. Cyberknife is a high-precision device that removes tumors with minimal impact on the body.
4. Brachytherapy – an implant with a radiation source is placed inside the tumor, which gradually kills cancer cells.

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Chemotherapy

Standard chemotherapy involves the introduction of certain drugs into the body that destroy malignant tumors. Success is more noticeable in treatment at the initial stages of the disease. In addition, the metastatic process is prevented, the base for the development of new cells is destroyed. Chemotherapy is carried out under strict medical supervision; the drugs completely kill the immune system and have many negative side effects on the body (hair loss, nausea, mouth ulcers, slow growth in a child).

Surgery

Various operations to remove malignant tumors are the most common measure in the treatment of bone oncology. Often the intervention is prescribed simultaneously with taking a biopsy. When removing a tumor, it is important not to leave cancer cells in the body, so a wide excision is used, when nearby healthy tissue is also removed and their edges are analyzed for the presence of cancer cells. This type of operation is used for cancer of the hip area and extremities, if the affected area is small.

There are cases when wide excision cannot guarantee the desired result. Extensive lesions of the limbs and jaw bones require amputation. In the case of jaw bones, tissue transplantation or the use of a bone graft is performed. For tumors of the bones of the skull and spine, operations are performed to scrape out the affected areas from the bone, while preserving the bone.

Radiation therapy

Treatment with ionizing radiation, otherwise known as radiation therapy, is the exposure of cancer cells to radiation rays in doses that are safe for humans. However, the disease is resistant to radiation therapy and requires high doses of radiation, which negatively affects the body, especially the brain. It is often used for Ewing's sarcoma; radiation is used as an addition to chemotherapy and for prophylactic purposes in the postoperative period. The use of modern radiation technologies is effective: remote therapy, exposure of cancer cells to protons.

Radiation therapy

Bone tissue is quite weakly susceptible to ionizing radiation, so it is used quite rarely. The main diagnosis for which it is used is Ewing's sarcoma. The purpose of the rays is to affect inoperable tumors and treat areas after operations. Intensity modulated radiation therapy (IMRT) shows higher effectiveness. The difference between such beams and traditional ones is the modeling of multidirectional beams according to the shape of the tumor, which allows targeted treatment of the malignant focus.

Risk factors, cancer prevention

Preventing cancer does not guarantee 100% protection from the threat, but it definitely reduces the risk. Measures recommended by experts include a healthy lifestyle - proper nutrition and physical activity, which stimulate the immune system. It is important to avoid bad habits such as smoking, drugs and alcohol abuse. In some cases, the risk of developing bone cancer is genetic; a hereditary factor is recognized in primary forms of bone cancer. If there is a close relative with this disease, children and young people in the family should undergo preventive testing, as this form is most noticeable in the early age group.

Factors for unblocking malignant transformations of cells are various radiations. They say that it is possible that the treatment of a cancerous form by radiation therapy is the initiating oncological process in the field of radiation. Experts also recommend limiting and carefully handling other sources of non-hazardous waves, such as cell phones, microwave ovens and other modern appliances at home and at work.

In addition, there is a connection between the occurrence of tumors in the area where bone fractures occurred.

Preventing Fractures

How can you prevent bone fractures to avoid exposure to one of the potential cancer risk factors? Such injuries can occur anywhere: on the playground, on bicycles, on icy roads, in accidents. It makes sense to advise avoiding risky situations - this also means taking care of maintaining a healthy skeletal system.

Cyberknife

This is also radiation therapy, but is distinguished by the highest precision and the use of stereotactic radiosurgery. The device that is used for such operations makes it possible to carry out the most complex operations without blood or pain. Brachytherapy also refers to radiation therapy. Its peculiarity is that the radiation source is not located outside the patient. The radiating element is introduced into the body and, being in close proximity to the lesion, acts on the tumor constantly, with a calculated intensity.

Symptoms and manifestations of bone cancer

Let's list the main signs of bone cancer.

1. Pain. Pain in the affected bone is the most common complaint of patients with bone cancer. At first, the pain is not constantly present. Typically, the condition worsens at night or while putting stress on the bone (walking or running). As the tumor grows, the pain becomes constant and lameness may develop.
2. Swelling of the affected area.
3. Fractures. Cancer weakens the bone in which it develops. Patients with bone cancer describe the sensation as a sharp, severe pain in a limb that had been painful for several months.
4. Other symptoms. Cancer often causes weight loss and increased fatigue. If the tumor has spread to other parts of the body, such as the lungs, then various respiratory disorders are possible.

How is bone cancer with metastases treated?

The specialist will recommend how to treat oncology in each specific case, based on the stage, symptoms and general condition of the patient. If bone cancer worsens by metastases, treatment becomes more complicated. As a rule, the treatment regimen does not change radically, but is supplemented with therapeutic measures aimed at eliminating metastatic foci. If the metastases are extensive and treatment does not bring results, it makes sense to start a course of palliative care. Sometimes this is the most humane and correct decision.

Preventive measures

Since the true causes of bone cancer have not yet been established, there is no specific prevention. A person is advised to move more, be in the fresh air, but avoid physical fatigue. You should be careful to avoid bone fractures, which can later lead to cancer. Cancer is less likely to develop in people who do not abuse bad habits. For preventive purposes, it is recommended to include foods that strengthen bone structures in your daily diet.

Postoperative period

Unfortunately, even the most effective and long-term treatment cannot provide a 100% guarantee that the disease will not relapse. The further prognosis of bone cancer, in particular its possible recurrence, directly depends on many factors. Therefore, after chemotherapy procedures and surgery, it is necessary to monitor the patient’s condition. It is rehabilitation that has a huge impact on the restoration of all functions of the body, including the psycho-emotional state of the patient. An individual rehabilitation process is developed for each person: it is based on the results of the treatment performed and all possible side effects are taken into account. With timely treatment of bone cancer and proper rehabilitation measures, the patient's chances of a long life increase significantly.

Causes leading to bone cancer

The main unfavorable factor that causes bone cancer is radiation (over 60 gray). The oncological process in bone structures can even occur at the time of intense radiation during the treatment of other forms of tumors. It is worth noting that a regular X-ray machine does not pose such a danger.

When studying what bone cancer is and what provokes it, it is worth highlighting the following unfavorable circumstances and conditions:

1. Previous trauma (bone cancer is often found where there once was a fracture or other type of injury);
2. Genetic predisposition (bone cancer with all symptoms and manifestations is more often diagnosed in people with Li-Fraumeni syndrome);
3. Pathologies in which the process of restoration of damaged bones or cartilage is disrupted (Paget's disease);
4. Previously undergone bone marrow transplant operations (any period of limitation);
5. DNA mutations of unknown etiology;
6. Long-term chronic diseases of the musculoskeletal system.

Prevention

Even the most advanced and modern preventive measures cannot provide complete protection against cancer. Unfortunately, this process can begin in anyone, even an absolutely healthy person. However, such measures still reduce the risk of developing cancer. Prevention is standard here; doctors recommend a number of classic solutions:

• Quitting alcohol, tobacco and drugs.
• Regular moderate physical activity.
• Eat a healthy diet, excluding excessively fatty, salty or sweet foods.
• Taking vitamin and mineral complexes to strengthen the body's defenses as recommended by a doctor.

All these methods will help minimize the risk of developing cancer even in old age.

Rehabilitation

Unfortunately, modern medicine does not have a clear answer to the question of what is the exact cause of the disease. What triggers it? Of course, a healthy diet and eating habits, giving up bad habits and regular exercise can be considered as the prevention of many diseases, including oncology.

Once it appears, the disease can develop again. Therefore, after successful treatment, it is also important how the patient recovers and what rehabilitation measures will be carried out.

In principle, rehabilitation affects the normalization and stabilization of blood parameters, physical strengthening and restoration of motor skills, normalization of the psycho-emotional state, etc. For each patient, it is necessary to develop an individual recovery plan depending on the effect of therapy and its side effects.

What is the effectiveness of treatment

Various types of bone cancer are treatable. The main condition for successful treatment is timely diagnosis and initiation of therapy. In general, many methods have been developed for the treatment of bone cancer, which allow us to count on a favorable outcome. If we talk about numbers, statistics show a good five-year survival rate - approximately 70%. This is statistics of all diagnoses associated with cancerous bone lesions. If we talk about the most common diagnosis - chondrosarcoma, then the percentage is higher, approximately 80% survival rate. This is a very good result, which allows patients to count on a favorable outcome.

Side effects of treatment

Chemotherapy and radiation therapy aim to kill cancer cells, but these treatments also kill healthy cells. Patients undergoing such therapeutic procedures complain of multiple side effects; They don't all have to happen at the same time, but that's a fact. There are various medications and methods to reduce their symptoms, but problems are still possible, for example:

• Loss of appetite;
• Nausea and vomiting;
• Weakness and constant fatigue;
• Inflammation of the mucous membranes - in the mouth, throat;
• Hair loss, complete hair loss;
• Weight gain;
• Premature menopause;
• Reduced resistance to infections.

Kinds

The variety depends on the location, aggressiveness and, ultimately, the type of treatment.

Myelomas, lymphomas

It occurs in the bone marrow, but initially grows from the lymph nodes and later spreads to the bone. In this case, a violation of the bone structure occurs, osteoporosis appears, and it becomes brittle.

Ewing's sarcoma

A very fast and aggressive cancer that affects the long tubular bones. The defeat goes to the middle part. Appears slightly less frequently in the ribs, shoulder blades, pelvic bones, etc. The age of the disease is young, from 11 to 16 years. Metastasis occurs in the early stages in almost 95% of cancer patients.

Giant cell formation

Or in other words, osteoblastoclastoma, which affects the tips of the limbs or bones. The course is benign at the beginning, but if the tumor is not removed, it can metastasize. Often, after surgical removal, a new growth forms in the same place.

Osteosarcoma

Metastases in Osteogenic sarcoma appear very early, and it develops from any bone elements. Localized in the lower extremities. In children, these are areas of active growth in the elbows, knees and hand joints. It can occur in the pelvis, shoulders and entire shoulder region.

Men get sick more often than women. Often occurs in young people from 10 to 28 years old. Statistics show that cancers themselves occur in areas of rapid growth and in people who have grown very quickly in a short period of time.

Fibrous histiocytoma

It grows mainly in the metaphyses of long bones and is localized in the retroperitoneal space. It is also called cancer of the knee joint because it forms there. Grows rapidly and metastasizes to lung tissue.

Chordoma

It occurs at a very early age, in children, and grows from the remains of embryonic tissue in the head and sacrum. According to the structure of the cells, the neoplasm itself is benign, but due to difficult localization, complications arise as a result of growth.

Fibrosarcoma

They often form on women's legs. First, the formation occurs in the soft tissues of muscles, tendons, etc. But then the cancer grows into the bone and attacks it.

Chondrosarcoma

Often the damage occurs to very small bones in the trachea and larynx. Penetration occurs mainly in flat bone tissues, rather than tubular cartilaginous tissues. Often appears in older people from 40 to 60 years old. It can proceed either quickly, aggressively or slowly - it all depends on the differentiation of cancer cells.

Osteoma

Grows from bone and connective tissue. A benign tumor with no known cause or symptoms. True, pain may appear later if the formation itself puts pressure on a nerve or muscle. It occurs more often in adolescents and children aged 10 to 15 years. Grows from the outer surface of the bone in the location of the skull.

Osteoid osteoma

Affects the femur, tibia, and humerus. It occurs quite rarely in only 11% of cases. The tumor itself has a clear border and is small in size, up to 1 cm. Once the tumor is removed, it almost never comes back.

Classification

As a rule, when considering bone cancer as an independent nosological entity, experts mean that the tumor formed in the bone tissue independently - as a primary focus.

More often, cancer cells are transferred to the bone area through the blood or lymph from other malignant foci. For example, cancer of the leg bone or pelvis can metastasize to the lungs, stomach, or liver. This is a secondary form of tumors.

Depending on the structure and location, malignant bone tumors are:

• An aggressive tumor that mainly affects long tubular structures - Ewing's sarcoma. Much less often, a tumor is diagnosed in the area of ​​the ribs, collarbones, scapula, and pelvic elements. Most patients with this tumor are teenagers aged 12 to 15 years. In elderly people, Ewing bone cancer is detected extremely rarely. Differs in early metastasis.
• Osteosarcoma is a tumor that usually affects the osteocytes of the extremities. For example, the shoulder girdle or pelvic bones. In children, cancer mainly forms in areas with intensive bone growth, as well as in the articular tissues of the elbow or knee. Young men suffer from osteosarcomas more often.
• Chondroma is a tumor that develops from the remains of embryonic cells. The main location of the tumor is the sacrum, as well as the bones of the base of the skull. According to the histological structure, the cancer focus is often a benign neoplasm. However, due to the difficulty of diagnosis and the frequent occurrence of complications, the tumor is still usually classified as a malignant process.
• Fibrosarcoma - forms in deep-lying soft tissues of the skeleton, for example, tendons. As the tumor progresses, it invades the bones. Women are more susceptible to this type of tumor.

Only a highly qualified specialist can finally recognize and establish the true diagnosis of bone cancer. Confirmation of the occurrence of cancer will be laboratory and instrumental studies.

First signs

Symptoms and first manifestations stand out as ordinary pain in the bones and muscles of oncology, which are not localized in any way. It is worth paying attention to the fact that subsequently the pain only becomes stronger.

• Periodic pain at the site of cancer. It can radiate into muscles and tendons. At first it is periodic, and later it develops into a systematic and continuous one. The pain is worse at night when completely relaxed or during daytime sleep. In the last stages, the pain is stronger and painkillers do not help.
• Pain in the head.
• Joint cancer can quickly lead to stiffness due to the rapid growth of the tumor. A tumor in the knee causes severe pain with any movement.
• Nausea and possible vomiting.
• Fatigue and severe fatigue.
• Intoxication in the body.
• Constant change of mood.
• Growth on any part of the body. Feels warmer to the touch due to inflammation.
• Flexion and extension of the injured limb becomes difficult. And the larger the stage, the more difficult it is.
• At the site of pathology, bones become more fragile and fractures appear.
• Anemia, increased number of leukocytes in the blood.
• Cancer of the leg bone greatly affects any movement as the tumor develops. Subsequently, the patient will not be able to move normally.

Legs

• Pain throughout the leg without an exact location.
• It is difficult to move, squat and perform physical exercises. loads.
• Also, leg cancer is accompanied by lameness and difficulty moving due to damage to the ankle and knee joints. Over time it gets worse and worse.
• Redness, swelling around the tumor.

Hands

• Pain similar to what athletes feel after exercise.
• They become stronger when stress is applied to the damaged area.
• The shoulder, elbow or wrist joints move less well.

Pelvic area

• Pelvic bone cancer is accompanied by severe pain in the spine, groin area and tailbone area.
• Difficulty moving, squatting, bending and any involvement of the hip bone.
• Redness next to the tumor.

NOTE! If there are several affected organs, the symptoms will be more pronounced.

Predisposing factors

By studying the stories of patients faced with this type of cancer, doctors were able to identify a number of pathological factors that provoke the development of this type of cancer. Among them are:

1. Skeletal injuries. According to statistics, more than 40% of oncological formations in bone tissue appear in the area of ​​​​injuries and bone fractures. Moreover, practice shows that the focus of an oncological tumor can arise both immediately after injury to bone tissue, and ten years after this incident.

2. Exposure to ionizing radiation. This type of cancer is encountered by persons who, during treatment or in their professional activities, have been exposed once or periodically to ionizing radiation in high doses.

3. Genetic pathologies. According to doctors, people with Rothmund-Thomson syndrome, Li-Fraumeni syndrome and retinoblastomas are most likely to experience bone tissue oncology.

4. Paget's disease. With this disease, the process of bone tissue restoration is disrupted, which leads to a variety of bone abnormalities, including the appearance of tumors in them. In general, any chronic pathology of bone tissue increases the risk of cancer by 4 times.

5. Bone marrow transplant. It has been noted that in 20% of cases, this type of cancer appears in people who have undergone bone marrow surgery.

6. DNA mutation. Scientists say that in some cases, the cause of bone tissue cell degeneration may be DNA mutations that destroy the mechanism that prevents this process.

7. Hereditary predisposition. It is also known that some DNA mutations can be acquired, while others are inherited. The mutated RB1 gene can be passed on to such a patient from parents.

All of the above applies to primary cancer, i.e. a tumor appearing directly in the bone. As for secondary bone cancer, it is formed as a result of the penetration of metastases from tumors that appeared in the mammary glands, in the lungs, in the prostate, and many other organs.

Stages of the disease

The stages of a malignant disease are determined depending on several factors, including the size of the tumor, the rate of its growth and development, the presence of metastases in other organs and tissues, and the degree of damage to local lymph nodes. It is customary to distinguish 4 stages of oncological pathologies of bone tissue:

• Stage 1 – the neoplasm cells are well differentiated, the tumor itself does not exceed 8 cm in size, does not extend beyond the bone, the pathology is single or there are several small lesions.
• Stage 2 – the tumor has a higher degree of malignancy, the cells become undifferentiated, but it does not grow into the surrounding tissues, remaining within the bone structure.
• Stage 3 – the presence of several lesions formed by undifferentiated cells.
• Stage 4 – the tumor extends beyond the bone tissue, metastases form in local lymph nodes, other tissues and organs.

Osteoid osteoma

One of the varieties of such a disease as osteoma of the femur or other long tubular bones is osteoid osteoma. It most often develops in young people 20-30 years of age of both sexes. This is a rather unusual neoplasm of the skeletal system with its own histology. It is localized in the diaphysis of tubular bones, in flat bones and has a characteristic course. In the initial stage of tumor development, the patient experiences quite strong painful sensations, reminiscent of muscle pain.

Over time, this symptom becomes more localized and can be relieved by taking analgesic medications. To a large extent, pain with osteoid osteoma intensifies at night. If the tumor is located in the bones of one of the lower extremities, then lameness appears due to the patient’s inability to strain the leg. If this type of bone tumor forms on the bones of the spine, the patient develops scoliosis due to the pain of the formation and the desire to relieve pain by changing the position of the body.

Such a neoplasm can be located on the surface of the bone - in the bone cortical layer or somewhat deeper - medullary, subperiosteal or intracapsular. Its structure has a concentric pattern:

• The nidus (tumor nest) is equipped with a network of dilated blood vessels, osteoblasts, as well as osteoid substance and the so-called bone beams, which are immature bone tissue. Also in the tumor, a central zone of mineralization can be observed on an x-ray;
• fibrovascular ring;
• zone of reactive sclerosis.

The central part of the tumor, the nidus, produces prostaglandins that cause pain. In order to completely get rid of such bone formation, it is necessary to perform an operation to remove the lesion. It is also necessary to remove a thin layer of sclerotic bone adjacent to the tumor. Such a high-quality intervention leads to complete recovery. But if the tumor is partially removed, this will cause relapse of osteoid osteoma. There are no cases of degeneration of this type of tumor into a malignant formation.

Types of tumors

Bone cancer is usually differentiated by the location of the malignant neoplasm. Each type has its own developmental characteristics, and therefore its own approaches to treatment.

1. Ewing's sarcoma. This lesion can occur in absolutely any bones of the skeleton, incl. in the clavicles, shoulder blades and pelvic bones, but most often in the long bones. This type of cancer is considered very aggressive, since it grows rapidly and the tumor quickly metastasizes to surrounding organs and tissues. Often teenagers and young adults experience this disease.

2. Osteosarcoma. This is the most common type of bone cancer and is most often found in the pelvis and extremities. What is typical is that the tumor actively “attacks” the bone cells, and metastasizes only at the very end, when the entire bone is affected.

3. Chondrosarcoma. This type of cancer appears in cartilage, after which it begins to directly affect bone tissue. Most often, the disease affects flat bones of the skeleton and is practically not found in tubular bones.

Doctors note that such a disease can develop in two ways. The first is favorable, because the tumor develops slowly and actually does not metastasize. With the second development path, metastases appear already at the first stage of the tumor. A characteristic feature of this cancer is that it appears in people aged 40–60 years.

4. Fibrosarcoma. This malignant formation is detected quite often. Its peculiarity is that cancer cells originate in soft tissues, i.e. in tendons or connective tissue, and only then transfer to bone tissue. Most often, fibrosarcomas affect the bones of the legs, and the fair sex encounters this disease much more often.

5. Chondroma. This growth appears quite rarely and belongs to cartilaginous tumors. Scientists believe that chondroma begins its development from embryonic tissue. Most often it is found in the sacrum or at the base of the skull.

6. Fibrous histocytoma. People suffering from Paget's disease (pathological reorganization of bone tissue) are most often exposed to tumor formation. Very often, such oncology occurs as a result of bone fractures, and it has an aggressive course and quickly metastasizes, affecting mainly lung tissue.

7. Giant cell tumor. This growth also has another name – osteoblastoclastoma. It mainly affects adjacent tissues and the terminal parts of bones. The tumor rarely metastasizes, but after its removal there is a high probability of relapse.

8. Lymphomas and myelomas of bones. Lymphomas are tumors that initially arise in the lymph nodes and then spread to the bones, and the term myeloma refers to the rapid division of bone marrow cells. As a result of such processes, areas of osteoporosis appear in bone structures, which leads to their fractures.

Treatment methods

The treatment method for patients diagnosed with cancer of any of the skeletal bones is selected individually in each case. The location of the neoplasm, its stage, the person’s age and the presence of other diseases are taken into account.

The main treatment method is surgery. Nowadays, it is rare to resort to amputation of limbs if the cancer affects the bones of the arms or legs. Usually the growth itself and part of the bone are removed, and later this place is reconstructed using prostheses made of plastic, metal and other materials.

Surgery may be combined with chemotherapy or radiation therapy. These methods are prescribed both before and after surgery to destroy any remaining cancer cells. In the final, non-operable stages, only chemotherapy can be used, the purpose of which in these cases is to prolong the patient’s life.

Types of malignant bone tumors

As noted above, bone tumors are called sarcomas. The source of their growth is both bone tissue itself and cartilage, without which normal functioning of bones, their growth, regeneration and connection into movable joints is impossible. Long tubular bones (humerus, femur, tibia) are more susceptible to the tumor process than ribs, spine or pelvis.

Most malignant bone tumors are prone to rapid growth and early metastasis, and their appearance often comes as a sudden and unpleasant surprise, because there were no signs of trouble. Patients include mainly children, adolescents and young people under 30 years of age; men are affected somewhat more often than women.

Depending on the morphological and clinical features, there are:

types of bone tumors and their distribution by age

1. Bone-forming tumors (benign osteoma, malignant osteosarcoma, osteoblastoma).
2. Cartilaginous (chondroma and chondrosarcoma).
3. Bone marrow tumors (Ewing's sarcoma, myeloma).
4. Giant cell tumor.

In addition to the listed varieties, bone tumors can be of vascular origin (hemangiomas, hemangiosarcomas), and there are also fibrosarcomas, liposarcomas, neuromas (from connective, adipose, nervous tissue).

Establishing the source of growth and histological characteristics of a bone tumor makes it possible to predict its clinical course and response to various types of treatment, therefore the choice of a specific method of therapy, radiation dose or name of a chemotherapy drug is possible only after a thorough morphological diagnosis.

Osteosarcoma (osteogenic sarcoma)

Among all bone tumors, osteogenic sarcoma (osteosarcoma) is the most common , in which connective tissue transforms into tumorous bone. It is possible to transform into a tumor through the cartilage stage, as would occur during normal bone growth.

Men develop osteosarcoma 2 times more often than women, and the maximum incidence occurs in the second decade of life, after adolescence, which was accompanied by intense lengthening of bones. In young men under 20 years of age, the most vulnerable place is the metaphysis of long tubular bones - a zone located between the diaphysis (middle part) and the peripheral part of the bone, covered with cartilage and facing the joint, which ensures the growth of bones in length.

In older people, osteogenic sarcoma can develop as a result of long-standing chronic osteomyelitis, as a complication of Paget's disease.

The favorite localization of osteogenic sarcoma is the bones of the lower extremities, which are affected several times more often than the upper extremities. Tumor growth in the femur is observed in approximately half of all cases of osteosarcoma; neoplasia is located near the knee joint, but the patella is involved extremely rarely. The second place in frequency is occupied by damage to the tibia, also from the side of the knee joint. In children, damage to the skull bones is possible, which is considered a rather rare occurrence in adults.

Osteosarcoma is extremely aggressive, grows quickly, damages soft tissues, metastasizes quite early mainly through blood vessels (hematogenous route), affecting the lungs, liver, brain and other internal organs.

Video: Osteosarcoma is the most common bone tumor

chondrosarcoma

Chondrosarcoma

The second most common tumor after osteogenic sarcoma is chondrosarcoma. This tumor is characterized by the formation of pathologically altered cartilage tissue, but osteogenesis (bone formation) is completely absent. The disease progresses slowly, metastases appear quite late, and patients are predominantly elderly. Damage to the pelvic bones and limbs is considered typical, but the tumor does not bypass the ribs, skull, and even the cartilages of the larynx or trachea.

Chondrosarcoma that develops on unchanged bones is called primary, and a tumor process that occurs after traumatic injuries, against the background of the presence of benign changes or neoplasms, is called secondary. Secondary chondrosarcomas are diagnosed more often in young people, and their prognosis is more favorable.

Ewing's sarcoma

Ewing's sarcoma. The most frequently affected areas are highlighted in red.

Ewing's sarcoma is the third most common. The disease mainly affects children, adolescents and young people under 30 years of age. The tumor affects the long tubular bones of the arms and legs, the pelvic area (especially the ilium), quickly increases in volume, invades the surrounding tissues, and metastasizes quite early to the internal organs (lungs, liver, brain) and lymph nodes.

Unlike osteosarcoma, which selects the metaphyses of bones for its growth, Ewing's sarcoma is more often found in the diaphysis (middle part), as well as flat bones (scapulae, ilium) and vertebrae. Filling the bone marrow canal, it quickly extends beyond the initial localization to the periphery.

Giant cell tumor of bone

Giant cell tumor of bone is malignant in approximately 10% of cases and is detected in young people in the bones of the arms and legs, and in the area of ​​the knee joint. Metastasis with this type of tumor is rare, but recurrence after treatment is common. There may be several such relapses, and each subsequent one is accompanied by damage to an increasingly larger volume of tissue.

histology of giant cell tumor

Chordoma

chordoma

Chordoma is a fairly rare tumor that grows from the remnants of embryonic cartilaginous tissue (notochord) . It is found in the bones of the base of the skull and spine. It is not prone to metastasize, but relapses after non-radical removal are frequent. With a relatively benign course, chordoma is dangerous due to the possibility of damage to vital nerve centers and blood vessels, being localized in the area of ​​the base of the brain. In addition, its location often complicates the use of surgical or radiation treatment, and therefore the consequences can be very dangerous.

fibrosarcoma

Fibrosarcoma, fibrous histiocytoma

Some soft tissue tumors can grow into the bone, for example, fibrosarcoma or malignant fibrous histiocytoma (more about combined tumors in the main material on sarcomas). Starting their growth in muscle, fatty or connective tissue, ligaments or tendons, these neoplasias invade the bones of the lower or upper extremities, and sometimes the jaws. Among the patients, elderly people predominate, in contrast to primary bone tumors.

Tumors of hematopoietic and lymphoid tissue, such as leukemia, myeloma, lymphoma can also be located within the bones. Since they come from elements of the bone marrow, which is not bone tissue, they are classified as hemoblastoses (tumors of the blood system), although bone damage often accompanies these diseases.

Cancer in the bones - metastases

Metastases of epithelial neoplasms (cancers) of internal organs can often be found in the bones. These tumors are secondary, appearing there when cancer cells are spread by the bloodstream. Bone metastases in prostate cancer are detected in advanced forms of the disease; the target for them is often the bones of the pelvis and lumbosacral spine.

metastatic bone disease

Metastasis of kidney cancer to the bone is diagnosed in approximately 40% of patients; this is the most common cause of severe pain. The most susceptible to metastatic damage are the pelvic bones, spine, ribs, hip and shoulder. Cells of some types of kidney cancer can cause destruction of bone tissue in the area where they are located, so patients are prone to frequent fractures. Growing in the vertebrae, metastatic tumor nodes can compress the roots of the spinal cord, leading to loss of sensitivity and motor function of the limbs, disruption of the pelvic organs (urination, defecation).

Lung cancer is often accompanied by metastasis to the bones - the spine, ribs, shoulder and femur, etc. The danger of metastases is that at first they can be asymptomatic, but at some point the destruction of bone tissue leads to a fracture, which is especially dangerous in case of damage vertebrae A characteristic sign of bone damage in lung carcinoma can be considered an increase in the level of calcium in the blood due to the destruction of bone tissue.

For an oncologist, it is important to determine the stage of an oncological disease, taking into account the size of the lesion, the spread of the tumor beyond the primary localization, the degree of damage to surrounding tissues, and the presence of metastases. The histological type is determined after taking a tumor fragment for morphological examination. The initial stages of the tumor are characterized by limited growth of the tumor, absence of metastasis and general symptoms of the tumor. The first three stages of the disease correspond to tumors without metastasis, and the degree of malignancy (differentiation) can be different. Stage 3 is characterized by the appearance of several foci of tumor growth in one bone, and at stage 4, patients have sarcoma metastases to internal organs or lymph nodes, which reflects the advanced stage of the process.

Video: principles of cancer metastasis (including to bones)

Symptoms of cancer in the arms

The occurrence of a malignant tumor in the bones of the hands occurs much less frequently than in the lower extremities. The explanation is the fact that the load on these areas is somewhat less, and therefore the blood flow in them is worse. However, hand bone cancer may develop more frequently in children and adolescents. Treatment should be carried out in specialized clinics.

The difficulty of diagnosing this form of tumor is due to the fact that the symptoms of bone cancer are often disguised as other pathologies - arthritis, arthrosis, cervical osteochondrosis. A person feels some pain in one part or another of the arm, but associates it with physical activity and overwork. Self-medication of the tumor - rubbing ointments, taking analgesics for a while brings relief, but then the unpleasant sensations reappear and intensify.

Pain syndrome is the leading symptom of cancer in the structures of the hands, but other signs of a tumor may be observed - local swelling of the tissues, numbness or crawling “goosebumps”. Less commonly, limb curvature is visually determined. Functional activity also suffers - flexion at the elbow or shoulder joint becomes increasingly difficult on the side of the cancer lesion.

Therapy methods

The goal of treatment is to remove the tumor along with part of the healthy bone and surrounding tissue (taking into account zonation), as well as to prevent recurrence and metastasis. Most often, combination cancer treatment is used using chemotherapy and/or radiation methods in combination with surgery.

Surgery

The extent of the operation is determined based on the results of histological examination, tumor size, and general condition of the patient. Often, along with the tumor, it is necessary to remove the muscular-fascial sheath (sheath principle). If the fascial border is technically difficult to access, then the layer of muscles that surrounds it is removed (zonal principle). These features must be taken into account when planning the operation.

The gold standard of surgical treatment is organ-conserving surgery. Such an intervention for cancer of the pelvic bones is interiliac-abdominal resection.

If the tumor affects the hip joint, then endoprosthetics can be performed simultaneously. The use of an endoprosthesis allows one to quickly improve the patient’s quality of life while fully restoring limb function.

Radiation therapy

The method of radiation therapy is selected taking into account the morphological type of cancer and its radiosensitivity. This treatment is used together with chemotherapy, as well as in the process of preoperative preparation.

Chemotherapy

Most often, several drugs are used that mutually potentiate each other's effects. If there is a solitary (single) lesion in the pelvic bones and subsequent surgical intervention, chemotherapy is carried out locally. The antitumor drug is delivered directly to the pathological focus using an arterial catheter. This method is highly effective because it helps to achieve an increased concentration of the drug in the tumor. For a generalized process, systemic chemotherapy is used.

Complications

Malignant bone tumors, especially osteosarcoma, are characterized by hematogenous metastasis. The most common localization of metastases is lung and brain tissue.

It is also common for bone cancer to recur even after complete treatment. 95% of local relapses occur within 2 years after surgery. In this regard, radiography is recommended every 3 months during the first year after tumor removal, once every six months in the second year and subsequently - once a year.

Malignant tumors

Osteogenic and parosteal sarcoma

Osteogenic sarcoma is a malignant neoplasm that develops from bone tissue. Main signs of a tumor:

1. Unfavorable prognosis for the patient.
2. Rough current.
3. Tendency to infiltrating growth.
4. Early metastasis.
5. It affects children and young people, with peak incidence occurring between 14 and 20 years of age.
6. A common location is large tubular bones.

The development of a malignant tumor is associated with faster bone growth, which is typical for children during puberty. Frequent injuries in one place and radiation energy also increase the likelihood of developing osteogenic sarcoma.

Classification

1. Osteolytic bone sarcoma is characterized by the destruction of bone tissue by tumor formation.
2. Osteoplastic (sclerosing type) – on the contrary, is characterized by the presence of a tumor of stone density.
3. Mixed option.

By localization they are affected:

1. Long tubular bones, most often the femur.
2. Skull bones, which is typical for children.

• Clinical picture

Patients with bone cancer are characterized by a triad of symptoms:

1. Pain syndrome.
2. Palpable formation.
3. Changes in joint function.

Pain is the earliest sign. The onset of the disease is characterized by a dull, aching pain without clear localization in the bone. Further progression of the pathology leads to unbearably severe pain, the peak occurs at night, and is not relieved by conventional analgesics.

Palpation of the tumor can be done in the later stages of the process, when there are already distant metastases. The main route of metastasis in bone sarcoma is hematogenous. Screenings are localized in the lungs, other bones, pleura, pericardium, kidneys, and brain.

A dysfunction of the joint is diagnosed when the process moves to the epiphysis of the bone and the articular joint.

Diagnostics

The patient often cannot say exactly when the disease began. People rarely pay attention to inexpressible pain in the limbs. When the pain becomes unbearable, the patient consults a doctor, most often this happens 3 months after the onset of the disease.

The main characteristic of the pain syndrome is an increase in intensity at night and the ineffectiveness of non-narcotic analgesics.

When palpating the affected area, the pain increases. In more than half of the patients, a structure softer in density than bone tissue is palpated at the site of tumor growth. The affected limb is swollen, there may be redness of the skin.

Osteogenic sarcoma early grows into blood vessels and begins to metastasize through the hematogenous route. At the time of visiting a doctor, 15% of patients have metastases in the lung tissue. An X-ray shows micrometastases that do not give a clinical picture. Bone sarcomas rarely involve regional lymph nodes.

Osteosarcoma on x-ray looks like this:

• Localized in the metaphyses of long tubular bones.
• Increased blood supply to the tumor, areas of sclerosis or bone lysis.
• Damage to soft tissues—foci of osteosynthesis.
• Destruction of the periosteum.
• Spicules (growth of the periosteal membrane in the form of needles) along the perimeter of the bone surface.

The diagnosis of osteosarcoma must be confirmed morphologically. To do this, use a core needle biopsy or a knife biopsy.

In addition to x-ray studies, the following are used to determine the extent of the process and distant metastases:

• Scintigraphy with technetium – 99.
• Spiral computed tomography.
• Magnetic resonance imaging.
• Angiography, ultrasound with Doppler effect.

The Russian edition of the journal Oncology contains information about improved MRI. The new method involves dynamic monitoring of contrast agent uptake by sarcoma before and after chemotherapy. Based on these data, a conclusion is made about the tissue characteristics of the tumor.

Treatment

For bone tumors, immobilization with a cast or splint can be used to help relieve pain. It is also possible to administer narcotic analgesics according to indications.

Help is provided in the scope of radical surgical treatment with limb preservation. Adjuvant and non-adjuvant chemotherapy is mandatory.

Chondrosarcoma

Chondrosarcoma is a malignant formation of cartilage tissue. Often chondrosarcomas are a consequence of the degeneration of a benign tumor. Features of the tumor:

1. Typical for retirement age
2. Most often the pelvic bones, shoulder blades, and sternum are affected.
3. Formed from hyaline cartilage

Classification

1. Primary chondrosarcomas, which develop in place of healthy cartilage tissue
2. Secondary, with malignancy of chondromas

Symptoms

In the case of degeneration of a benign tumor, the time of appearance of the malignant process is difficult to trace. When pain and progressive growth of the formation appear, the patient consults a doctor. When the pelvic bones are affected, chondrosarcoma most often grows into the pelvic cavity, and in the process of enlargement it compresses organs, nerve fibers, and blood vessels. Depending on the organ involved, clinical manifestations vary:

• Bladder. Symptoms of cystitis appear without changing the urine test, with significant compression, the outflow of urine is disrupted
• In case of compression of the iliac vein - swelling of the limb, swelling of the veins
• Affected iliac artery – limb dysfunction, pain, intermittent claudication

Diagnostics

The X-ray method in diagnosing chondrosarcomas will not always help make a diagnosis. Intraosseous tumors have the form of destructive changes in the bone and deformation of its contours. Extraosseous formations are usually smaller on photographs than they are palpable.

MRI and CT usually complement the diagnostic picture.

Treatment

Surgical care comes to the fore in the treatment of chondrosarcomas. Chemotherapy is ineffective.

Ewing's sarcoma

Ewing's sarcoma is a process that has a malignant nature and certain characteristics:

1. Very aggressive course: rapid growth and early metastasis
2. Age group from 5 to 30 years. Peak incidence at 10-15 years
3. Localization of the lesion: ribs, pelvic bones, shoulder blades, vertebrae, lower part of long bones
4. Tumor development is caused by chromosomal mutations

Clinical picture

The early and most pronounced symptom is pain, which does not decrease with rest or after using non-narcotic drugs. Then a disruption occurs in the functioning of the nearest joint, and then the tumor begins to be palpated. After about 3 months of disease progression, the body temperature rises, hyperemia, swelling, and expansion of the venous network develop at the site of formation. Pathological fractures of the damaged bone are not uncommon.

More than half of patients at the time of visiting a doctor have metastases in distant organs. Cells hematogenously enter the lungs, bones, bone marrow, and brain.

Diagnostics

1. X-ray of the affected area
2. Morphological examination of the tumor
3. MRI, CT of organs most likely affected by metastases
4. Bone marrow puncture
5. Scintigraphy
6. Angiography, ultrasound with Doppler effect

Treatment

The first line of help includes chemotherapy with drugs: cyclophosphamide, vincristine. The scientific journal “Oncology” published data on the effectiveness of external beam radiation therapy aimed at the site of development of the tumor process. Surgical treatment, if possible, is carried out in the scope of radical removal of the tumor.

If the treatment is ineffective and the disease progresses, the patient is prescribed symptomatic therapy, which includes a 24-hour nursing station at the patient’s bedside and injections of narcotic analgesics.

Soft tissue formations

Benign soft tissue tumors, if they do not cause a cosmetic defect, are recommended to be observed.

Malignant soft tissue tumors are not prone to metastasis, but often recur. Surgical treatment and non-adjuvant therapies are indicated.

Tumors of the skeletal system have a small percentage of development among the general population of people, but the tragedy of the situation lies in the greater incidence of children and adolescents. However, at present, thanks to modern research methods and medications, the 5-year survival rate after a malignant process of bone tissue is 70% after radical surgery and chemotherapy.