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小木虫论坛-学术科研互动平台 » 生物医药区 » 医学 » 临床旧帖 » 求助:我得了骨肿瘤,谁能帮帮我
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biotichero

新虫 (小有名气)

[交流] 求助:我得了骨肿瘤,谁能帮帮我

大家好,我也是搞生物研究的,虽然自己的课题不是生物,但是自己就是肿瘤实验室的,没想到今天却得了肿瘤,呵呵
  我现在的境况不太好,可能已经恶化了,但是还没有进行病理检测,因为我对肿瘤认识并不是那么深,所以想让大家帮我出出主意,我知道这里的人都是做科研的,有些人一定是很了解骨肿瘤或者是肿瘤的,所以我想问问大家,希望大家能说说,比如怎么治疗比较好,吃些什么东西对癌症有好处,哪里的治疗比较好,等等的,
  呵呵,谢谢大家了

[ Last edited by madchs on 2009-10-7 at 19:47 ]
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1楼2009-10-02 19:10:12
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1949stone

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海纳百川
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小木虫(金币+0.5):给个红包，谢谢回帖交流
黑色腰带(金币+1,VIP+0):谢谢交流 10-3 21:12
听大夫的 不要自作主张治疗
希望您很快好起来
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海纳百川止于至善
2楼2009-10-02 19:12:11
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biotichero

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我知道自己要听大夫的啊,只是我想多知道些,尤其是食疗等等的
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3楼2009-10-02 19:17:50
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arthurii

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小木虫(金币+0.5):给个红包，谢谢回帖交流
amisking(金币+2,VIP+0): 10-2 21:02
还去去咨询专业人员，在医院安心治疗。
不能乱搞，很多治疗方法之间会有不容易发现的一些冲突，只有有经验的人才懂处理
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4楼2009-10-02 19:19:55
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HarveyWang

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小木虫(金币+0.5):给个红包，谢谢回帖交流
amisking(金币+2,VIP+0): 10-2 21:03
黑色腰带(金币+3,VIP+0):很好的资源 10-3 21:12
拥抱一下，兄弟！
首先，你要在2-3家医院完全确诊！
一定要知道自己到底是哪类的骨肿瘤！
并同时听取数位临床医生的治疗建议！
然后再做决定！

自己查资料，可以得到更有价值的治疗信息！下面的简单资料有一点你所说的食物注意事项等。

骨肿瘤，google关键词，（下面文章内有中文的主要关键词）
英文的（bone tumors） ，去goole国外的参考文献，（下面文章内有英文的主要关键词）
楼主，你可以把这个当做课题来做的，

当你查过一个月的资料后，你会发现，其实你比医生懂的不会少！

在2003年，医生诊断我患有结肠炎，给我开一年的磺胺嘧啶让我吃，
我知道这是其中的治疗方法之一，而且治愈率不好，还会复发!
吃一年的磺胺药物，说不定会把肝或肾吃坏的！

我就自己google国内外的文献，结合自己的症状，
摸索灌肠药物治疗方法，使自己慢慢康复的，从来没有口服什么药

请记住，国内那些号称可以治愈疑难杂症的，99%都是骗人的！
还是国内外的科学文献更有用哦

^_^

----------------------------------------
骨肿瘤是指发生于骨骼的恶性肿瘤，主要有骨肉瘤，软骨肉瘤、纤维肉瘤、多发性骨髓瘤、脊索瘤、网状细胞肉瘤等。骨肿瘤的症状和体征主要有贫血、乏力、营养不良和恶病质。局部疼痛和压痛为最常见，可与肿块同时出现或先出现，开始疼痛轻微，呈间歇性钝痛，继而变为持续性剧痛。浅表部位可触及骨膨胀变形及软组织肿块，皮肤呈暗红色，紧张发亮，皮温增高，短期内形成较大肿块，功能障碍，骨骼畸形及病理性骨折等。
　　骨肿瘤总体发病率虽不高,但常造成病人肢体残疾甚至危及生命,因此在骨科临床上占有极其重要的地位。随着科学技术的不断发展,骨肿瘤的基础与临床研究都取得了长足的进步,尤其对于恶性骨肿瘤,其5年生存率已由过去的10%~20%提高到现在的50%
　　现代医学对骨肿瘤发生的病因尚未明确，大致可概括为机体与周围环境多种因素的作用，如素质学说，基因(遗传)学说，化学、物理、病毒、外伤学说等。
　　骨肿瘤的病因与发病情况
　　骨肿瘤的病因至今未明，以往认为损伤特别是慢性轻微损伤、慢性感染均可引起骨肿瘤。近年通过实验研究如Fujinaga曾用Harvey和Moloney的肉瘤病毒制成大量鼠骨肉瘤模型，Ｆinkel曾用不同类型的同位素和病毒制成骨肉瘤动物模型，亦有人用放射性物质如镭、锶等制成骨肉瘤动物模型。这些致病因素已被许多学者确认。骨肿瘤发病年龄男性为15～24岁，女性为5～14岁，可能与不同性别骨的生长与内分泌发育的早晚和时间长短有关。
[编辑本段]骨肿瘤的组织学分类
　　过去，对骨肿瘤的命名、分类及组织发生等方面的看法比较混乱。国际卫生组织（WHO）决定单纯依据组织学的标准，即依据肿瘤细胞的分化类型及其产生的细胞间物质的类型进行分类。凡不符合规范类型者，均属于未分化型的范畴。分类的目的在于有效地预测该肿瘤的生物学行为，为临床处理提供依据。所以，上述的分类虽然并非完全合理，却不失为目前国际上最通用的一种。现介绍如下：
　　原发性肿瘤和瘤样病变的组织学分类
　　一、成骨性肿瘤
　　（一）良性
　　1.骨瘤（Osteoma）
　　2.骨样骨瘤和骨母细胞瘤（Osteoid Osteoma and Osteoblastoma）
　　（二）恶性
　　1.成骨肉瘤（Osteosarcoma）
　　2.皮质旁成骨肉瘤（Juxtacortical osteosarcoma）
　　二、成软骨性肿瘤
　　（一）良性
　　1.软骨瘤（Chondroma）
　　2.骨软骨瘤（Osteochondroma）
　　3.软骨母细胞瘤（Chondroblastoma）
　　4.软骨粘液样纤维瘤（Chondromyxoid fibroma）
　　（二）恶性
　　1.软骨肉瘤（Chondrosarcoma）
　　2.近皮质软骨肉瘤（Juxtacortical Chondrosarcoma）
　　3.间叶性软骨肉瘤（Mesenchimal Chondrosarcoma）
　　三、骨巨细胞瘤（Ciant Cell Tumor of bone）
　　四、骨髓肿瘤
　　1.尤文氏肉瘤（Ewing's sarcoma）
　　2.骨网织细胞肉瘤（Reticulosarcoma of bone）
　　3.骨淋巴肉瘤（Limphosarcoma of bone）
　　4.骨髓瘤（Myeloma）
　　五、脉管肿瘤
　　（一）良性
　　1.血管瘤（Hemangioma）
　　2.淋巴管瘤（Limphoangioma）
　　3.血管球瘤（Glomangioma）
　　（二）中间型或未定型
　　1.血管内皮瘤（Hemangioendothelioma）
　　2.血管外皮瘤（Hemangiopericytoma）
　　（三）恶性
　　血管肉瘤（Angiosarcoma）
　　六、其它结缔组织肿瘤
　　（一）良性
　　1.成纤维性纤维瘤（Desmoplastic fibroma）
　　2.脂肪瘤（Lipoma）
　　（二）恶性
　　1.纤维肉瘤（Fibrosarcoma）
　　2.脂肪肉瘤（Liposarcoma）
　　3.恶性间叶瘤（Malignant mesenchymoma）
　　4.未分化肉瘤（Undifferentiated sarcoma）
　　七、其它肿瘤
　　（一）脊索瘤（Chordoma）
　　（二）长管骨“牙釉质瘤”（Adamantinoma of lone bone）
　　（三）神经鞘瘤（Nearilemnoma）
　　（四）神经纤维瘤（Neurofibroma）
　　八、未分化类肿瘤
　　九、瘤样病变
　　1.孤立性骨囊肿（Solitary bone cyst）
　　2.动脉瘤样骨囊肿（Aneurysmal bone cyst）
　　3.近关节性囊肿（Juxta articular bone cyst）
　　4.干骺端纤维缺损（Metaphyseal fibrous defect）
　　5.嗜伊红肉芽肿（Eosinophilic granuoma）
　　6.纤维结构不良（Fibrous dysplasia）
　　7.骨化性肌炎（Myositis ossificans）
　　8.甲状旁腺机能亢进性“棕色瘤”（“Brown tumor”）
[编辑本段]骨肿瘤的诊断
　　多数骨肿瘤的诊断较为复杂，有时存在一定的困难，因为不同骨肿瘤可有相近似的表现，良性骨肿瘤可发生恶变；有些骨肿瘤组织学检查显示分化良性，但临床上表现为高度恶性，常常早期出现肺转移。还有一些病变的临床，X线或病理表现与骨肿瘤相似。一般来说，骨肿瘤的诊断必需强调临床，X线表现及病理三结合，综合分析，才能作出正确诊断。在诊断过程中，应注意区分几个问题：①骨肿瘤与非骨肿瘤病性变；②良性骨肿瘤与恶性骨肿瘤；③原发性骨肿瘤与转移性骨肿瘤。
　　一、临床表现
　　（一）疼痛　是骨肿瘤的一个主要症状，休息后不能缓解，由于外界刺激减少而夜间疼痛加重，尤其是恶性骨肿瘤夜间痛，静止痛更明显，是与创伤及炎症疾病造成的疼痛的主要区别。
　　（二）肿块　往往表现在肢体或躯干的异常隆起，需注意肿块部位、大小、局部温度、质地、边界、有无压痛、表面性质、活动度及其生长速度。
　　（三）年龄分布　骨肿瘤的年龄分布有一定的规律。人群中因恶性肿瘤死亡者有两个年龄的高峰。一个为15至20岁，另一个为30至75岁，第一个高峰大多为原发性恶性肿瘤，如6个月婴儿恶性骨肿瘤几乎全为神经母细胞瘤。尤文氏瘤（Ewing's sarcoma）多发生在儿童，成骨肉瘤多发生在青少年，淋巴瘤及其它小圆细胞瘤、骨巨细胞瘤等多发生在20～40岁，多发性骨髓瘤及转移性肿瘤大多为50岁以上的患者。
　　（四）部位特征　某些骨肿瘤有比较特定的好发部位。
　　一般来说，良性骨肿瘤生长缓慢，疼痛轻微或不痛，除位置表浅者外，早期不易察觉，当肿瘤长大或压迫周围组织时，疼痛加重或发生病理性骨折时始被发现。恶性肿瘤呈浸润性生长，发展迅速，骨皮质破坏后，可蔓延至周围软组织。患部常呈梭形肿胀，肿块边界不清，质地较硬，局部血管扩张，皮肤温度升高，早期出现疼痛并呈进行性加重。后期出现贫血及恶液质，并可发生多处转移病灶，其中以肺部转移最多见。
　　二、放射线检查
　　X线检查对明确骨肿瘤性质、种类、范围及决定治疗方针都能提供有价值的资料，是骨肿瘤重要的检查方法。
　　然而X线片仅是骨肿瘤的投影，骨肿瘤的X线表现不恒定，需密切结合临床表现和病理检查，才能作出准确诊断。
　　良性骨肿瘤形态规则，与周围正常骨组织界限清楚，以硬化边为界，骨皮质因膨胀而变薄，但仍保持完整，无骨膜反应，恶性肿瘤的影像不规则，边缘模糊不清，溶骨现象较明显，骨质破坏，变薄，断裂，缺失，原发性恶性肿瘤常出现骨膜反应，其形状可呈阳光放射状，葱皮样及Codman三角。
　　X线片可为医生提供有关肿瘤发病过程四个信息：
　　（一）骨肿瘤的位置　如肿瘤可位于骨骺，也可位于干骨骺端，可位于长骨，也可位于扁平骨；青少年骨骺发生的肿瘤应首先考虑软骨母细胞瘤，而成年人上述骨骺部的肿瘤应考虑为骨巨细胞瘤。
　　（二）肿瘤对宿主骨的影响　肿瘤与宿主骨间边界有无浸润性是确定病变性质的首要因素，边界清楚者表明肿瘤生长缓慢且浸润性弱。反之，边界模糊者则表明肿瘤浸润性强。
　　（三）宿主对肿瘤的反应　宿主总是力图消灭肿瘤，将其包裹，形成纤维组织包膜，生长快速的肿瘤可浸润和破坏这种反应性骨包膜，而仅在肿瘤的一端或两端能见到这种包膜的残余，通常表现为Codman三角。
　　（四）肿瘤组织的密度　骨组织显像中如有任何密度变化，均可怀疑该组织有病变，有些肿瘤为溶骨性病变，如骨巨细胞瘤，而有些为成骨性病变，成骨不规则或为雪花状，如骨肉瘤、软骨肉瘤。
　　发生在骨盆、脊柱等部位的肿瘤，普通X光片不能很好地显示时，CT扫描、B超、MRI、ECT等新型显像技术可以帮助判明肿瘤的部位和范围。
　　骨扫描可以在普通X光尚未有阳性改变时即显示出原发、继发性骨肿瘤的存在。对可疑者应选择性地作99锝等的骨扫描。
　　三、组织学检查
　　骨肿瘤最终诊断的完成有赖于组织学检查，通常经常活检术获取组织标本。活检术需要有经验的医生施行，要保证得到有诊断意义的组织。切口设计应照顾到后续手术，最低限度地减少肿瘤细胞的扩散及对邻近正常组织的污染，决不可认为活检术为小手术而轻率从之，取材应避开坏死区，多取几个部位。肿瘤的外围部分多为反应区，有时不足以作出肯定的诊断，但是，病理检查也有其局限性，如疲劳骨折、骨化肌炎容易误诊为骨肉瘤；甲状旁腺功能亢进时的棕色瘤易误诊为巨细胞瘤；软骨来源的肿瘤难以区分良恶性等。
　　某些肿瘤的诊断中，化验检查有一定的帮助，如成骨肉瘤患者硷性磷酸酶可以增高，多发性骨髓瘤患者可有盆血、尿本周氏蛋白阳性，棕色瘤患者有血钙、血磷异常等。
　　现代医学对本病主要采用手术治疗为主的综合治疗。放射治疗对尤文氏肉瘤、网状细胞肉瘤、多发性骨髓瘤等疗效较为显著。化疗作为辅助性治疗。化疗与手术、放疗并用效果好些。
　　中医认为骨肿瘤属于“骨痨”、“肾虚劳损”的范畴，内因多为禀赋不足，肾精亏损，劳倦内伤，骨髓空虚。 因肾主骨，骨生髓，故肾虚骨病。外因多为寒湿、热毒之邪乘机入侵，气血凝滞，伤筋蚀骨，经络受阻，蓄结成毒瘤。本病好发于四肢，伴有局部疼痛如刺，久之功能障碍，骨生阴毒。
　　骨肿瘤是发生于骨骼或其附属组织（血管、神经、骨髓等）的肿瘤，是常见病。同身体其它组织一样，其确切病因不明；骨肿瘤有良性，恶性之分，良性骨肿瘤易根治，预后良好，恶性骨肿瘤发展迅速，预后不佳，死亡率高，至今尚无满意的治疗方法。恶性骨肿瘤可以是原发的，也可以是继发的，从体内其它组织或器官的恶性肿瘤经血液循环，淋巴系统转移至骨骼或直接侵犯骨骼。还有一类病损称瘤样病变，肿瘤样病变的组织不具有肿瘤细胞形态的特点，但其生态和行为都具有肿瘤的破坏性，一般较局限，易根治。
　　良性与恶性骨肿瘤的区别
　　良性骨肿瘤 恶性骨肿瘤（原发性）
　　症　状
　　先有肿块 先有疼痛
　　生长缓慢 生长迅速
　　疼痛轻或无 疼痛重，夜间重
　　无全身症状 发热、贫血，晚期有恶液质
　　界限清楚 不清楚，周围组织有浸润粘连
　　局部体征 表面无改变 皮肤发热、静脉扩张
　　无压痛、轻压痛 压痛明显
　　无转移、少复发 可转移，复发率高
　　X线表现 膨胀性生长 浸润性生长
　　界限清楚 界限不清楚
　　骨皮质完全或变薄 早期有破坏
　　无骨膜反应 骨膜反应明显
　　细胞形态 分化成熟，近乎正常排列 异形明显，大小不等，
　　可紊乱 排列紊乱，核大深染，有核分裂
　　化　检 多无异常 贫血、血沉增快，碱性磷酸酶可增高
　　愈　后 愈后好 死亡率高
[编辑本段]如何治疗：
　　一、良性肿瘤
　　多以局部刮除植骨或切除为主，如能彻底去除，一般不复发，予后良好。
　　二、恶性肿瘤
　　治疗上尚存在不少困难，尽管近年来采用所谓的综合方法，疗效有所提高，但仍远远不能令人满意，在“挽救生命，最大限度保留肢体功能”的原则下，人们在积极地寻求更有效的方法。
　　手术切除是治疗的主要手段。截肢、关节离断是最常用的方法。但是，由于化疗方法的进步，近年来一些学者开始作瘤段切除（Enbolc resetion）或全股骨切除，用人工假体置换。据称，近期效果较好，但远期效果仍很差。对于恶性程度偏低的肿瘤，如纤维肉瘤，采取保留肢体的“局部广泛切除加功能重建”辅以化疗等措施，是一种可取的方法。至用于尸体关节作为置换材料问题，部分作者认为“愈合满意”，但有些病例出现较大的排异反应，尚须研究克服。
　　化学治疗分全身化疗、局部化疗，常用的药物有阿霉素及大剂量氨甲喋呤，但药物的作用选择性不强，肿瘤细胞在分裂周期中不同步，都影响化疗的效果。用单克隆抗体携带药物，选择性攻击瘤细胞（即“导弹方法”），只是一种设想，距实际应用尚有距离。
　　局部化疗包括动脉内持续化疗及区域灌注，其中以区域灌注效果较好，五年生存率得到提高，但达不到完全“化学截除”的作用。今后需要继续研究以期改善灌注方法，如合理的联合用药、选择灌注液的最适宜温度、灌注后根治性手术的时机等，均需深入探讨，使其日臻完善。
　　免疫疗法：目前仍停留在非特异性免疫治疗阶段，因肿瘤抗原是一个复杂的问题，还没有理想的特异性免疫疗法。干扰素也在不断扩大应用范围，但其来源有限，还不能广为应用。
　　放疗方法对骨肿瘤的治疗只能作为一种辅助治疗，目前也有一些改进（如快中子、射频等的作用）。
　　骨癌治疗常用中药:
　　1.骨癌原发癌灶抑制、症状控制药物：复方斑蝥胶囊 西黄丸 消癌平片
　　2.骨癌扩散转移治疗药物：鸦胆子油口服液 参丹散结胶囊 珍香胶囊
　　3.骨癌放化疗辅助药：微达康颗粒 贞芪扶正颗粒 贞芪扶正胶囊 参芪十一味颗粒
　　4.骨癌癌性疼痛控制药：蟾乌巴布膏
　　骨肿瘤的氩氦刀微创治疗
　　氩氦超冷刀适用于早期、中期和晚期各期实体肿瘤的治疗，尤其是那些不能手术切除的中晚期患者、或因年龄大身体虚弱等各种原因不愿手术肿瘤的患者；2mm以上探针内自带温度传感器，可监测冷冻区域中心的温度。1.47mm探针内不带温度传感器，如需监测温度，可单独插入温度探针监测组织内的温度。监测到的温度变化、冷冻时间可在液晶显示屏显示为温度时间曲线，以便操作者及时了解冷冻过程。
　　选用氩氦刀冷冻治疗的适应证：
　　·自1999年中国国家医药管理局批准氩氦超冷刀进入中国，中国著名的吴孟超院士、汤钊猷院士、郝锡山院士及国内其他专家已先后应用此技术进行了20000多例中晚期肝癌、肺癌、乳腺癌、胰腺癌、脑肿瘤、前列腺癌、肾肿瘤等的治疗，取得了显著效果。
　　·2000年，鉴于氩氦超冷刀治疗肿瘤的良好疗效及优越的安全性，美国将实体肿瘤氩氦超冷刀治疗纳入全民医保计划，欧洲医学保险公司均为氩氦超冷刀治疗提供保险。现美国已有360多家医院装备了氩氦超冷刀。
　　骨肿瘤的饮食忌宜
　　【宜】
　　(1)宜多吃具有抗骨肿瘤作用的食物：山羊血、鲎、蟹、羊脑、海参、牡蛎、鳖、龟、沙虫、鹿血、大叶菜、麦片、小苋菜、油菜籽、沙枣、香芋、栗、野葡萄。
　　(2)宜吃具有止痛消肿作用的食物：芦笋、藕、慈姑、山楂、獭肉、鹭肉、蟹、鲎、海龟、海蛇。
　　(3)宜吃预防放疗、化疗副作用的食物：蜂乳、核桃、猕猴桃、银耳、香姑、大头菜、花粉。
　　【忌】
　　(1)忌烟、酒。
　　(2)忌辛辣刺激性食物，如葱、蒜、姜、花椒、辣椒、桂皮等。
　　(3)忌肥腻食物。
　　(4)忌发物
[编辑本段]预后
　　肿瘤的部位距躯干越近的，病死率越高。至于肿瘤的类型和血管丰富的程度与预后的关系很难判断。病人对所患肿瘤的免疫反应也值得注意。有文献报道，晚期肿瘤作截肢手术的病人，有的可长期存活，经放射治疗后局部不复发，肺部转移也奇迹般地消散。这可能与免疫反应有关，提示治疗后死亡的肿瘤细胞产生了免疫作用。
　　影响预后的因素关键在于就诊早，手术前后的化疗和放疗。此外，还有瘤细胞的组织类型、肿瘤大小、手术前后血清碱性磷酸酶增加的变化以及是否累及局部淋巴结等。
[编辑本段]验方偏方
　　验方：①党参9g，黄芪9g，归尾9g，赤芍9g，白术9g，川断12．5g，寄生31g，王不留行9g，牡蛎31g，夏枯草12．5g，陈皮6g，木香5g，海藻、海带各12．5g(包煎)。同时，加服二黄丸(五厘装)，每周吞服1粒。
　　疗效：上海中医学院附属曙光医院报告1例溶骨性肉瘤治愈。
　　②内服方：玄胡、乳香、没药、丹参、红花、刘寄奴、牛膝、续断、益母草各9g，苏木、血竭各6g，土鳖3g，水煎服。外敷药：当归12．5g，赤芍、儿茶、雄黄、刘寄奴、血竭各9g，乳香、没药各6g，西红花2g，冰片3g，麝香0．15g。研末调敷患处，3天一换，取下稍加新药重新再敷。
　　疗效：湖南省中医药研究所报告1例骨巨细胞瘤治愈。
　　偏方：薏苡仁30克，绿心豆30克，赤小豆30克，煮熟如粥，吃豆喝汤。
[编辑本段]骨癌手术后护理
　　骨肿瘤主要是由血路转移，软组织肿瘤则除血路外，也通过淋巴道转移。部分分化高的软组织肉瘤，以局部复发为主，较少远处转移。
　　骨肿瘤要注意局部有无复发，肝脏及淋巴结有无肿大，并定期作胸部透视。1年以内最好每隔2—3月摄胸片1次。
　　骨癌温馨提示骨转移患者不宜继续放化疗，因为免疫功能底下，抵抗力降低。以免疫治疗为主。不能过度运用麻醉药止疼。会抑制胃肠蠕动。使患者不能正常进食。恶心，呕吐。

[ Last edited by HarveyWang on 2009-10-2 at 19:53 ]
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5楼2009-10-02 19:36:09
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------------------------------------------------------------------------
Understanding bone cancer

Bone is a living tissue. The hard bone tissue is made of collagen fibres (tough, elastic fibres) and minerals (gritty, hard material). There are two main types of cells within the hard bone tissue that make and mould bone. One type (osteoblasts) makes and lays down bone material. Another type (osteoclasts) resorbs (dissolves) particles of bone. These cells are active throughout life. They work in a balanced way to make and mould bone, repair damage and keep the bone structure correctly 'woven'. There is a slow but constant turnover of bone. Chondrocytes are cells which make cartilage, the tissue that covers the ends of bones in joints.

In the centre of some larger bones is the soft bone marrow. This is where blood cells are made (red blood cells, white blood cells, and platelets).

What is cancer?

Cancer is a disease of the cells in the body. The body is made up from millions of tiny cells. There are many different types of cell in the body, and there are many different types of cancer which arise from different types of cell. What all types of cancer have in common is that the cancer cells are abnormal and multiply 'out of control'.

A malignant tumour is a 'lump' or 'growth' of tissue made up from cancer cells which continue to multiply. As they grow, malignant tumours invade into nearby tissues and organs which can cause damage.

Malignant tumours may also spread to other parts of the body. This happens if some cells break off from the first (primary) tumour and are carried in the bloodstream or lymph channels to other parts of the body. These small groups of cells may then multiply to form 'secondary' tumours (metastases) in one or more parts of the body. These secondary tumours may then grow, invade and damage nearby tissues, and spread again.

Some cancers are more serious than others, some are more easily treated than others (particularly if diagnosed at an early stage), some have a better outlook (prognosis) than others.

So, cancer is not just one condition. In each case it is important to know exactly what type of cancer has developed, how large it has become, and whether it has spread. This will enable you to get reliable information on treatment options and outlook. See separate leaflet called 'What are Cancer and Tumours' for further details about cancer in general.

What is primary bone cancer?

Cancer of the bone can be divided into primary bone cancer and secondary bone cancer.

Primary bone cancer means that the cancer started (originated) from cells in the hard bone tissue. Primary bone cancer is a rare type of cancer. Only a few hundred cases of primary bone cancer occur each year in the UK.
Secondary (metastatic) bone cancer means that a cancer which started in another part of the body has spread to a bone. Many types of cancer can spread to the bone. Most commonly, cancers of the breast, prostate, lung, kidney and thyroid. Secondary bone cancer is common. The behaviour, treatment and outlook of secondary bone cancers is often quite different to primary bone cancer.
Cancers of blood cells that originate in the bone marrow are not classified as bone cancers. For example, leukaemia, lymphoma and myeloma.
The rest of this leaflet is only about primary bone cancer. See the separate leaflets for other types of cancer which may spread to one or more bones, and for information about leukaemias, lymphomas and myeloma.
Types of primary bone cancer

There are different types of primary bone cancer. They are classified by the type of cell which occurs in the cancer. Most types of primary bone cancer end with ...sarcoma. A sarcoma is a cancer that originates from cells which occur in and make connective tissues (supporting tissues) of the body. For example, bone, muscle, cartilage, ligaments, etc.

Osteosarcoma
This is the most common type of primary bone cancer, but even this is rare. It arises from bone forming cells. Most cases occur in young people between the ages of 10 to 25, but it can occur at any age. It typically develops in the growing ends of the bone in young people, most commonly in bones next to the knee. However, any bone can be affected.

Ewing's sarcoma
This is named after the doctor who first described it in the 1920's. The cells of this cancer look different to the more common osteosarcoma. Most cases occur in young people between the ages of 10 to 20, but it can occur at any age. It most commonly affects the pelvis and long bones of the leg. However, any bone can be affected.

Chondrosarcoma
This type of cancer arises from cartilage forming cells. As well as occuring in the cartilage, a chondrosarcoma may also develop within a bone, or on the surface of a bone. Most cases occur in people between the ages of 40 and 75. It most commonly affects the pelvis, scapula (shoulder blade), ribs, and the bones of the upper parts of the arms and legs.

Other
Other rare types of primary bone tumour include fibrosarcoma, leiomyosarcoma, malignant fibrous histiocytoma, and chordoma.


What causes primary bone cancer?

A cancerous tumour starts from one abnormal cell. The reason why a cell becomes cancerous is unclear. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiply 'out of control'. (See separate leaflet called 'What Causes Cancer' for details.) In most cases of primary bone cancer it is not known why cells become cancerous. The most common types, osteosarcoma and Ewing's sarcoma, mainly occur in young people. The cause of these may have something to do with changes in the bone as it is growing.

In some cases, there is a known 'risk factor'. For example, your risk of developing a primary bone tumour is increased if you have:

High dose radiotherapy for other problems.
Paget's disease. This is a disease of the bone which occurs in some older people.
An osteochondroma (chondroma). This is a benign (non-cancerous) bone tumour which occasionally turns into a chondrosarcoma.
Certain rare inherited disorders including: Li-Fraumeni syndrome and hereditary multiple exostoses (HME), and hereditary retinoblastoma (a rare childhood cancer of the eye).
Ollier's disease (enchondromatosis) - a rare bone condition.
What are the symptoms of primary bone cancer?

Pain. The pain may be quite vague at first, but tends to gradually becomes persistent and more severe over the affected part of the bone.
Swelling over the affected part of the bone. (May only be noticeable with bones close to the surface of the skin.)
Difficulty in moving a joint if the cancer is near to a joint.
Pressure symptoms if the tumour grows from the bone and presses on nearby structures. For example, pressure on a nerve may cause pain, tingling, weakness of muscles, or numbness of an area of skin.
A break (fracture) of a bone may occur at the site of the tumour after a minor injury.
General symptoms may occur as the cancer becomes larger. For example, tiredness, weight loss, sweats. If the cancer spreads to other parts of the body, various other symptoms can develop.

How is primary cancer of the bone diagnosed and assessed?

Initial assessment and diagnosis
If a doctor suspects that you may have primary bone cancer, you are likely to have a number of tests. These may include one or more of the following:

An x-ray. Primary bone cancers often have a characteristic appearance on an x-ray.
A bone scan. A bone scan involves an injection of a a small dose of radioactive material. This is taken up by active bone tissue. Cancerous bone tissue is very active and shows on a scanner as a 'hot spot'.
MRI scan. This is useful to show the exact site and size of a tumour.
A bone biopsy. A biopsy is when a small sample of tissue is removed from a part of the body. The sample is then examined under the microscope to look for abnormal cells.
If you are confirmed to have primary bone cancer then further tests are usually advised to assess if the cancer has spread. This may include various blood tests, x-rays and scans.医学全在线www.med126.com

Assessing the severity of the cancer - grading and staging
The results of the biopsy can show the type of the cancer. Also, by looking at certain features of the cells the cancer can be 'graded'. For primary bone cancers, two grades are used.

Low grade - the cells look reasonably similar to normal bone cells. The cancer cells are said to be 'well differentiated'. The cancer cells tend grow and multiply quite slowly and are not so 'aggressive'.
High grade - the cells look very abnormal and are said to be 'poorly differentiated'. The cancer cells tend to grow and multiply quite quickly and are more 'aggressive' and are more likely to spread.
The stage of primary bone cancer is based on the grade of the cancer, and how much it has grown or spread. The staging system commonly used is:

Stage 1A - the cancer consists of low-grade cells, and is totally within the bone. There is no spread to other parts of the body.
Stage 1B - the cancer consists of low-grade cells, but has grown through the wall of the bone. There is no spread to other parts of the body.
Stage 2A - the cancer consists of high-grade cells, and is totally within the bone. There is no spread to other parts of the body.
Stage 2B - the cancer consists of high-grade cells, but has grown through the wall of the bone. There is no spread to other parts of the body.
Stage 3 - the cancer is any grade but has spread to other parts of the body.
The staging is important as the treatment options and outlook (prognosis) differ depending on the stage of the cancer.


What are the treatment options for primary bone cancer?

The main treatments used for primary bone cancer are surgery, chemotherapy and radiotherapy. The treatment or combination of treatments advised in each case depends on various factors such as:

The type of primary bone cancer.
The exact site of the cancer.
The stage of the cancer (how large the cancer is and whether it has spread).
Your general health.
You should have a full discussion with a specialist who knows your case. They will be able to give the pros and cons, likely success rate, possible side-effects, and other details about the possible treatment options for your type of cancer.

You should also discuss with your specialist the aims of treatment. For example:

In some cases, treatment aims to cure the cancer. (Doctors tend to use the word 'remission' rather than the word 'cured'. Remission means there is no evidence of cancer following treatment. If you are 'in remission', you may be cured. However, in some cases a cancer returns months or years later. This is why doctors are sometimes reluctant to use the word cured.)
In some cases, treatment aims to control the cancer. If a cure is not realistic, with treatment it may be possible to limit the growth or spread of the cancer so that it progresses less rapidly. This may keep you free of symptoms for some time.
In some cases, treatment aims to ease symptoms ('palliative treatment'). For example, if a cancer is advanced then you may require painkillers or other treatments to help keep you free of pain or other symptoms. Some treatments may be used to reduce the size of a cancer which may ease symptoms such as pain.
Surgery
The types of operation vary depending on the type and site of the cancer. If the cancer is in an arm or leg, it is often possible to remove it with 'limb-sparing' surgery. This means surgery where just the affected part is removed, and is replaced with an artificial metal fitting (prosthesis) or a bone graft. Amputation (removing a limb) used to be the main operation, but this is done less often these days due to the improved surgical techniques with limb-sparing surgery. However, amputation is still needed in some cases, depending on the size, spread, or site of the tumour.

Your specialist will advise on whether surgery is possible, and the types of operation which can be done.

Radiotherapy
Radiotherapy is a treatment which uses high energy beams of radiation which are focussed on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. (There is a separate leaflet which gives more details about radiotherapy.)

Radiotherapy may be used as an alternative to surgery for Ewing's sarcoma. For example, if the tumour is in the spine when surgery is not possible. Radiotherapy is not usually used for osteosarcomas or chondrosarcoma as they are not very sensitive to radiation.

Chemotherapy
Chemotherapy is a treatment which uses anti-cancer drugs to kill cancer cells, or to stop them from multiplying. (There is a separate leaflet which gives more details about chemotherapy.)

Chemotherapy may be given in addition to surgery or radiotherapy, depending on the type and stage of the bone cancer. This may be before surgery to shrink the size of the cancer which makes it easier to remove. Chemotherapy may also be given after surgery or radiotherapy, to make sure any cancer cells which may have been left in the body are killed.

What is the prognosis (outlook)?

It is difficult to give an overall outlook. Every case is different, and the success of treatment depends on the type, site and stage of the cancer - the earlier the stage, the better the outlook. In general, the outlook for primary bone tumours has improved in the last 10-20 years. This is due to improved surgical techniques and improved chemotherapy.

The treatment of cancer is a developing area of medicine. New treatments continue to be developed and the information on outlook above is very general. The specialist who knows your case can give more accurate information about your particular outlook, and how well your type and stage of cancer is likely to respond to treatment.


该文章转载自医学全在线：http://www.med126.com/yingyu/2008/21624_3.shtml

该文章转载自医学全在线：http://www.med126.com/yingyu/2008/21624_2.shtml

该文章转载自医学全在线：http://www.med126.com/yingyu/2008/21624.shtml
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【我一直认为做土匪很性感很坏，很直接，可以大声喊：JCMM我爱你！所以，我自从博士毕业后，就一直在寻找黑道大哥一起去抢钱、抢粮、抢地盘】
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biotichero

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引用回帖:
Originally posted by HarveyWang at 2009-10-2 19:36:
拥抱一下，兄弟！
首先，你要在2-3家医院完全确诊！
一定要知道自己到底是哪类的骨肿瘤！
并同时听取数位临床医生的治疗建议！
然后再做决定！[ ...

谢谢了,我一定会努力治疗的,我还要接着研究生物,要造福人类呢
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7楼2009-10-02 19:38:22
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8楼2009-10-03 00:07:00
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snow889

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小木虫(金币+0.5):给个红包，谢谢回帖交流
祝福楼主！保持好心态，配合医生，你一定会好起来的！
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9楼2009-10-03 00:25:29
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溪儿维娅

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祝福你，相信你一定会好起来的！
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