Chondrosarcoma

Overview

Chondrosarcoma is a rare type of cancer that usually begins in the bones, but can sometimes occur in the soft tissue near bones. The most common locations for chondrosarcoma tumors are in the pelvis, hip and shoulder. More rarely, the base of the skull is affected.

The defining characteristic of a chondrosarcoma is that its cells produce cartilage. Some types of chondrosarcomas grow slowly and, provided they are removed completely, have a low risk of spreading to other organs and bones. Others grow rapidly and have a high risk of metastasis.

Surgical removal of the tumor is the mainstay of chondrosarcoma treatment. Radiation and chemotherapy are rarely helpful in the treatment of chondrosarcoma

Symptoms

Chondrosarcoma signs and symptoms may include:

  • Increasing pain
  • A swelling or palpable mass
  • Fracture due to weakened bone

If the tumor is pressing on the spinal cord, you might experience weakness, numbness or incontinence.

Causes

Chondrosarcoma is associated with certain genetic mutations. Some varieties of chondrosarcoma arise from the transformation of benign cartilage lesions into cancers.

Risk factors

While chondrosarcoma can occur at any age, the most prevalent variety typically affects middle-aged to older adults.

Ollier disease and Mafucci syndrome are conditions marked by an increased number of benign cartilage lesions (enchondromas) in the body. These lesions sometimes transform into chondrosarcoma.

Diagnosis

Because most chondrosarcoma tumors grow so slowly, they may not be diagnosed for years. In some cases, tumors are discovered during imaging tests for unrelated problems. A biopsy may be needed to confirm the diagnosis.

Imaging tests

An X-ray may identify a suspicious area of bone for further examination. Other imaging tests, such as magnetic resonance imaging (MRI) and computerized tomography (CT), can offer additional information about the tumor.

Biopsy

Doctors can confirm a diagnosis of chondrosarcoma by removing a sample of suspicious tissue with a needle or a scalpel and testing it in a lab. A biopsy must be performed in a certain way so that it doesn't make it more difficult to remove the cancer during a later operation.

Treatment

Surgery is the primary treatment for chondrosarcomas. The goal is to remove the cancer and a margin of healthy tissue around it. The type of surgery you undergo will depend on the location of your chondrosarcoma.

Most chondrosarcomas are suitable for limb salvage surgery, where the cancer is removed and the affected bone is replaced or reconstructed. A small percentage of chondrosarcomas require amputation. This option is chosen when a tumor involves major nerves, blood vessels, or is so large that removal essentially destroys the function of the limb.

Radiation

If your tumor is in a location such as the base of the skull, which makes it difficult to remove all the cancer, your doctor might suggest using radiation therapy before or after the operation.

Chemotherapy

Chondrosarcoma is typically a very slow-growing cancer and chemotherapy targets cells that grow very quickly, so this treatment is generally not very effective. Some rare variations of chondrosarcoma do grow more swiftly, so chemotherapy may be helpful in these cases.

Cancerous thighbone replaced with artifical femur

A bone scan (left) shows extensive cancer in right thighbone (femur). The entire femur, plus the hip joint and knee joint, were replaced with artificial components.

Coping and support

A cancer diagnosis can change your life forever. Each person finds his or her own way of coping with the emotional and physical changes cancer brings. But when you're first diagnosed with cancer, sometimes it's difficult to know what to do next.

Here are some ideas to help you cope:

  • Learn enough about cancer to make decisions about your care. Ask your doctor about your cancer, including your treatment options and, if you like, your prognosis. As you learn more about cancer, you may become more confident in making treatment decisions.
  • Keep friends and family close. Keeping your close relationships strong will help you deal with your cancer. Friends and family can provide the practical support you'll need, such as helping take care of your house if you're in the hospital. And they can serve as emotional support when you feel overwhelmed by cancer.
  • Find someone to talk with. Find a good listener who is willing to listen to you talk about your hopes and fears. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.

Preparing for an appointment

Start by seeing your family doctor or a general practitioner if you have any signs or symptoms that worry you. If your doctor determines you have cancer, you'll likely be referred to one or more specialists, such as doctors who treat cancer (oncologists) and surgeons.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Write down your family's history of cancer. If other members of your family have been diagnosed with cancer, make a note of the types of cancer, how each person is related to you and how old each person was when diagnosed.
  • Make a list of all medications, vitamins or supplements that you're taking.
  • Consider taking a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor.

Preparing a list of questions in advance can help you make the most of your time with your doctor. List your questions from most important to least important in case time runs out. For cancer, some basic questions to ask your doctor include:

  • What type of cancer do I have?
  • What stage is my cancer?
  • Will I need additional tests?
  • What are my treatment options?
  • Can treatments cure my cancer?
  • If my cancer can't be cured, what can I expect from treatment?
  • What are the potential side effects of each treatment?
  • Is there one treatment you feel is best for me?
  • How soon do I need to begin treatment?
  • How will treatment affect my daily life?
  • Can I continue working during treatment?
  • Are there any clinical trials or experimental treatments available to me?
  • I have these other health conditions. How can I manage them during my cancer treatment?
  • Are there any restrictions that I need to follow?
  • Should I see a specialist? What will that cost, and will my insurance cover it?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there brochures or other printed material that I can take with me? What websites do you recommend?
  • What will determine whether I should plan for follow-up visits?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover other points you want to address. Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Does anyone in your family have cancer?
  • Have you ever had cancer before? If so, what kind and how was it treated?

Last Updated Aug 8, 2018


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