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Chondrosarcoma: Causes, Symptoms, Diagnosis, Treatment, and Prevention

The cancer chondrosarcoma usually begins in the cartilage, a soft tissue that allows bones and joints to move. In the body, cartilage can be found anywhere, but it is most commonly found in the pelvis, hip, shoulder, ribs, and spine. There are more cases of chondrosarcoma in middle-aged and older adults, and the disease affects both sexes equally.

Causes of Chondrosarcoma

Chondrosarcoma's exact cause is unknown. There is a possibility that some genetic mutations or changes in cartilage cells' DNA could cause abnormal growth and division, resulting in a tumor. Chondrosarcoma may be caused by a combination of factors, including:

• Having a history of other bone diseases, such as Ollier’s disease or Maffucci’s syndrome, that cause benign (noncancerous) growths of cartilage in the body. These growths may sometimes transform into chondrosarcoma.

• Having a history of radiation therapy or exposure to certain chemicals that may damage the DNA of the cartilage cells.

• Having a family history of chondrosarcoma or other bone cancers.

Symptoms of Chondrosarcoma

Chondrosarcoma may not cause any symptoms in the early stages, as it tends to grow slowly. However, as the tumor grows larger, it may cause some signs and symptoms, such as:

• Pain in the affected bone or joint, which may worsen with movement or at night.

• Swelling, redness, or warmth in the area of the tumor.

• A lump or mass that can be felt under the skin.

• Fracture or weakness of the affected bone, especially if the tumor is located near a weight-bearing joint.

• Nerve compression or spinal cord compression, if the tumor is located in the spine, which may cause numbness, tingling, weakness, or loss of bladder or bowel control.

Diagnosis of Chondrosarcoma

To diagnose chondrosarcoma, the doctor will perform a physical examination and ask about the medical history and symptoms of the patient. The doctor may also order some tests, such as:

• X-rays, to show the location, size, and shape of the tumor and the surrounding bone.

• MRI or CT scan, to provide more detailed images of the tumor and the nearby tissues, organs, and blood vessels.

• Bone scan, to check if the cancer has spread to other bones in the body.

• Biopsy, to remove a small sample of the tumor tissue and examine it under a microscope to confirm the diagnosis and determine the type and grade of the chondrosarcoma.

Treatment of Chondrosarcoma

Surgical treatment for chondrosarcoma involves the removal of the entire tumor, along with some normal tissue surrounding it. The surgery may involve the following procedures, depending on the size and location of the tumor:

• A limb-sparing surgery preserves the affected limb by removing only the tumor and some surrounding bone. The removed bone may be replaced by a metal implant, a bone graft from another part of the body, or a bone from a donor.

• It may be necessary to amputate the affected limb if the tumor is too large or too close to a vital structure, such as a major blood vessel or nerve. Patients may need a prosthesis (artificial limb) after the surgery.

• When the tumor is located in the pelvis, pelvic surgery involves removing some of the surrounding pelvic bone and tissue as well as the tumor. Depending on the extent of the removal, the patient might need to undergo pelvic reconstruction surgery to restore the shape and function of the pelvis.

• Surgery on the chest wall involves removing the tumor and some of the surrounding ribs, sternum, or spine. Depending on how much the tumor is removed, the patient may have difficulty breathing or heart functioning. In order to restore the chest wall's shape and function, the patient may need reconstructive surgery.

In some cases, the doctor may also recommend other treatments, such as:

• Cancer cells are killed or shrinked by radiation therapy, which uses high-energy rays or particles. In addition to reducing the risk of the cancer coming back or spreading, radiation therapy may also relieve cancer symptoms before or after surgery. Chondrosarcomas that cannot be surgically treated, such as mesenchymal chondrosarcomas and dedifferentiated chondrosarcomas, may also benefit from radiation therapy as a primary treatment.

• To reduce the risk of the cancer coming back or spreading, or to relieve the symptoms of the cancer, chemotherapy may be used before or after surgery. Chemotherapy uses drugs to kill or stop the cancer cells from growing. Some types of chondrosarcoma, such as mesenchymal chondrosarcoma or dedifferentiated chondrosarcoma, which cannot be operated upon, can also be treated with chemotherapy.

Prevention of Chondrosarcoma

There is no known way to prevent chondrosarcoma, as the cause of the disease is not clear. However, some general measures that may help reduce the risk of developing chondrosarcoma or other cancers include:

• Avoiding exposure to radiation or chemicals that may damage the DNA of the cells.

• Eating a healthy diet that is rich in fruits, vegetables, whole grains, and lean proteins, and low in fat, sugar, and processed foods.

• Maintaining a healthy weight and avoiding obesity, which may increase the risk of some cancers.

• Exercising regularly and staying physically active, which may boost the immune system and lower the risk of some cancers.

• Quitting smoking and avoiding secondhand smoke, which may increase the risk of some cancers.

• Limiting alcohol consumption, which may increase the risk of some cancers.

• Getting regular check-ups and screenings, which may help detect chondrosarcoma or other cancers at an early stage, when they are easier to treat.

Outlook of Chondrosarcoma

The outlook for chondrosarcoma depends on several factors, such as:

• It determines how aggressive and likely the cancer is to spread based on the type and grade of chondrosarcoma. Chondrosarcomas such as conventional chondrosarcoma tend to grow slowly and have a better prognosis than others, like mesenchymal chondrosarcoma or dedifferentiated chondrosarcoma, which grow rapidly and have a poor prognosis.

• The stage of the chondrosarcoma, which indicates how far the cancer has spread in the body. The earlier the stage, the better the prognosis.

• The location and size of the tumor, which affect the possibility and difficulty of the surgery and the function of the affected limb or organ.

• The response to the treatment, which depends on how well the cancer cells are killed or removed by the surgery, radiation therapy, or chemotherapy.

• The overall health and age of the patient, which affect the ability to tolerate and recover from the treatment and the risk of complications or infections.

A survival rate for chondrosarcoma refers to how many people survive for a certain period of time following diagnosis. According to the American Cancer Society, the five-year survival rate for chondrosarcoma is as follows:

• 90% for localized chondrosarcoma, which means the cancer is only in the bone where it started and has not spread to other parts of the body.

• 81% for regional chondrosarcoma, which means the cancer has spread to nearby lymph nodes or tissues, but not to distant organs.

• 36% for distant chondrosarcoma, which means the cancer has spread to distant organs, such as the lungs or liver.

Survival rates are only estimates and may vary depending on the patient's circumstances. They do not predict a patient's future outcome, as other factors may affect his or her prognosis. In addition, survival rates do not reflect a patient's quality of life, as some treatments can cause side effects or complications that can adversely affect the patient's health, mental, and emotional well-being.