The human body is made up of lots of cells of various shapes and work. Also the internal organs in the skin and bone, there is a cell that was determined for each. In addition, dying cells every day, and old, I will replaced with new cells. Is designed to serve fixed in a way that depends on the (gene) exact blueprint, new cells, the human body seems to be no change to look for it. This mechanism becomes strange, abnormal cells that do not harmonize with the surroundings is made fast, come become tumor mass is.
In addition to the tumor may be larger at the location that can be spread away riding the flow of blood and lymph. Ri is like flying sparks can spread on the wind at the time of the fire, I just say this transition. Simply put, it is the tumor that may metastasize and malignant tumors. The distinction between benign and malignant is sometimes difficult to see how the tumor tissue under a microscope is the most reliable. It should be noted that I said something sarcoma cancer called what came out of the skin and mucous membranes of the malignant tumor, bones and muscles came from and nerve.
● What is Osteosarcoma
I said something to make osteosarcoma of bone out of the bone sarcomas. There chondrosarcoma, Ewing's sarcoma and osteosarcoma in addition to, respectively, out of the bone sarcomas, the speed of the spread, is greater, and response to treatment are different. Malignant tumor and cancer in the sense that osteosarcoma is the same, each is characterized, in reaction to the drug have also different.
What kind of disease or osteosarcoma
● What, do you want to cause genetic
I do not know the cause of it is honest. Genetics are not allowed. There are very few parents also occur in the world, of the brother. I did not find any relationship between food, virus, and the like lifestyle.
● More or any person in any place
Most 10 units in the first half, is about 1.5 times more sick man is a woman. 80% 7 ー can around the knee, shoulder rest is mostly (proximal humerus). I can think of as a disease is small, approximately 10 patients will be the new osteosarcoma per year in Hokkaido.
Only the most pain. I considered a pain to have to destroy the bone just could osteosarcoma without pain, increases. When I consulted a doctor, have some overhang outside the bone is destroyed I is normal. In such a case, there is a feeling of heat in its place is swollen. may also be discovered for bone fracture becomes brittle.
However, these symptoms may be seen in other diseases not intended characteristic of osteosarcoma.
● How will the diagnosis
I know quite a radiograph. However, X-ray picture I do not say with certainty is like looking at the shadow. Take part to the location of the disease, should be viewed with a microscope and finally, (histopathological diagnosis). To see the spread of the disease, we carried out if necessary CT, MRI, scintigraphy, and angiography.
● How do you go progressing
If you do not want to treat, breaking the bone become bigger and bigger in the local press osteosarcoma will spread around the muscles. Are speed and may be as much as 2-fold in four weeks early. Sometimes many lung metastases seen bone, liver, and lymph nodes to other. Many of the transition, I come out within the next two years. It is unlikely after 5 years.
● What does a treatment
There are currently three ways to treat malignant tumors. Surgery, chemotherapy, radiation it is. Depending on the type of tumor, of which some may then only one may need to use in combination. For the treatment of osteosarcoma is a combination of surgery and chemotherapy have been made.
● Or cured by treatment
You need to take bone invaded by osteosarcoma. There is no way to heal without surgery. I will explain at the surgery for more information. However, very often cause a transition properly, no matter how just the surgery, does not mean that was cured. Because there is a possibility to come out later, the transition we can not determine in advance whether a transition in future not cause another to heal completely. However, it is certainly less likely to transition out of the time went. So, I think once was cured in the absence of metastasis even after five years. Even when the surgery without left behind the era that is doing the surgery alone was the 5-year survival rate of approximately 10-20%. In the current method of performing together Chemotherapy is about 60-70%. I'm sorry, I can not determine in advance what people do recover. Therefore, taking the X-ray at regular intervals after completion of treatment you will need.
About the surgery● Do you not must be cut
Osteosarcoma surgery may be required to take all the parts invaded by tumor. However, osteosarcoma cells may not only just making the mass, are scattered around it without visible. I'll also make a lump there, after a while after the surgery and left behind this (local recurrence). Therefore, it is necessary to the naked eye until it wears Toru appear normal. Specifically, taken together with bones and muscles around the tumor. However, blood vessels and nerves may be running close to the bone. Fewer blood vessels that lead to the hands and feet, dead blood does not flow to its destination and this would take. In other words, if the bone is large spread out, if not leave the vessel, cutting may be unavoidable. But I may not necessarily disconnected if you have not spread outside the bone over and said to reverse. I say this with limb-sparing surgery. Or limb salvage is mainly determined by the extent of cutting or osteosarcoma, it is necessary to consider the efficacy of chemotherapy, age, and other sites.
● What kind of surgery you need when you do not want to cut
Case of limb-sparing surgery, you need to fill with something after taking the tumor. They say this reconstruction, the method, there are two in the case of my bones and filled with artifacts when using roughly. Their advantages, disadvantages follow the indications below.
Artifacts (artificial joints, artificial femoral head) my bones (bone graft)
Advantage
• After surgery, there is a move early and durability
Shortcoming
· There is always wear, damage
And surgery, which is unstable and there is no strength increases
• It takes time to bone with Joint and is fixed
Corruption issues of the prosthesis is particularly important, I have not cut when you can not be replaced. We believe that in the case of young people towards the bone graft is good as far as possible. In the end, I will give priority to the wish of the patient.
I will be wearing a prosthetic leg. In the case of above-knee amputation above the knee most often, I made to fit the shape of the femur that remains something like a plastic tube that socket. Will look like with just sucking right there and have the shape, I will be without suspended from above, such as band. I assembled pipes, fittings, etc. say prosthesis that are currently used and skeletal formula. Has the advantage of repair, and ease of adjustment, which is good because the appearance is also covered with a foam rubber on. In the prosthesis to walk without a cane, in principle, most people can be, except the elderly. I can also Agra. Also, when the leg is cut in, a lot of movement is possible even with a left knee prosthesis so. Some people enjoy a baseball or ride a bicycle. Prosthesis is required to practice in January - 3 months in order to use, do not slow progress during chemotherapy for the rest of my trouble. Rehabilitation may be performed again after chemotherapy.
● Rotation Plasty for (rotation plasty)
There is another option when you need to cut. As mentioned earlier, the need to cut, because I have to cut the blood vessels and nerves. So part of it is dead do not go ahead because the blood circulation from the lesion, it is healthy at the time of surgery. So, you can take the focus part, helped by a method such as suturing the blood vessels causing a portion of its destination. Of course, the state can be used as it is shorter in length because I will not. And when there is a lesion in the knee, it will be in the form attached to the opposite thigh remaining around the part of the foot. I will be on behalf of the knee joint of the foot is no longer that way. Equipment is required. Of course, the usual cut, motion, walking ability, and durability are excellent artificial joint, than arthrodesis. There is a problem of the appearance, please contact us because you have available as well as video.
First and do not need to cut blood transfusion in about an hour. If limb salvage, depending on the size and spread, it will take roughly 2-3 hours just take the tumor. Reconstruction may require skin grafting as well as sometimes in addition to it. Anesthesia should be performed in general anesthesia. Although blood transfusion is often not until the bleeding 1000ml, children and people with anemia may be transfused early. At the time of surgery of the lower extremities, may be contained in the tube for a back pain.
For chemotherapy
● Why is chemotherapy
A disease that can be many limbs, osteosarcoma can be taken to be complete in the worst case to the cut. Unlike lung cancer, stomach cancer and I will not take this point to proceed. However, the experience of age old days had been cut only, most people caused the lung metastases within a year. Tumor since we will be there instead of cutting, I do not meet the theory that the cause of lung metastases after cutting. So I began to think of when you find the transition you already have a small cut in the inspection do not know, it eventually becomes large. The main purpose of the current chemotherapy is to reduce lung metastases that are invisible to the naked eyes.
Chemotherapy is effective as the tumor is small. The most important thing in the treatment of osteosarcoma, chemotherapy is to start from the time of the inspection does not find small enough yet, suppressed lung metastases. Concrete choices of drugs, there are various ways to use time, several universities and cancer centers across the country are using our current - is what was decided in collaboration with. In Hokkaido, Hokkaido is done in the same way, even Sapporoidai. Point is to sufficiently chemotherapy before surgery. Kept as small as possible from the time that the lung metastases, so to increase the people who live in or shrink the tumor before surgery, without the need to cut to reduce the small handouts around it is the purpose.
NOTE
● Medicines used in chemotherapy
I am currently using drugs that have side effects Do. That's what I can say about fateful because the drug also beat normal cells along with the tumor cells, with no side effects and no drug effect. But you can prevent the progression to a more serious side effects, or to reduce the side effects in a variety of attention. Nausea, Common to the following drugs is loss of appetite. Although there are individual differences, be sure to take water alone as much as possible. Need to be given fluids intravenously when you do not drink strong nausea.
The intravenous drug in red: (ADM) adriamycin. White blood cells decreased after 2 weeks from the week. Seen in 2-3 weeks almost all hair loss in men. May become irregular pulse rarely affects the heart. White blood cells is low because it has the function to kill bacteria, such as pneumonia may cause heat and out. Hair is restored completely to come grow chemotherapy is finished also. It is often temporary (pulse illegal) even though there is a side effect of the heart.
I use it in conjunction with adriamycin: (CDDP) cisplatin. I do infusions of 4 hours. There are side effects that cause vomiting, have recently been developed to prevent this drug. Because it can cause kidney failure, it is necessary to ensure a day over 3000ml urine volume, use (drugs that produce urine) and diuretic infusion for hydration before and after using the medicine. The next few days, and when it is used to increase the amount of urine needs to be supplemented with some moisture vomiting may continue to drip water treatment is one day. When strong vomiting may also add a variety of drugs in order to suppress it.Administered by infusion days in a row 7: (IFM) Ihomaido. So may cause hematuria in stimulating drugs, diuretics and infusion is required to increase the amount of urine also. Since recently, is now available drugs to prevent side effects, I no longer unlikely that the cause hematuria. Leukocytes may decrease seen other hair loss.
Has tentatively determined as Attachment, I'll decide while watching such side-effects and general condition. Because of that drug is effective is different for each individual, may be once before surgery to avoid wasted drugs inadequate effect once after surgery, to modify the drug using a determination is made of the effect .
Other questions
● Are there any good medicine did not work with insurance
Normally, the treatment will be done using the health insurance. When a new drug has been developed, it is true that it takes some time to become available in the insurance. This is because it takes time to verify whether the drug really works. When you think you can get in the form of clinical trials in many cases, in our hospital, it is likely to work against osteosarcoma, I've been using before that can be used by insurance. As for drugs that you are currently using, was one of the facility you are using from the beginning at least in Japan.
Many of these, because it is what was announced at the meeting, is certain that might work. However, at the stage that there were cases where it was effective, it is a terrible stage of in vitro or animal studies. There are a lot of things have disappeared as it appeared touted drugs and dreams. There is much talk and not even really that often joke that works with the stock price than tumors. I think that there is currently no treatment of tumors that can be solved at once has found one silver bullet, as we only have stacked the treatment improved little by little.
● Is the vaccine effective Maruyama
I think that does not work when it comes to osteosarcoma. It is not enough to say that the work referred to here means, appetite or decreased pain and came out in the sense that the smaller tumor. Drugs currently used are the ones that all the tumor becomes smaller with osteosarcoma has been confirmed. Experience is certainly up to now, there was no example of Maruyama vaccine was effective in osteosarcoma. In addition, the following drugs or treatment if you do not mind my saying so dare, it is not objectionable.Hasumi vaccine, lymphocyte therapy Sato, germanium, chlorella, therapy Young,Such as water, vitamin therapy C, of God
● How far should I say to the person
I think it is difficult to say categorically, to the treatment without saying anything is bad. During surgery I did not qualify as normal even when the limb salvage. There is also a side effect of chemotherapy.
If you do not understand why I must do my best here himself, I desire to treatment then you are probably not on. Although it is not osteosarcoma, there is also data that results will differ by willingness to treatment. However, it is of course say how far personality, such as the coming age is changed. Directly, please consult your doctor.
