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Chondrosarcoma is a rare type of cancer that usually begins in the bones, but can sometimes occur in the soft tissue near bones. Chondrosarcoma happens most often in the pelvis, hip and shoulder. More rarely, it can happen in the bones of the spine.
Most chondrosarcomas grow slowly and may not cause many signs and symptoms at first. Some rare types grow rapidly and have a high risk of spreading to other areas of the body, which can make these cancers difficult to treat.
Chondrosarcoma treatment usually involves surgery. Other options might include radiation therapy and chemotherapy.
Symptoms
Chondrosarcoma tends to grow slowly, so it might not cause signs and symptoms at first. When they occur, signs and symptoms of chondrosarcoma may include:
- • Increasing pain
- • A growing lump or area of swelling
- • Weakness or bowel and bladder control problems, if the cancer presses on the spinal cord
Causes
It's not clear what causes chondrosarcoma. Doctors know that cancer begins when a cell develops changes (mutations) in its DNA. A cell's DNA contains the instructions that tell it what to do. The instructions tell the cell to multiply quickly and to continue living when healthy cells would die. The accumulating cells form a tumor that can grow to invade and destroy normal body tissue. In time, cells can break away and spread (metastasize) to other areas of the body.
Risk factors
Factors that can increase the risk of chondrosarcoma include:
- Increasing age. Chondrosarcoma occurs most often in middle-aged and older adults, though it can occur at any age.
- Other bone diseases. Ollier's disease and Maffucci's syndrome are conditions that cause noncancerous bone growths (enchondromas) in the body. These growths sometimes transform into chondrosarcoma.
Diagnosis
Tests and procedures used to diagnose chondrosarcoma include:
- Physical exam. Your doctor may ask about your signs and symptoms and examine your body to gather more clues about your diagnosis.
- Imaging tests. Imaging tests may include X-ray, bone scan, MRI and CT scan.
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Removing a sample of tissue for testing (biopsy). Biopsy is a procedure to collect suspicious tissue. The tissue is sent to a lab where doctors analyze it to determine whether it's cancer.
How the biopsy sample is collected depends on where the suspicious tissue is located. The procedure requires careful planning so that the biopsy is done in a way that won't interfere with future surgery to remove the cancer. For this reason, ask your doctor for a referral to a team of experts with experience in treating chondrosarcoma.
Treatment
Chondrosarcoma treatment often involves surgery to remove the cancer. Other treatments might be recommended in certain situations. Which options are best for you depends on where your cancer is located, how quickly it's growing, whether it has grown to involve other structures, your overall health and your preferences.
Surgery
The goal of surgery for chondrosarcoma 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. Options might include:
- Scraping the cancer away from the bone. Small and slow-growing chondrosarcomas in the arms and legs are sometimes treated with a procedure to scrape the cancer cells from the bone. The surgeon might apply cold gas or a chemical to kill any cancer cells that remain. The bone can be repaired with a bone graft or bone cement, if needed.
- Cutting away the cancer and some healthy tissue around it. Most chondrosarcomas require a procedure to cut away more of the bone in order to remove all of the cancer. For chondrosarcoma in an arm or a leg, it might be necessary to remove the entire limb. When possible, surgeons remove the cancer in a way that preserves the limb. For example, the surgeon might remove the affected bone and replace it or reconstruct it (limb salvage surgery).
Radiation therapy
Radiation therapy uses high-powered energy beams from sources such as X-rays and protons to kill cancer cells. During radiation therapy, you lie on a table while a machine moves around you, directing radiation to precise points on your body.
Radiation might be recommended for chondrosarcomas located in places that make surgery tricky or if the cancer can't be removed completely during surgery. Radiation may also be used to control cancer that spreads to other areas of the body.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. It's not often used for chondrosarcoma because this type of cancer often doesn't respond to chemotherapy. But some fast-growing types of chondrosarcoma may respond to this treatment.