Rak kości – Etiologia i przyczyny

Rak kości
Etiologia i przyczyny

Rak kości (osteosarcoma) jest rzadkim, złośliwym nowotworem wywodzącym się z tkanki kostnej, którego etiologia pozostaje w większości przypadków nieznana. Zmiany genetyczne w komórkach kostnych, zarówno dziedziczne (np. zespół Li-Fraumeni z mutacją TP53, dziedziczne siatkówczaki z mutacją RB1), jak i nabyte, prowadzą do niekontrolowanego wzrostu komórek nowotworowych. Czynniki ryzyka obejmują ekspozycję na wysokie dawki promieniowania jonizującego, szczególnie u dzieci poddanych całkowitemu napromieniowaniu ciała przed przeszczepem komórek macierzystych, oraz chemioterapię alkilującą. Ponadto, niektóre łagodne schorzenia kości, takie jak choroba Pageta, enchondroma, osteochondroma, dysplazja włóknista czy przewlekłe zapalenie kości, mogą zwiększać ryzyko rozwoju kostniakomięsaka lub chrzęstniakomięsaka, zwłaszcza u osób powyżej 50-60 roku życia.

Etiologia raka kości

Mutacje genetyczne jako przyczyna raka kości
Dziedziczne uwarunkowania raka kości
Wpływ napromieniowania na rozwój raka kości
Wpływ chemioterapii na rozwój raka kości
Inne schorzenia kostne związane z rakiem kości
Czynniki demograficzne i inne czynniki ryzyka

Wtórny rak kości
Brak jasnych przyczyn i czynniki zapobiegawcze
Badania nad przyczynami raka kości
Podsumowanie etiologii raka kości

Kolejne rozdziały

Etiologia raka kości

Rak kości (osteosarcoma) jest rzadkim nowotworem złośliwym, który rozpoczyna się w tkance kostnej. W większości przypadków dokładna przyczyna rozwoju raka kości pozostaje nieznana. Badacze zidentyfikowali jednak szereg czynników, które mogą zwiększać ryzyko wystąpienia tego nowotworu¹².

Mutacje genetyczne jako przyczyna raka kości

Rak kości rozpoczyna się, gdy komórki w kości lub w jej pobliżu rozwijają zmiany w swoim DNA. DNA zawiera instrukcje, które wskazują komórce, co ma robić. W zdrowych komórkach DNA daje instrukcje do wzrostu i rozmnażania w określonym tempie oraz umierania w określonym czasie. W komórkach nowotworowych zmiany w DNA powodują inne instrukcje – nakazują komórkom nowotworowym szybko wytwarzać wiele więcej komórek. Komórki nowotworowe mogą żyć, gdy zdrowe komórki powinny umrzeć, co prowadzi do powstania guza¹³.

Chociaż niektóre osoby dziedziczą mutacje genów zwiększające ryzyko raka kości, zmiany genetyczne prowadzące do raka kości są zwykle nabywane w ciągu życia, a nie dziedziczone. Zmiany te czasami wynikają z czynników takich jak narażenie na promieniowanie, ale większość z nich to prawdopodobnie przypadkowe zdarzenia, które czasami zachodzą wewnątrz komórki, bez zewnętrznej przyczyny⁴.

Dziedziczne uwarunkowania raka kości

Niewielka liczba przypadków raka kości jest związana z dziedzicznymi schorzeniami. Do najważniejszych należą⁵⁶:

Zespół Li-Fraumeni – rzadkie zaburzenie genetyczne spowodowane mutacją genu supresorowego TP53, które znacząco zwiększa ryzyko rozwoju raka kości, a także kilku innych rodzajów nowotworów⁷⁸.
Dziedziczne siatkówczaki – charakteryzujące się mutacją genu RB1 na chromosomie 13q14. Osoby, które miały rzadki typ raka oka zwany siatkówczakiem w dzieciństwie, mogą być bardziej narażone na rozwój raka kości, ponieważ ta sama odziedziczona wadliwa mutacja genu może być odpowiedzialna za oba schorzenia⁵⁹.
Zespół Rothmunda-Thomsona – zwiększający ryzyko rozwoju kostniakomięsaka⁶.
Zespół Wernera – dziedziczne schorzenie związane z przedwczesnym starzeniem¹⁰.

Wpływ napromieniowania na rozwój raka kości

Ekspozycja na wysokie dawki promieniowania jonizującego jest dobrze udokumentowanym czynnikiem etiologicznym raka kości⁹. Wcześniejsza radioterapia, zwłaszcza w wysokich dawkach, może powodować zmiany nowotworowe w komórkach kostnych w późniejszym etapie życia, chociaż to ryzyko jest uważane za niewielkie⁵.

Ryzyko jest największe w obszarze, który był leczony radioterapią. Osoby, które otrzymały napromieniowanie całego ciała (tzw. całkowite napromieniowanie ciała) przed przeszczepem komórek macierzystych, mają najwyższe ryzyko rozwoju raka kości¹¹. Ryzyko to jest szczególnie wysokie, jeśli narażenie nastąpiło w dzieciństwie¹².

Wpływ chemioterapii na rozwój raka kości

Osoby leczone chemioterapią z powodu innych nowotworów mają zwiększone ryzyko rozwoju raka kości w późniejszym okresie życia. Dotyczy to szczególnie leków alkilujących¹²⁹. Ryzyko zwiększa się wraz z ilością podanego leku i jest szczególnie wysokie u dzieci leczonych tymi lekami¹¹.

Inne schorzenia kostne związane z rakiem kości

Niektóre nienowotworowe (łagodne) schorzenia dotyczące kości mogą zwiększać ryzyko rozwoju raka kości, chociaż ryzyko to nadal pozostaje niewielkie⁵. Do najważniejszych należą:

Choroba Pageta kości – nienowotworowe schorzenie kości, które występuje u niektórych starszych osób i może zwiększać ryzyko raka kości u osób powyżej 50-60 roku życia⁷. Osoby z chorobą Pageta mają zwiększone ryzyko rozwoju kostniakomięsaka, chociaż jest to rzadkie powikłanie¹³.
Enchondroma lub osteochondroma – łagodne guzy kości, które mogą zwiększać ryzyko rozwoju chrzęstniakomięsaka (chondrosarcoma) lub kostniakomięsaka (osteosarcoma)¹².
Choroba Olliera (enchondromatoza) – rzadkie schorzenie kości, które również może zwiększać ryzyko raka kości⁵.
Dysplazja włóknista – schorzenie, w którym zdrowa tkanka kostna zostaje zastąpiona tkanką włóknistą¹⁴.
Przewlekłe zapalenie kości i szpiku – długotrwałe zakażenie kości może zwiększać ryzyko rozwoju raka kości¹⁵.

Czynniki demograficzne i inne czynniki ryzyka

Badania epidemiologiczne wskazują na kilka innych czynników, które mogą mieć związek z rozwojem raka kości⁹:

Wiek – niektóre typy raka kości, zwłaszcza kostniakomięsak (osteosarcoma) i mięsak Ewinga, występują częściej u dzieci i młodych dorosłych, podczas gdy chrzęstniakomięsak (chondrosarcoma) jest częstszy u dorosłych¹². U młodych osób może to być związane ze zmianami zachodzącymi w rosnących kościach¹⁶.
Płeć – mężczyźni są bardziej narażeni na rozwój niektórych typów raka kości niż kobiety¹⁰.
Wzrost i wzrost kości – ryzyko kostniakomięsaka zwiększa się podczas gwałtownego wzrostu. Dlatego kostniakomięsak jest najczęstszy u dzieci i nastolatków, których ciała szybko się rozwijają¹⁷.
Przepuklina pępowinowa – badania wykazały, że niemowlęta urodzone z przepukliną pępowinową mają 3 razy większe ryzyko rozwoju mięsaka Ewinga, chociaż ryzyko to jest nadal bardzo małe⁵.
Przeszczep szpiku kostnego – osoby, które przeszły przeszczep szpiku kostnego w ramach leczenia innego schorzenia, mogą mieć zwiększone ryzyko rozwoju kostniakomięsaka¹⁸.
Metalowe implanty – osoby, które miały złamania naprawiane metalowymi implantami, mogą być bardziej narażone na rozwój kostniakomięsaka w późniejszym okresie¹⁹.
Historia innych nowotworów – historia raka piersi, płuc, prostaty, nerek lub tarczycy może zwiększać ryzyko rozwoju raka kości¹⁵.

Wtórny rak kości

Wtórny rak kości (przerzutowy) różni się od pierwotnego raka kości, ponieważ rozprzestrzenia się do kości z zaawansowanego nowotworu, takiego jak rak prostaty lub rak piersi. Jest to częstsze niż pierwotny rak kości²⁰.

Po przerzucie do kości, kość zaczyna replikować komórki raka prostaty lub raka piersi, zamiast osteoblastów i osteoklastów, które normalnie tworzą zdrowe kości²¹. Wtórny rak kości jest zawsze spowodowany pierwotnym nowotworem. Każdy rodzaj raka może rozprzestrzeniać się do kości, ale najczęstsze są rak prostaty, piersi, płuc, tarczycy i szpiczak²².

Brak jasnych przyczyn i czynniki zapobiegawcze

Mimo wszystkich znanych czynników ryzyka, dokładna przyczyna większości przypadków raka kości pozostaje nieznana²³. Większość osób, u których rozwija się rak kości, nie ma żadnych znanych czynników ryzyka. Zwykle występuje on bez wyraźnej przyczyny²³.

Nie zidentyfikowano żadnych konkretnych sposobów zapobiegania rakowi kości¹³. Według American Cancer Society nie istnieje znany sposób zapobiegania rakowi kości²⁴. Zapobieganie rakowi kości będzie wymagało lepszego zrozumienia jego przyczyn niż jest to obecnie dostępne²⁵.

Badania nad przyczynami raka kości

Naukowcy wciąż próbują dokładnie określić, co powoduje raka kości²⁴. Chociaż poczyniono duże postępy w badaniach nad tym zagadnieniem, wciąż nie mamy jednoznacznej odpowiedzi²⁴.

Trwające badania obejmują analizę czynników środowiskowych i społecznych, które mogą przyczyniać się do rozwoju raka kości²⁶. Niektóre badania sugerują, że bliskość ośrodków przemysłowych może zwiększać częstość występowania guzów kości u dzieci w promieniu 13 km²⁷. Obecność metali ciężkich w środowisku wiąże się z częstszym występowaniem chorób związanych z wiekiem, w tym raka, w populacji zamieszkującej to środowisko²⁷.

Zanieczyszczenia niemetaliczne, takie jak wielopierścieniowe węglowodory aromatyczne, stymulują enzymy produkujące wolne rodniki, zwiększając w ten sposób ryzyko uszkodzenia DNA, co jest jedną z dróg prowadzących do rozwoju raka²⁸. Badania wykazały również, że osoby w wieku 40 lat i starsze mieszkające w odległości 14 km od regionów przybrzeżnych są narażone na znacznie większe ryzyko wystąpienia nowotworów kości i tkanek miękkich²⁸.

Kilka grup badawczych bada komórki macierzyste raka i ich potencjał do wywoływania guzów, a także geny i białka powodujące różne fenotypy²⁹. Trwają również badania nad rolą fluoru w rozwoju raka kości, chociaż dotychczasowe wyniki nie wykazały zwiększonego ryzyka kostniakomięsaka związanego z fluoryzacją wody u ludzi³⁰.

Podsumowanie etiologii raka kości

Etiologia raka kości jest złożona i wieloczynnikowa. Dokładne przyczyny większości przypadków raka kości pozostają nieznane, choć zidentyfikowano szereg czynników ryzyka¹². Wśród nich znajdują się czynniki genetyczne (zespół Li-Fraumeni, dziedziczne siatkówczaki), wcześniejsza ekspozycja na promieniowanie jonizujące czy chemioterapię, a także istniejące schorzenia kości jak choroba Pageta⁶¹².

Przyczyny raka kości są aktywnie badane, a naukowcy wciąż odkrywają nowe mechanizmy i czynniki ryzyka. Lepsze zrozumienie etiologii tego rzadkiego nowotworu może prowadzić do opracowania skuteczniejszych strategii prewencyjnych i terapeutycznych w przyszłości²⁸.

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Materiały źródłowe

#1
#1 Bone cancer – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/bone-cancer/symptoms-causes/syc-20350217
The cause of most bone cancers isn’t known. Bone cancer starts when cells in or near a bone develop changes in their DNA. A cell’s DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells. […] Healthcare professionals haven’t found any ways to prevent bone cancer.
#2 What Causes Bone Cancer? | American Cancer Society
https://www.cancer.org/cancer/types/bone-cancer/causes-risks-prevention/what-causes.html
The information here focuses on primary bone cancers (cancers that start in bones) that most often are seen in adults. […] There are different types of primary bone cancers (cancers that start in the bones), and while they might have some things in common, these different cancers most likely do not all have the same causes. […] Researchers have found some risk factors for bone cancer, but often its not clear exactly how these factors might affect how cells in the bones become cancer cells. […] Scientists have learned how certain changes in the DNA in bone cells can cause them to become cancerous. […] Cancers can be caused by gene mutations (defects) that create oncogenes, or that turn off tumor suppressor genes. […] Some people inherit gene mutations (changes) from a parent that increase their risk of bone cancer.
#3 Osteosarcoma – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/osteosarcoma/symptoms-causes/syc-20351052
Osteosarcoma is a kind of bone cancer. It most often starts in the long bones of the legs or the arms. But it can happen in any bone. […] Osteosarcoma happens when bone cells develop changes in their DNA. A cell’s DNA holds the instructions, called genes, that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. […] In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells. […] Most people with osteosarcoma don’t have any known risk factors for the cancer. But these factors can increase the risk of osteosarcoma: Certain conditions that run in families. These include hereditary retinoblastoma, Bloom syndrome, Li-Fraumeni syndrome, Rothmund-Thomson syndrome and Werner syndrome. […] There is no way to prevent osteosarcoma.
#4 What Causes Bone Cancer? | American Cancer Society
https://www.cancer.org/cancer/types/bone-cancer/causes-risks-prevention/what-causes.html
But the gene changes leading to bone cancer are usually acquired during life rather than inherited from a parent. […] These changes sometimes result from factors such as exposure to radiation, but most of these changes are probably just random events that sometimes happen inside a cell, without having an outside cause.
#5
https://www.nhs.uk/conditions/bone-cancer/causes/
In particular, a condition called Paget’s disease of the bone can increase the risk of bone cancer in people over 50 to 60 years of age. […] Rarer conditions that cause tumours to grow in your bones, such as Ollier’s disease, can also increase your risk of bone cancer. […] A rare genetic condition called Li-Fraumeni syndrome can increase your risk of developing bone cancer, as well as several other types of cancer. […] People who had a rare type of eye cancer called retinoblastoma as a child may be more likely to develop bone cancer, because the same inherited faulty gene can be responsible for both conditions. […] Research has also found that babies born with an umbilical hernia are 3 times more likely to develop a type of bone cancer called Ewing sarcoma, although the risk is still very small.
#5
https://www.nhs.uk/conditions/bone-cancer/causes/
Cancer occurs when the cells in a certain area of your body divide and multiply too rapidly. This produces a lump of tissue known as a tumour. […] The exact reason why this happens is often not known, but certain things can increase your chance of developing bone cancer, including: previous radiotherapy treatment, other bone conditions, such as Paget’s disease of the bone, rare genetic conditions, such as Li-Fraumeni syndrome, a history of certain other conditions, including retinoblastoma and umbilical hernia. […] Previous exposure to high doses of radiation during radiotherapy may cause cancerous changes in your bone cells at a later stage, although this risk is thought to be small. […] Some non-cancerous (benign) conditions affecting the bones may increase your chances of developing bone cancer, although the risk is still small.
#6 Primary Bone Cancer – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK560830/
Primary bone cancer is a rare malignant tumor of the bone originating from primitive mesenchymal cells. This condition accounts for around 0.2% of all malignancies worldwide and is idiopathic in most cases. Multiple subtypes are prevalent, with osteosarcoma, chondrosarcoma, and Ewing sarcoma being the most common. Each varies in demographics, imaging appearance, and biological behavior. They are frequently aggressive and require early diagnosis, utilizing imaging and tissue biopsy. Surgical excision remains the mainstay of curative treatment, with chemotherapy and radiotherapy used in conjunction. […] Though primary bone cancer is most often idiopathic, risk factors also play a role in developing this cancer. […] Genetic factors are linked. Germline abnormalities in hereditary cancer predisposition syndromes have an increased risk of later developing bone cancer through the downregulation of tumor suppressor genes or upregulation of oncogenes. The TP53 tumor suppressor gene is often altered in Li-Fraumeni syndrome, putting patients at an increased risk of developing osteosarcoma. Similarly, a mutation in the Rb1 gene leading to hereditary retinoblastoma is linked to osteosarcoma. Werner and Rothmund-Thomson syndromes are also linked to an increased risk of developing osteosarcoma.
#7 Bone cancer | NHS inform
https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/bone-cancer/
Previous exposure to high doses of radiation during radiotherapy may cause cancerous changes in your bone cells at a later stage, although this risk is thought to be small. […] Some non-cancerous (benign) conditions affecting the bones may increase your chances of developing bone cancer, although the risk is still small. […] In particular, a condition called Pagets disease of the bone can increase the risk of bone cancer in people over 50 to 60 years of age. […] A rare genetic condition called Li-Fraumeni syndrome can increase your risk of developing bone cancer, as well as several other types of cancer. […] People who had a rare type of eye cancer called retinoblastoma as a child may be more likely to develop bone cancer, because the same inherited faulty gene can be responsible for both conditions. […] Research has also found that babies born with an umbilical hernia are three times more likely to develop a type of bone cancer called Ewing sarcoma, although the risk is still very small.
#8 Bone Cancer Causes & Risk Factors: Is it Hereditary?
https://www.cancercenter.com/cancer-types/bone-cancer/risk-factors
Cancers that start in the bones (known as primary bone cancer) are uncommon, representing fewer than 1 percent of all cancer cases diagnosed, according to the American Cancer Society. […] The exact causes of bone cancer are unknown, but certain factors may increase a person’s risk for developing bone cancer. Some examples are genetic disorders and previous treatments for other conditions. […] Several hereditary syndromes caused by mutations in specific genes are considered risk factors for bone cancer, including: Li-Fraumeni syndrome, Rothmund-Thompson syndrome and mutation of the retinoblastoma gene (associated with a rare eye cancer) have been associated with an increased risk in children for developing osteosarcoma. […] Multiple exostoses syndrome (also known as multiple osteochondromas syndrome), an inherited condition associated with bumps of cartilage on the bones, has been associated with an increased risk for chondrosarcoma.
#9 The etiology of osteosarcoma – PubMed
https://pubmed.ncbi.nlm.nih.gov/20213384/
Studies to determine the etiology of osteosarcoma involve epidemiologic and environmental factors and genetic impairments. […] Factors related to patient characteristics include age, gender, ethnicity, growth and height, genetic and familial factors, and preexisting bone abnormalities. […] Genetic aberrations that accompany osteosarcoma have received increasing recognition as an important factor in its etiology. […] A genetic predisposition to osteosarcoma is found in patients with hereditary retinoblastoma, characterized by mutation of the retinoblastoma gene RB1 on chromosome 13q14. […] The Li-Fraumeni syndrome is an autosomal dominant disorder characterized by a high risk of developing osteosarcoma and has been found in up to 3% of children with osteosarcoma. […] Osteosarcoma has also been associated with solitary or multiple osteochondroma, solitary enchondroma or enchondromatosis (Ollier’s disease), multiple hereditary exostoses, fibrous dysplasia, chronic osteomyelitis, sites of bone infarcts, sites of metallic prostheses and sites of prior internal fixation. […] Ionizing radiation is a well-documented etiologic factor. […] Exposure to alkylating agents may also contribute to its development, and it is apparently independent of the administration of radiotherapy.
#10 Primary Bone Cancer | Types, Causes and Treatment | Bone Tumor
http://www.drsatishortho.com/orthopedic-conditions/musculoskeletal-tumour/bone-tumour
Bone cancer can occur in any bone in our body. It begins when the healthy cells in the bone grow uncontrollably and form a mass called a tumor. The exact cause of bone tumors is unknown. A few possible causes are genetics (family history), previous radiation treatments, treatment with certain anticancer drugs, and some injuries to the bones. […] Other risk factors that may cause primary bone cancer include: A prior history of other cancers like breast, lung, prostate, kidney, or thyroid cancer. Paget’s disease (a noncancerous bone condition). Injury to a bone, causing chronic infection. […] Some inherited conditions such as: Retinoblastoma, an eye malignancy with retinal origins; Li-Fraumeni syndrome (an inherited familial disorder due to a small change in a tumour suppressor gene known as TP53); Rothmund-Thomson syndrome (a rare condition characterized by abnormalities of the skin, hair, eyelashes, and eyebrows); Werner syndrome (hereditary condition associated with premature aging). […] Males are more likely to develop bone tumor like osteosarcoma than females. Race is also a risk factor for primary bone cancers. Multiple myeloma is common in blacks, while Ewing sarcoma is more common in whites than in blacks or Asians.
#11 Risks for bone cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/bone/risks
Some things can affect your risk, or chance, of developing cancer. Certain behaviours, substances or conditions can increase or decrease the risk. Most cancers are the result of many risks. But sometimes bone cancer develops in people who don’t have any risks. […] Several things could increase your risk for bone cancer. None of these risks can be changed. Until we learn more about these risks, there are no specific ways you can lower your risk for bone cancer. […] The following can increase your risk for bone cancer: exposure to radiation, bone disorders or conditions, genetic conditions, previous chemotherapy. […] High-dose radiation therapy used to treat childhood cancers can increase the risk for bone cancer. The risk is greatest in the area that was treated with radiation. People who had their entire body treated with radiation (called total body irradiation) before a stem cell transplant have the highest risk of developing bone cancer.
#11 Risks for bone cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/bone/risks
High levels of ionizing radiation causes a high risk for bone cancer. For example, people coming into contact with radiation from an atomic bomb have a higher risk for bone cancer, especially for people who were children when they were exposed. […] Exposure to radium increases the risk for bone cancer. […] A genetic condition is a disease caused by a change (mutation) in one or more genes. Having certain genetic conditions increases the risk of developing bone cancer. […] Children with cancer who are treated with a type of drug called an alkylating agent have a higher risk of developing bone cancer later in life. The risk increases with the amount of the drug given.
#12 Risks and causes of bone cancer | Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/bone-cancer/risks-causes
We dont know what causes most bone cancers. But there are some risks factors that can increase your risk of developing it. Some of these include your age, exposure to ionising radiation and inherited conditions. […] Like most cancers, the risk of bone cancer increases with age. But for some types of bone cancer, younger people have a higher risk. […] Exposure to high energy (ionising) radiation can cause cancer. This is because it can affect your cells and damage the DNA. […] Having radiotherapy for cancer in the past can increase your risk of developing bone cancer. This risk is highest if you have had radiotherapy as a child. […] People who have had treatment with chemotherapy drugs called alkylating agents have an increased risk of developing bone cancer. […] Some types of bone disease can increase the risk of bone cancer: Enchondroma or osteochondroma are non cancerous (benign) bone tumours. If you have these tumours, you are at an increased risk of getting types of bone cancer called chondrosarcoma or osteosarcoma.
#13 Primary Bone Cancer – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK560830/
Previous treatment for cancer with radiotherapy is linked to an increased risk of developing primary bone cancer in later life, particularly when exposed to ionizing radiation in childhood. […] Several benign conditions show the potential to progress to primary bone cancer. Paget disease of the bone is a condition characterized by a disorder of bone metabolism, particularly osteoclastic function. These patients are at an increased risk of developing osteosarcoma; however, it is a rare complication. Enchondromas and osteochondromas are benign cartilaginous neoplasms that can later develop into malignant chondrosarcoma.
#14 Bone Cancer Causes and Diagnoses | Northwestern Medicine
https://www.nm.org/conditions-and-care-areas/cancer-care/sarcoma-program/bone-cancer/causes-and-diagnoses
Specialists are unsure of the exact cause of most bone cancers. […] Certain conditions or factors can increase your chances of developing bone cancer, including: […] For example, children with hereditary retinoblastoma, a type of eye cancer, have an increased risk of developing osteosarcoma. […] Radiation treatment for other conditions or cancers increases risk of bone cancer at the site of the radiation therapy. […] Some chemotherapy medicines used to treat cancer may increase the risk of developing a secondary cancer, usually osteosarcoma. […] Pagets disease of the bone may lead to osteosarcoma. […] Other noncancerous bone diseases, such as fibrous dysplasia, may increase the risk of osteosarcoma.
#15 Bone Cancer: Causes, Symptoms & Treatment | UPMC
https://www.upmc.com/services/orthopaedics/conditions/bone-cancer
No one knows the main cause of bone cancer. We do know that genetics play a role in most cases. […] Gene changes are often to blame for bone cancer, because they make cancer cells grow. Scientists are trying to learn more about these gene changes, but they don’t yet understand what causes them. […] Certain factors may raise your risk for getting bone cancer, including: A history of breast, lung, prostate, kidney, or thyroid cancer. […] Having certain types of benign bone tumors linked to developing bone cancer. […] Paget’s disease (a noncancerous bone condition). […] Exposure to radiation. […] Injury to a bone, which has caused a chronic infection. […] A family history of bone cancer.
#16 Primary Bone Cancer | Types, Causes and Treatment
https://patient.info/cancer/primary-bone-cancer
Primary bone cancer occurs where a cancer originates in a bone. It is a rare type of cancer. […] What causes primary bone cancer? […] A cancerous (malignant) 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’. 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 to treat other problems. Paget’s disease of bone. This is a disease of the bone which occurs in some older people. An osteochondroma (chondroma). This is a non-cancerous (benign) bone tumour which occasionally turns into a chondrosarcoma. Certain rare inherited disorders including: Li-Fraumeni syndrome, hereditary multiple exostoses (HME) and hereditary retinoblastoma. Ollier’s disease (enchondromatosis) – a rare bone condition. […] There is no evidence that having a previous injury to a bone increases your risk of developing bone cancer in the future.
#17 Osteosarcoma (Osteogenic Sarcoma): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15041-osteosarcoma
Osteosarcoma is a type of bone cancer. In the beginning, the cancer cells appear to be regular bone cells. Then, they create malignant (cancerous) tumors, and those tumors create irregular, diseased bone. […] Experts aren’t certain what causes osteogenic sarcoma. Some causes may include: […] Rapid bone growth. The risk of osteosarcoma increases during growth spurts. That’s why osteogenic sarcoma is most common in kids and teens whose bodies are developing rapidly. […] Exposure to radiation. Exposure to radiation at work, in the environment or as part of radiation therapy to treat other types of cancer may cause osteogenic sarcoma. […] Genetic factors. A genetic change (mutation) that affects your p53 gene may cause some kinds of cancers, including osteosarcoma. […] Bone infarction. This happens when something cuts off blood supply to your bone tissue. This lack of blood destroys healthy bone cells and may cause cancerous osteogenic sarcoma cells to form.
#18 Bone Cancer Causes & Risk Factors: Is it Hereditary?
https://www.cancercenter.com/cancer-types/bone-cancer/risk-factors
Some osteosarcomas and chordomas have been found to run in families, but the underlying genetic mutation has not been identified. […] Paget’s disease has been associated with bone cancer in approximately 1 percent of individuals. […] Patients with many benign cartilage tumors, known as enchondromas, are at increased risk for developing chondrosarcoma. […] Exposing bones to high doses of radiation, such as the type of radiation therapy used in cancer treatments, may increase the risk of a primary bone cancer forming in those areas. […] Individuals who have undergone a bone marrow transplant for the treatment of another condition may be at an increased risk for developing osteosarcoma.
#19 Bone Tumor: Types, Causes, and Symptoms
https://www.healthline.com/health/bone-tumors
The causes of bone tumors arent known. A few possible causes are genetics, radiation treatment, and injuries to the bones. Osteosarcoma has been linked to radiation treatment (particularly high doses of radiation) and other anticancer drugs, especially in children. However, a direct cause hasnt been identified. […] The tumors often occur when parts of the body are growing rapidly. People whove had bone fractures repaired with metal implants are also more likely to develop osteosarcoma later.
#20 July is Bone Cancer Awareness Month – Know the Types, Causes and Symptoms – Rocky Mountain Oncology Center
https://rockymountainoncology.com/news/july-is-bone-cancer-awareness-month-know-the-types-causes-and-symptoms/
Bone cancer can be found in any bone of the body and has the potential to spread. […] Although it is less common than other cancer types, its good to be proactive and understand the different kinds of bone cancer, whos at risk and the symptoms associated. […] There are many types of primary bone cancer. […] The risk of chondrosarcoma increases with age. […] Ewing sarcoma is a group of tumors that start in the bone or nearby soft tissues. […] Osteosarcoma is the most common type of primary cancer. […] Bone metastasis differs from primary bone cancer because it spreads into the bone from an advanced cancer such as prostate cancer or breast cancer. […] This is more common than primary bone cancer. […] Common symptoms associated with most types of bone cancer are pain, a lump or swelling, and fractures.
#21 Bone Cancer: Causes, Symptoms & Treatments
https://www.cancercenter.com/cancer-types/bone-cancer
These previous treatments may also play a role: Radiation therapy, such as the type used in cancer treatments, which may allow radioactive minerals to build up in the bones. […] Secondary bone cancer results when cancer cells such as prostate cancer, lung cancer, or breast cancer metastasize in the bone. After bone metastasis, the bone begins replicating prostate cancer cells or breast cancer cells, rather than the osteoblast and osteoclast cells that normally comprise healthy bones.
#22 Secondary bone cancer | Cancer Council
https://www.cancer.org.au/cancer-information/types-of-cancer/secondary-bone-cancer
Secondary bone cancer is always caused by a primary cancer. This is when cancer cells spread to the bone from a primary cancer such as prostate cancer. […] Secondary bone cancer is more common than primary bone cancer as the bone is one of the most common sites cancer spreads to. Any type of cancer can spread to the bones but the most common are prostate, breast, lung, thyroid and myeloma.
#23 Bone Cancer: Symptoms, Treatment & Outlook
https://my.clevelandclinic.org/health/diseases/17745-bone-cancer
Bone cancers can start in any bone, but they more commonly form in your thigh bone, shin bone or upper arm. […] Cancers that form in the bone itself are called primary bone cancers or bone sarcomas. […] Experts aren’t certain what causes bone cancers. But as with other cancers, bone tumors form when problems with cell DNA cause cells to grow out of control. […] Researchers have found links between bone cancers and other factors that may increase your risk. Risk factors for bone cancers include: Previous cancer treatment. Radiation therapy and some chemotherapy drugs to treat other cancers may increase your risk of developing bone cancer in the future. […] Still, most people who develop bone cancers don’t have any risk factors. It usually happens without cause.
#24 What Causes Bone Cancer? | Immunity Therapy Center
https://www.immunitytherapycenter.com/blog/what-causes-bone-cancer/
Scientists are still trying to discover exactly what causes bone cancer. […] At this time, the American Cancer Society notes that there is no known way for how to prevent bone cancer. […] Many people want to know how do you get bone cancer, and though great strides have been made toward researching it, we dont have a definitive answer yet. […] A small number of bone cancers, particularly osteosarcomas, seem to be hereditary. […] These are caused by defects, or mutations, in genes. […] People with this mutation have an increased risk of developing both a soft tissue sarcoma and a bone sarcoma. […] The risk increases if radiation is used to treat the retinoblastoma which can lead to osteosarcoma in the bones or around the eyes. […] Family members have been known to develop osteosarcoma with no inherited changes in the known genes, yet the defects that perhaps cause cancer in the families have not yet been discovered.
#25 Bone cancer | Description, Types, Symptoms, & Treatment | Britannica
https://www.britannica.com/science/bone-cancer
bone cancer, disease characterized by uncontrolled growth of cells of the bone. Primary bone cancer that is, cancer that arises directly in the bone is relatively rare. […] Only a small portion of bone cancer cases are associated with known risk factors, which include exposure to radiation or chemotherapy, Paget disease, and rare hereditary syndromes such as hereditary retinoblastoma. The majority of cases seem to occur randomly in otherwise healthy individuals. […] Prevention of bone cancer will require a better understanding of its causes than is currently available.
#26 Analyzing socio-environmental determinants of bone and soft tissue cancer in Indonesia | BMC Cancer | Full Text
https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-11974-8
This study is designed to explore the potential impact of individual and environmental residential factors as risk determinants for bone and soft tissue cancers, with a particular focus on the Indonesian context. […] While it is widely recognized that our living environment can significantly influence cancer development, there has been a notable scarcity of research into how specific living environment characteristics relate to the risk of bone and soft tissue cancers. […] Both bivariate and multivariate analyses revealed two significant factors associated with the occurrence of bone and soft tissue cancer. Age exhibited a statistically significant influence (OR of 5.345 and a p-value of 0.0000.05), indicating a robust connection between cancer development and age. Additionally, residing within a distance of less than 14 km from the sea significantly affected the likelihood of bone and soft tissue cancers OR 5.604 and p-value (0.0010.05).
#27 Analyzing socio-environmental determinants of bone and soft tissue cancer in Indonesia | BMC Cancer | Full Text
https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-11974-8
The study underscores the strong association between age and the development of these cancers, emphasizing the need for heightened vigilance and screening measures in older populations. Moreover, proximity to the sea emerges as another noteworthy factor influencing cancer risk, suggesting potential environmental factors at play. […] These results highlight the multifaceted nature of cancer causation and underscore the importance of considering socio-environmental variables when assessing cancer risk factors. […] There is limited information in the literature on environmental influences on the incidence of bone and soft tissue tumors. […] There is one piece of literature that states that proximity to industrial centers increases the prevalence of bone tumors in children by 13 km. […] The presence of heavy metals in an environment is linked to the incidence of age-related diseases, including cancer, within the population residing in that environment.
#28 Analyzing socio-environmental determinants of bone and soft tissue cancer in Indonesia | BMC Cancer | Full Text
https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-11974-8
Non-metallic pollutants, like polycyclic aromatic hydrocarbons, stimulate enzymes that produce free radicals, thereby elevating the risk of DNA damage, which is one of the pathways to cancer development. […] The examination of socio-environmental risk factors for bone and soft tissue cancer through the use of statistical models has played a crucial role in unraveling the complexities of this disease. […] While previous research has made significant progress in understanding the biological impact of pollution on non-human ecosystems, there is a noticeable research gap concerning its effects on human health, specifically in the context of bone and soft tissue malignancies in Indonesia. […] The study’s objective is to offer insights into the risk factors and root causes of these particular malignancies, thereby enhancing our overall comprehension of how pollution affects human health. […] Individuals aged 40 and older residing within a 14-km proximity to coastal regions are identified as significant risk factors for bone and soft tissue cancers.
#29 Osteosarcoma – Wikipedia
https://en.wikipedia.org/wiki/Osteosarcoma
Osteosarcoma is the most common histological form of primary bone sarcoma. […] Several research groups are investigating cancer stem cells and their potential to cause tumors along with genes and proteins causative in different phenotypes. […] Radiotherapy for unrelated conditions may be a rare cause. […] A small supernumerary marker chromosome or a giant rod chromosome is present in the tumor cells of low grade OS including low grade central OS and paraosteal OS, carry various potentially pro-cancerous genes, and are thought to contribute to the development of these OS. […] Familial cases where the deletion of chromosome 13q14 inactivates the retinoblastoma gene is associated with a high risk of osteosarcoma development. […] Bone dysplasias, including Paget’s disease of bone, fibrous dysplasia, enchondromatosis, and hereditary multiple exostoses, increase the risk of osteosarcoma.
#30 Osteosarcoma – Wikipedia
https://en.wikipedia.org/wiki/Osteosarcoma
Li-Fraumeni syndrome (germline TP53 mutation) is a predisposing factor for osteosarcoma development. […] Rothmund-Thomson syndrome is associated with increased risk of this disease. […] Large doses of Sr-90, nicknamed bone seeker, increases the risk of bone cancer and leukemia in animals and is presumed to do so in people. […] There is no clear association between water fluoridation and cancer or deaths due to cancer, both for cancer in general and also specifically for bone cancer and osteosarcoma. […] Fluoride concentration levels in water supplies are regulated, such as United States Environmental Protection Agency regulates fluoride levels to not be greater than 4 milligrams per liter. […] Yet, further research shows no osteosarcoma risks from fluoridated water in humans. […] The statistic analysis of the data shows no significant difference in occurrences of osteosarcoma cases in different fluoridated regions. […] The result is that the median fluoride concentrations in bone samples of osteosarcoma patients and tumor controls are not significantly different. […] Fluoride exposures of osteosarcoma patients are also proven to be not significantly different from healthy people.