What is chondrosarcoma?
Chondrosarcoma is a group of bone cancers. What they have in common is that their cells can produce cartilage matrix.
It’s the third most common primary cancer in bone. (Only myeloma and osteosarcoma are more common.)
What causes chondrosarcoma?
No one is sure about what causes chondrosarcoma, as most of them arise on their own (de novo). However, sometimes chondrosarcomas develop from benign tumors of cartilage. Some examples of these are enchondromas or osteochondromas.
What are the kinds of chondrosarcoma? How does chondrosarcoma behave?
There are a couple of ways to describe and classify chondrosarcomas. Conventional chondrosarcomas are classified based on their location in the bone. Central chondrosarcomas start off in the central (medullary) portion of the bone. Peripheral chondrosarcomas and periosteal chondrosarcomas are located in the surface regions. There’s also a juxtacortical chondrosarcoma ; these have been reported to have a good prognosis.
How they behave depends on several factors. An important one is their grade, or differentiation. That’s a fancy word for describing how aggressive they look under the microscope.
Most of them are low grade. They grow slowly, and rarely metastasize. If its located in a place that’s accessible by surgery, then that is the best treatment option. Radiation therapy can be useful for places that are unresectable.
There are some other special subtypes of chondrosarcoma that more considered more aggressive. This includes mesenchymal chondrosarcoma and dedifferentiated chondrosarcoma. Chemotherapy becomes an important consideration for these types of chondrosarcomas.
What studies are used to evaluate chondrosarcoma?
CT scans and MRI scans are both important and often used to determine the location and amount of bone and soft tissue that is involved.
What is the right treatment for chondrosarcoma?
Surgery remains an important treatment for intermediate and high grade tumors. Wider excisions are generally needed for these higher grade chrondrosarcomas. However, sometimes, these higher grade tumors develop metastatic disease, or come back locally.
There’s still more work to be done in order to figure out what role chemotherapy plays, and what is the best chemotherapy for chondrosarcoma too. Radiation therapy for chondrosarcoma is also often recommended when there is a positive margin after surgery.
Clinical trials continue today to help answer these questions. In the meantime, it’s important for surgeons and oncologists to communicate together and decide what the best treatment options are for you.
Questions to ask the doctor about chondrosarcoma:
– What are my treatment options for chondrosarcoma?
– What are the benefits of each treatment option?
– What are the expected and possible side effects of each option?
– What do you think is the best option for me?