Sarcomas are cancers of the tissues that form bones, muscles, tendons, fat, blood vessels and nerves. Sarcomas are named more specifically by the type of tissue that they have arisen from, for example, sarcomas of fat are called lipo-sarcomas, sarcomas from bone are called osteo-sarcomas. Some sarcomas are so bizarre it is impossible to tell what they developed from and these are often given descriptive names, for example, pleomorphic sarcoma. They occur most commonly in children and teenagers but can affect people of any age. The limbs are the usual site of involvement but sarcomas can affect almost any part of the body. Treatment usually involves a combination of chemotherapy, radiation therapy and surgery and may extend over many months. It will often require major surgery that involves removal of muscles and bones and sometimes amputation. Despite this aggressive treatment the cure rate is in the order of 50%.

Chondrosarcoma	Sarcoma arising from cartilage cells
Ewing’s sarcoma	Sarcoma arising from bone marrow cells
Malignant fibrous histiocytoma	Sarcoma arising from a cell of unknown origin
Osteosarcoma	Sarcoma arising from bone cells
Liposarcoma	Sarcoma arising from fat
Leiomyosarcoma	Sarcoma arising from muscle found in blood vessels or the uterus
Rhabdomyosarcoma	Sarcoma arising from muscle used for movement
Malignant peripheral nerve sheath tumour	Sarcoma arising from a nerve
Synovial sarcoma	Sarcoma arising from a cell that remains unknown

Bone Cancer

Secondary bone cancer is cancer that has started in another place and has spread to the bones. This happens most commonly with breast and prostate cancer. Cancer that spreads to bone causes weakening of the bone and can result in the bone breaking. Damage to the bone often leads to pain and loss of function (it can also cause metabolic disturbances due to the breakdown of bone tissues). Treatment may involve a combination of chemotherapy, radiation therapy and surgery. Surgery may involve stabilisation or even replacement of weakened bones with metallic prostheses.

Osteoporosis

Osteoporosis means porous bones, which are more susceptible to fractures. Indians are thought to be particularly prone to osteoporosis. Osteoporosis, which literally means porous bone, is a disease in which the density and quality of bone are reduced. As bones become more porous and fragile, the risk of fracture is greatly increased. The loss of bone occurs silently and progressively. Often there are no symptoms until the first fracture occurs.

There are several good remedies available for osteoporosis. Consult your doctor (endocrinologist) for the right choice of drug. Calcium vitamin D and exercise remain the mainstay of any program, regardless of which specific drug is used.

 Causes osteoporosis

Our bones are living tissue and constantly changing. From the moment of birth until young adulthood, bones are developing and strengthening. Our bones are at their most dense in our early 20s – called peak bone mass

Children are the best bone builders. The growing years are the most important for building our bank balance (calcium and mineral in the bone). Adequate intake of milk and milk products during this period is a must, as is regular exercise (outdoor sports) and sunlight exposure. Beyond adulthood, most effort is directed toward preventing or slowing bone loss.

Osteoporosis is a silent disease, since bone loss is without symptoms, till a fracture actually occurs.Your bones are the frame on which your body is built. Weak bones (“osteoporosis”) means a weak frame, which tends to break easily. That is why it is important to have healthy, strong bones.

As we age some of our bone cells begin to dissolve bone matrix (resorption), while new bone cells deposit osteoid (formation). This process is known as remodeling.

For people with osteoporosis, bone loss outpaces the growth of new bone. Bones become porous, brittle and prone to fracture

Osteoporotic fractures

Around the world, 1 in 3 women and 1 in 5 men are at risk of an osteoporotic fracture. In fact, an osteoporotic fracture is estimated to occur every 3 seconds. The most common fractures associated with osteoporosis occur at the hip, spine and wrist. The likelihood of these fractures occurring, particularly at the hip and spine, increases with age in both women and men.

Of particular concern are vertebral (spinal) and hip fractures. Vertebral fractures can result in serious consequences, including loss of height, intense back pain and deformity. A hip fracture often requires surgery and may result in loss of independence or death.

Risk factors for osteoporosis

Risk factors for osteoporosis include: female sex, thin built, old age, family history of osteoporosis, early menopause or amenorrhoea, sedentary life style, smoking, poor calcium intake and vitamin D deficiency. Both calcium deficiency and vitamin D deficiency are very common in urban Indians.

Osteoporosis is diagnosed by measuring bone density, which is ideally performed using DEXA densitometer. Ideally all women at menopause and all individuals over 65 should uindergo this test.

Prevention, diagnosis and treatment

The good news is there are many steps that can be taken to prevent and diagnosis osteoporosis. It’s now a largely treatable condition and, with a combination of lifestyle changes and appropriate medical treatment, many fractures can be avoided. There are several good remedies available for osteoporosis. Consult your doctor (endocrinologist) for the right choice of drug. Calcium vitamin D and exercise remain the mainstay of any program, regardless of which specific drug is used.