Pathology: The study of structural and functional changes that disease causes.
BONE CANCER
Cancer: When normal control of cells is lost and they begin to grow and divide out of control. These cells become abnormal and their functions are altered. They can be destructive to the surrounding, normal cells.
Tumor: A collection of abnormal cells grouped together. Benign tumors do not spread, while malignant, or cancerous, tumors can. This is called metastasizing. The cancer cells enter the body’s bloodstream or lymphatic system and travel to other body sites, which is usually when cancer becomes fatal.
Causes: Bone cancer is cancer that arises from cells that make up the bone, causing a malignant tumor to form on the bone. The main types of bone cancer include osteosarcoma, Ewing’s sarcoma, chondrasarcoma, malignant fibrous, histiocytoma, fibrosarcoma, and chordoma. A cancerous tumor on a bone can be seen on the right.
Symptoms: The most common symptom is pain that becomes more sever over time and in some cases is only present at night or during activity. Sometimes a mass or a lump can be felt on the bone or surrounding tissues. The bone is weakened by the tumor and can fracture from little or no trauma. There might also be numbness, tingling, or constricted blood flow in the area of the bone cancer. If it metastasizes, one might experience fever, chills, night sweats, or weight loss.
Treatment: Diagnosis can be done with x-rays, CAT scans, MRI, bone scans, or biopsies. Treatments of bone cancer are surgery, chemotherapy, and radiation therapy. It depends on the type of bone cancer, its location, how aggressive it is, and whether or not it has begun to metastasize, but often more than one of these methods is necessary.
Surgery aims to remove the tumor completely, along with a surrounding area of bone. Traditionally this was done through amputation but newer techniques allow only the affected portion of the bone to be removed. The part of the bone that is taken away is then replaced with bone cement, a bone graft, or metal implants. Complications include infection, recurrence of the cancer, injury to the surrounding areas, loss of sensation, weakness, and bone fracture.
Chemotherapy uses various medications to try to stop the growth of cancer cells by killing them. It may be used before surgery to shrink the tumor or it may be used afterwards to kill any cancer cells that might remain. Normal cells may also be killed in the process and side affects include hair loss, nausea and vomiting, infection, and fatigue, but these usually resolve after treatment is completed.
Radiation therapy uses high-energy x-rays aimed at the site of the tumor to try to kill the abnormal cells. It is given daily in small does for a period of days to months. Like chemotherapy, it may be used before or after surgery. Side affects include fatigue, loss of appetite, and damage to surrounding skin and soft tissues.
Treatment is more often than not successful and the 5-year survival rate of bone cancer is 70%.
SPINA BIFIDA
Causes: Spina bifida is a birth defect where the laminae of the vertebrae fail to unite during the first few months of pregnancy, causing the neural ach to remain incomplete and the contents of the vertebrae to protrude outward. It is most common in the lumbar or sacral region of the spine. Spina bifida occulta is a mild case that is extremely common but causes no symptoms or complications and is not visible. Spina bifida cystica is a much more severe form of the defect. It is thought that if mothers take folic acid while pregnant, most cases can be prevented.
Symptoms: In some cases the meninges (protective layers that surround the spinal cord) may bulge through the open vertebral laminae, resulting in a prominent fluid filled sac called a meningocele to form beneath the skin of the back. In spina bifida cystica a section of the spinal cord and nerves that stem from it are exposed and visible on the outside of the body. If gone untreated, it is often fatal and those who do survive are severely disabled.
Treatment: The only treatment is surgery. This done in the first 48 hours of the infant’s life and antibiotics are given before to prevent infection of the exposed spinal cord and nerves. Surgery makes survival almost certain, but it often leaves some degree of permanent paralysis (usually of the lower limbs) and difficulties with bowel and bladder functions. Sometimes mental retardation or learning disorders are also present.
ENDOCRINE DISORDERS
Acromegaly: The overproduction of growth hormone.
Symptoms: The early symptoms of Acromegaly include headaches, joint pain, fatigue, and depression. As the condition worsens enlarged heart, bones, thyroid gland, facial features, hands, feet, and head are all affects of the disease. What causes the facial features to distort is the overproduction of cartilage.
Causes: Acromegaly is caused by overproduction by the pituitary gland. The pituitary gland is relatively small and located at the base of the brain and produces many important hormones to maintain the body functions for instance growth, development, reproduction, and metabolism. The hormone that the pituitary gland overproduces is one that deals with the growth of the body.
1 Symptoms of acromegaly
Treatments: The current treatments include surgical removal of the tumor, drug therapy, and radiation therapy.
Surgery is rapid and effective. The doctor would get to the tumor through the nose and would get rid of the tumor tissue through transphenoidal surgery. This surgery should relieve the pressure on the brain quickly and the levels of certain hormones would go back to normal. Some complications of this procedure are cerebrospinal fluid leaks, meningitis, or damage to the surrounding normal pituitary tissue, which would then make lifelong pituitary hormone replacement a necessity.
Drug Therapy is another option in the treatment for Acromeagaly. The side effects are gastrointestinal upset, nausea, vomiting, light-headedness while standing, and nasal congestion. These side effects won’t be as harsh if the drugs are taken in cautious manner.
Radiation therapy can cause a decrease of production of other pituitary hormones through time. Loss of vision and brain injury, are some very rare side effects of radiation therapy.
Parathyroidism: Theoverproduction of parathyroid hormone.
Symptoms: The symptoms of parathyroidism are all primarily caused by high levels of calcium in the blood. They include a lack of energy, depression, and bone pain, loss of focus, restless sleeping and thinning of hair. Some other symptoms are heartburn, headaches and kidney stones.
Causes: This disease is apparent when one or more, parathyroid glands, grows into a tumor. After the parathyroid gland is a tumor, it loses control of its hormone regulatory system and starts making the parathyroid hormone all the time. All the extra parathyroid hormones go into your blood taking the calcium out of your bone and transferring it into your blood. The extra calcium in your blood is what makes you sick, and it affects all parts of your body from your brain to your heart.
Treatments: There are multiple types of drugs to slow and mollify the effects of this disease. Gallium nitrate is a drug made to lower the levels of calcium in the blood. Certain bisphosphonate drugs can stop the reabsorption of bone into the body and the destruction of the bones like pamidronate or etidronate. Another option is to get IV fluids to stop the process of parathyroidism.
ABNORMAL CURVATURES OF THE SPINE
Kyphosis: When the thoracic curvature is exaggerated posteriorly.
Symptoms: They include osteoporosis, compression fractures, chronic contractions in muscles and abnormal vertebra growth as well as a round back appearance.
Causes: This abnormality is caused by poor posture and a weakening of the muscles and ligaments in the back.
Treatments: Usually the degree of kyphosis doesn't require treatment. The options are pain relieving medication, physical therapy or a back brace. Drugs aren't always the best option they can become addictive and have a wide range of side affects. Physical therapy is almost always a good option if done correctly. The back brace is 90% affective but it doesn't work on severe curvatures.
Lordosis: The anterior exaggeration of the lumbar curvature.
Symptoms: Include a swayed back appearance, pain, loss of mobility and the buttocks/abdomen often protrude.
Causes: Discitis, obesity and osteoporosis are all factors that contribute to this abnormality.
Treatments: For the pain and swelling a doctor might subscribe some pain medications. For some physical therapy is the best option to build up muscle strength and flexibility. Braces can stop the curve from getting too severe in children and teens. Another good solution is to loss any excess weight. If the curvature is severe and causes other symptoms there are potential surgical treatments for lordosis like artificial disc replacements.
Scoliosis: The abnormal lateral curvature, also the most common spine abnormality.
Symptoms:Include development problems, muscular paralysis in the back, this is also most common in adolescence girls.
Causes:One of the main causes is the abnormal growth of the spine.
Treatments: There are exercises, braces and surgical medication all to help lessen the effects of this abnormality. This is better treated the earlier it is detected.