The incidence of osteosarcoma accounts for 80% of malignant bone tumors Be alert! Adolescents are the high incidence group There are benign and malignant tumors in general, and bone tumors are no exception. Bone tumors are classified as primary bone tumors originating from bones, which are divided into benign and malignant. Benign bone tumors are generally less likely to metastasize and have low recurrence, such as osteochondroma (most common in adolescents) and giant cell tumor of bone (most common in adults). On the contrary, malignant tumors have high recurrence and are prone to metastasis, the most common being osteosarcoma, which accounts for 80% of all primary malignant tumors, “The most frequent group of osteosarcoma is adolescents, because adolescents are in the stage of rapid growth and development and are most vulnerable to external stimulation and interference. The process of growth and development of each person is metabolism, old cells keep dying and new cells keep arising. If the new cells are stimulated by external stimulation or environmental disturbance during the process of generation, it can mutate and mutate during the growth and development to form tumor cells.” Therefore, the occurrence of swelling and pain in adolescents must be a cause for concern. In addition, there are two types of bone tumors. First, cancer cells from other tissues or organs in the body can be transferred to bone tissue through blood circulation or lymphatic system to form bone metastatic cancer. Secondly, some lesions are not real tumors, but their clinical manifestations, X-ray or pathological manifestations are similar to bone tumors, which are called tumor-like lesions. However, as for the etiology of bone tumors, “bone tumors, like other tumors, do not have a clear etiology. Meanwhile, there is no clear evidence on what lifestyle habits can cause bone tumors, but some stimuli, such as traumatic radiation and other stimuli can promote or induce bone tumors.” Although the cause is unknown and it is difficult for us to prevent it, it is possible to achieve early detection and early diagnosis if we give more attention to it. 2. Teenagers with unexplained bone pain need to be alert to bone tumor There are many clinical cases of bone tumor that are not detected early enough to miss a good time for treatment. “Early diagnosis and early treatment will greatly improve the effect of treatment.” Whether early detection and diagnosis can be achieved depends largely on the alertness of patients, family members and receiving doctors to bone tumors. For benign bone tumor, early symptoms will appear as benign lumps, growing very slowly, usually in years, without pain or itching. For malignant bone tumor, the early symptoms will be pain or swelling around the bone and joint, often aggravated at night, and not necessarily related to sports or trauma, etc. The growth of the lump is fast, usually measured in months. Sometimes there is also skin fever and even pathological fractures. ”Parents should frequently observe and ask about their children’s development, and if an adolescent has unexplained swelling and pain in the joints that is not related to sports or trauma, they need to promptly go to a specialist hospital for an examination to rule out the possibility of bone tumors.” However, many parents will mistake their children for growing pains or pains caused by sports injuries and not take them seriously, and the local general clinics are often unable to diagnose the disease correctly. Therefore, Prof. Shen repeatedly emphasized that any patient who has caused bone and joint pain and cannot be relieved after ten days should go to a specialist hospital for examination as soon as possible, or visit different tertiary hospitals to avoid the case of missed diagnosis and misdiagnosis. 3.Confirmation of diagnosis: three steps to diagnose bone tumor How to diagnose bone tumor correctly? There are three steps in the diagnosis of bone tumor: firstly, the bone tumor specialist will make a preliminary judgment through clinical manifestations, whether there is pain, whether there is pressure pain, whether there is trauma, whether there is lump, whether there is hardness and size of lump, and experienced specialists can generally distinguish whether it is tumor or trauma or infection based on these symptoms. Secondly, according to the imaging examination, such as X-ray, CT, MRI, whole body bone scan, etc. Finally, pathological examination is recommended, and a biopsy with a puncture needle is recommended to determine whether the tumor is benign or malignant according to the tumor cells, which is the final method to confirm the diagnosis. What should be done when bone tumor is diagnosed? When most people hear about tumor, they think it is a terrible thing. In fact, with the improvement of medical technology nowadays, the surgical treatment and adjuvant treatment of bone tumors have been improved, and the survival period of patients with malignant tumors has been extended. At present, benign bone tumors or tumor-like lesions are mainly resected or scraped out surgically, which generally have lower recurrence, easy to cure and better prognosis. For malignant bone tumors, the treatment effect is not so good and long-term follow-up is required. As long as after standardized surgery and chemotherapy, the five-year survival rate can reach 50%-70%. Malignant bone tumors are usually treated by extensive resection or amputation. Is limb preservation or amputation better? There are also many debates in the medical field. Professor Shen Jingnan said, “Nowadays, the overall five-year survival rate of malignant bone tumors is improving, so much so that the surgical method of amputation and limb preservation is not considered an important factor affecting the postponed survival. This is because malignant tumors can cause danger not locally, but it metastasizes to other places such as the lungs through blood circulation.” It is important to note that limb preservation treatment depends largely on whether the surgeon can completely remove the tumor and yet protect the important surrounding blood vessels, which depends largely on different medical technologies. In places with good medical conditions and advanced and developed technology, limb preservation exceeds amputation, “but the current situation in our country is that there are more amputations because most patients come in with a long delay, the mass is relatively large and affects the surrounding muscles and nerves and blood vessels, so it is difficult to perform limb preservation surgery.” It is hoped that the majority of patients will be able to detect early and treat the important causes early. If you find any have caused pain and lumps around the joints, you should go to a high-level specialist hospital for examination as soon as possible and choose a different tertiary hospital to avoid missing the diagnosis. In addition, the majority of patients should not believe that traditional Chinese medicine can cure tumors. Traditional Chinese medicine can be used as an adjuvant treatment, not as the only treatment. The most effective treatment is combined treatment, not just surgery, or just chemotherapy and radiotherapy, only integrated treatment can improve the long-term survival of patients.