I get frustrated where sarcomas are concerned because it seems that little progress has ensued over the generations. Though, I am sure, perhaps on the molecular level there are strides as any scientist will tell me. However, still no definitive cure in sight. Bone tumors capture most of my interest simply because I was born with a plethora of them. I have Multiple Hereditary Exostoses, otherwise known as Multiple Osteochondromas. That means I have many cartilage bone tumors all over my body. One of them mutated into a form of bone cancer called Chondrosarcoma. Since my diagnosis in 1967 I have sought answers, and have waited for science to come up with a cure. Here we are 40 years later and, well, no cure. Sometimes it seems to me that nothing is new in the world of bone cancers and sarcomas. To illustrate my point, I spent some time researching a little history of chondrosarcoma. This is some of what I gleaned from various sources:

Hippocrates had a special interest in bone tumors. One of the things he said, "What cannot be cut out, can be burned". (Hence, with tongue in cheek, I suggest the concept of RFA was born.)

1850
Dr. Langenbeck reported on a complete scapular resection for a cartilage tumor. (Guess what? We are still performing this type of surgery today.)


1867
Rudolf Virchow (considered father of modern pathology) recognizes primary bone tumors such as fibrosarcoma, myxoid sarcoma, osteosarcoma and chondrosarcoma as more rare than tumors metastasized to bone. (Yes, and they are still considered rare today. A blessing I suppose that many people do not have to suffer from them. A curse, on the other hand, because little research funding is put to finding a cure.)

1876
Dr. Hinds introduced "scraping" for palliative treatment. (What amazes me is that a big clinical trial for this sort of treatment for Chondrosarcoma has been going on for the last couple years. Did someone forget it had already been done? Yes, I am admittedly a bit cynical.)

1879
Professor of Surgery, Samuel Gross, published "Sarcoma of the long bones..." stating those which form a matrix (osteosarcoma and chondrosarcoma) metastasized to the lung, and much less commonly to the lymph nodes. Because of aggressiveness, he recommended amputation as the treatment of choice. (And amputation is still a treatment option. (Though, I must be kind, not the only method these days. But, it is still used more than I would like to see, especially where hemipelvectomies are concerned!)

1905
Dr. William B. Coley was impressed with how effective radiation was with aggressive osteosarcoma. (Yes, you guessed it, still doing this today. I so much would wish they would come up with something better after all this time. Don't you?) Coley is famous also for his fever cures cancer theory and used bacterial vaccine to create it. Fascinating, authentic article about it here.

1912
Dr. A. H. Tubby becomes aware there is a difference between primary and secondary tumors, as well as benign and malignant in relationship to exostoses and chondrosarcomas. (I kid you not. That's his name.)

1924
Dr. Joseph Bloodgood suggested curretage, phenol wash, and autograft as acceptable treatment option for Giant Cell Tumor. He also developed the Bone Tumor Registry. He also suggested the name myxoma for what was probably a myxoid chondrosarcoma. (Again, there's that curretage, though I'd rather have clear margins.)

1930
Dr. Phemister clarifies a distinction between chondrosarcoma and osteogenic sarcoma. This classification was not accepted and approved until 1942! (What took them so long?)

1931
Dr. Warren shares information on a patient with a vascular chondrosarcoma who had a blood clot go to the lungs. (I had a pulmonary embolism after one of my surgeries. You think with all this forwarning there might have been some way of watching out for that possibility, or maybe even preventing it. Okay, I am grumpy about this one.)

1941
Dr. L. Mayer declared a chondrosarcoma patient cured five years after chondrosarcoma resection. ( I wonder what he would have said of my seven recurrences over eleven years and late lung mets another eleven years after that?)

1942
Jaffe admitted: To make a diagnosis of chondrosarcoma on a histologic basis alone is often difficult if not impossible... hardly any studies which adequately indicate distinctions or transition stages between benign and malignant cartilage tumors of bone on a histologic basis alone. (This is true today. And sadly, many of the chondrosarcoma patients in my Chondrosarcoma Support Group have had the unfortunate experience of having been misdiagnosed for this same reason.)

1943
Two pathologists published the rules of recognizing chondrosarcoma as it's own entity, a bone tumor, and established the difference between central (arising from enchondromas) to peripheral (arising from osteochondromas) At that time, they knew CS developed in those who might have a solitary benign tumor, MHE, or Ollier's. They also knew that CS could be the result of irradation. The only treatment for CS was amputation.

1950
Amputations could be modified with the "turn about" procedure as designed by Dr. Van Nes, though not applied to sarcomas until 1982, whereby The foot became the substitute for the knee joint. (Gosh, and I thought this was something new developed in the 21st century.)

1959
Dr. Dahlin noted that those with pelvic chondrosarcoma were more likely to develop metastasis and did poorly. (I'm guessing it was because the only way to diagnose was with palpation and X-ray, then surgery. Unfortunately, full hemipelvectomy (half the pelvis, including the leg) were amputated.

1959
Mesenchymal Chondrosarcoma finally recognized as a different entity from conventional Chondrosarcoma.

1964
By this time scientists were able cause chondrosarcoma to grow in a rabbit by giving intravenous Beryllium, (presently used in nuclear weapons, by the way).


1967
An internal Hemipelvectomy was performed by Dr. Eugene Mindell, of Buffalo NY. The patient eventually was able to walk again. Though there were many recurrences the patient survived many years. (I can't say this was a first, but it was for me.)

1973
Still, the most common treatment for chondrosarcoma was amputation, unless the lesions were small or easily accessible.

I suppose I should have sited my sources now that I realize I didn't. Duh!

Well, I stopped putting this info together at 1973 because it was four o'clock in the morning. To be continued.....