Osteosarcoma Paleopathology Presentation


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Osteosarcoma Paleopathology Presentation

  1. 1. Osteosarcomain Paleopathology<br />Joanna K. Suckling<br />Anth5374 · Paleopathology<br />April 20, 2011<br />
  2. 2. Outline<br />What is cancer?<br />History<br />What is osteosarcoma?<br />Diagnosis<br />Why look for osteosarcoma in the archaeological record?<br />Conclusions<br />
  3. 3. What is Cancer?<br />The uncontrolled growth of abnormal cells in the body.<br />Normal cells  Grow, divide, and die.<br />Cancer cells  Grow and divide.<br />Develop because of damage to DNA<br />
  4. 4. What is Cancer?<br />Metastasis<br />When cancer cells travels to other parts of the body, grow, and replace normal tissue.<br />Primary bone cancer<br />When cancer starts in the bone.<br />
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  7. 7. Cancer in Antiquity<br />Greeks first to identify cancer<br />Hippocrates “Father of Medicine”<br />Descriptions of disease that may be cancer exist in several cultures (Egypt, Peru, etc.)<br />Little understanding until the past 200 years<br />
  8. 8. Ancient Treatments<br />Egypt <br />Papyrus Ebers describe spells and fumigation to prevent “eating” of body tissues<br />Greece<br />Surgical treatments<br />Topical treatments<br />
  9. 9. History<br />Campbell Greig De Morgan (1811-1876)<br />Idea that cancer spreads from a tumor to other parts of the body (1871-1874)<br />Theodor Boveri (1862-1915)<br />Proposed genetic basis of cancer (1902)<br />Marie Curie (1867-1934)<br />First non-surgical treatment for cancer (~1910)<br />
  10. 10. What causes cancer?<br />Genetics<br />Environment<br />Radiation<br />Viruses<br />Chemicals and toxins<br />Anything that can damage DNA!<br />
  11. 11. What is osteosarcoma?<br />One of the most common malignant neoplasms of bone<br />But one of the more uncommon types of cancer<br />~1500 reported each year in the US<br />Sometimes known as “osteogenic sarcoma”<br />40-60% of primary malignant tumors in bone are osteosarcoma<br />7% of adolescent cancers<br />19% of all tumors in bone<br />
  12. 12. What is osteosarcoma?<br />Develops from the metaphyseal growth plate and extends into the bone cortex<br />Usually starts in osteoblasts<br />
  13. 13. What is osteosarcoma?<br />Usually affects juvenile individuals (< 20)<br />Occurs during growth periods<br />Males more often affected<br />
  14. 14. Other Risk Factors<br />Radiation therapy<br />Medications<br />Genetics<br />Paget’s disease <br />
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  16. 16. Diagnosis<br />Production of osteoid<br />“Osteoblast-like” tumor cells<br />“Sunburst”<br />Codman’s Triangle<br />Swelling over a bone<br />Pain<br />Pathological fracture<br />
  17. 17. Differential Diagnosis<br />
  18. 18. Modern Treatment<br />Four standard options:<br />Surgery<br />Chemotherapy<br />Radiation therapy<br />Samarium<br />
  19. 19. Modern Case Study<br />17 year old male<br />Growing mass on the leg<br />Pain<br /><ul><li>X-ray and biopsy confirm osteosarcoma</li></li></ul><li>Modern Case Study<br />Emergency above knee amputation<br />Patient started on chemotherapy<br />Image removed<br />
  20. 20. Survival?<br />Malignant<br />Early death<br />Bone cells can release hormone-like factors that cause cancer cells to grow faster (American Cancer Society 2008)<br />Rate depends on treatment plan and metastasis<br />20% survival with only surgery<br />
  21. 21. Is cancer a “new” disease?<br />Popular theory that age at death, diet, and environment contributed to a substantial rise in the incidence of cancer<br />
  22. 22. Is cancer a “new” disease?<br />Industrialized nations: 2nd leading cause of death<br />Very few references to cancer in antiquity<br />Few definite examples in archaeology<br />~176 total?<br />Mostly metastatic (not primary sarcoma)<br />Evidence of cancer does exist in animal fossils, non-human primates, possibly Neanderthal, and modern humans.<br />
  23. 23. Why look for osteosarcoma in the archaeological record?<br />Important to paleopathology:<br />Produces bone<br />Likely to survive!<br />Occurs most often in young individuals<br />Should appear in populations despite shorter life expectancy<br />
  24. 24. Physical Evidence of Osteosarcoma<br />Femur found in Peru(Aufderheide et al. 1997)<br />Hawaii (Suzuki 1987)<br />Europe (Brothwell 1967; Strouhal et al. 1997)<br />Possibly Egypt, Spain, Germany, Poland, and France<br />Very few cases!<br />
  25. 25. The Increase of Cancer Incidence?<br />Osteosarcomaaffects young individuals<br /> Should show up in the record despite differences in life expectancy!<br />Perhaps the increase of cancer that we’re seeing in recent decades is more due to our environment rather than solely living longer.<br />
  26. 26. But wait…<br />Explanations for rarity:<br />Osteosarcoma is rare in general<br />Lack of sufficient diagnostic methods in the past<br />Insufficient data<br />In past societies not all social classes may have had equal access to care<br />Not all cases recorded or recognized<br />
  27. 27. Conclusions<br />Cancer has always affected humans<br />BUT it was most likely really rare<br />(Can’t know that for sure!)<br />Osteosarcoma is rarely found<br />Increase in cancer rates is most likely a new concern, resulting from increases in life expectancy and changes in our environment<br />Historical accounts in this century support this conclusion<br />
  28. 28. Conclusions<br />… But the debate continues.<br />Need more data!<br />Better diagnoses<br />Paleopathology has the potential to contribute to the study of cancer.<br />
  29. 29. References<br />American Cancer S. 2008. Bone metastasis : what you need to know-- now. Atlanta, Ga.: American Cancer Society.<br />Aufderheide A, Ragsdale B, Buikstra J, Ekberg F, and Vinh TN. 1997. Structure of the radiological "sunburst" pattern as revealed in an ancient osteosarcoma. JOURNAL OF PALEOPATHOLOGY 9:101-106.<br />Aufderheide AC. 2003. The scientific study of mummies. Cambridge, UK; New York: Cambridge University Press.<br />Boveri T. 2008. Concerning the Origin of Malignant Tumours by Theodor Boveri. Translated and annotated by Henry Harris. J Cell Sci 121(Supplement_1):1-84.<br />Bronner F, and Farach-Carson MC. 2009. Bone and cancer. London: Springer.<br />Brothwell DR, and Sandison AT. 1967. Diseases in antiquity; a survey of the diseases, injuries, and surgery of early populations. Springfield, Ill.: C.C. Thomas.<br />Capasso LL. 2005. Antiquity of cancer. International journal of cancer Journal international du cancer 113(1):2-13.<br />Dorfman HD, and Czerniak B. 1998. Bone tumors. St. Louis: Mosby.<br />Halperin EC. 2004. Paleo-Oncology: The Role of Ancient Remains in the Study of Cancer. Perspectives in Biology and Medicine 47(1):1-14.<br />Mirabello L, Troisi RJ, and Savage SA. 2009. Osteosarcoma incidence and survival rates from 1973 to 2004. Cancer 115(7):1531-1543.<br />
  30. 30. References<br />Mould RF. 1998. The discovery of radium in 1898 by Maria Sklodowska-Curie (1867-1934) and Pierre Curie (1859-1906) with commentary on their life and times. The British journal of radiology 71(852):1229-1254.<br />Ortner DJ. 2003. Identification of pathological disorders in human skeletal remains. Amsterdam; London: Academic.<br />Pinhasi R, and Mays S. 2008. Advances in human palaeopathology. Chichester, England; Hoboken, NJ: John Wiley & Sons.<br />Roberts CA, and Manchester K. 2007. The archaeology of disease. Ithaca, N.Y.: Cornell University Press.<br />Strouhal E, Vyhnanek L, Horackova L, Benesova L, and Nemeckova A. 1997. A Case of Osteosarcoma in a Late Medieval-Early Modern Skull from Kyjov (Czech Republic). INTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY 7(1):82-90.<br />Suzuki T. 1987. Paleopathological study on a case of osteosarcoma. American journal of physical anthropology 74(3):309-318.<br />http://www.cancer.gov/cancertopics/pdq/treatment/osteosarcoma/patient<br />
  31. 31. Images<br />http://www.cancer.gov/cancertopics/cancerlibrary/what-is-cancer<br />http://ak47boyz90.files.wordpress.com/2010/09/34.png<br />http://upload.wikimedia.org/wikipedia/commons/3/32/Hippocrates_rubens.jpg<br />http://upload.wikimedia.org/wikipedia/commons/8/8b/Ebers7766.jpg<br />http://www.mlahanas.de/Greeks/images/AchillesPatroclos.jpg<br />http://benefitsofhoneyblog.com/wp-content/uploads/2011/03/honey.jpg<br />http://upload.wikimedia.org/wikipedia/en/c/c4/GHS_carcinogen_sign.svg<br />http://www.rsc.org/images/b514317a-250_tcm18-48745.jpg<br />http://www.foodchannel.com/gallery/french%20fries.jpg<br />http://static.howstuffworks.com/gif/carcinogens-cause-cancer1.jpg<br />http://upload.wikimedia.org/wikipedia/commons/thumb/5/5d/WVSOM_Osteoblast.JPG/800px-WVSOM_Osteoblast.JPG<br />http://orthoinfo.aaos.org/figures/A00040F01.jpg<br />http://www.sciencesway.com/vb/t9961-p2.html<br />http://www.nrc.gov/reading-rm/basic-ref/teachers/images/radiation-symbol.gif<br />http://images.radiopaedia.org/images/134711/840a4d1c5181499ad4ad78f8b72874.png<br />http://www.gsdhelp.info/cancer/osteosarcoma1.gif<br />http://www.medic.usm.my/~pathology/bonepath/bonepath/Ostsac1.jpg<br />http://images.radiopaedia.org/images/141917/ae078b640009823890876ea1e72510_gallery.png<br />http://1.bp.blogspot.com/_FYzmMSSuvWc/TI8otppx-7I/AAAAAAAAF-M/jW6FWpnuRaY/s1600/4bd460824d898TEK-bone-tumor3.jpg<br />http://www.cancer.iu.edu/research/programs/cancer_control/Cancer_Continuum2.jpg<br />http://sarcomahelp.org/osteosarcoma.html<br />http://www.ccs.k12.in.us/chsBS/kons/kons/age%20and%20cancer%20graph.jpg<br />http://kpbs.media.clients.ellingtoncms.com/img/photos/2011/01/05/Backdrop5_2_tx700.jpg?8e0a8887e886a6ff6e13ee030987b3616fc57cd3<br />