Let's jump right into it, shall we?

讓我們直接進入主題，好嗎？

Today, we're doing a deep dive into osteosarcoma.

今天，我們將深入探討骨肉瘤。

And more specifically, we're going to try to understand what causes it.

更具體地說，我們要試著瞭解它的成因。

Not something you think about every day, but definitely important.

這不是你每天都要考慮的事情，但絕對很重要。

Our main source today is this web page from Dr. Po Kuang Wu.

我們今天的主要資料來源是吳寶光博士的這一網頁。

He's an orthopedic oncology specialist.

他是骨科腫瘤專家。

And get this, he's based at Taipei Veterans General Hospital.

還有，他在臺北榮民總醫院工作。

One thing I really appreciate about how he's put this information together is that he takes these really complex medical concepts and makes them clear, which, honestly, is what we all want, right?

我非常欣賞他將這些資訊整合在一起的方式，他將這些非常複雜的醫學概念變得清晰明瞭，老實說，這正是我們想要的，對嗎？

Like, I don't need a medical degree to understand the basics.

比如，我不需要醫學學位就能瞭解基本知識。

Absolutely.

當然可以。

So one of the first things that Dr. Wu addresses is this idea that you can inherit osteosarcoma directly from your parents.

是以，吳博士首先要解決的問題之一，就是骨肉瘤會直接遺傳給父母這一觀點。

I think it's something that a lot of people worry about, especially when they hear the word cancer.

我想這是很多人擔心的問題，尤其是當他們聽到癌症這個詞的時候。

What are your thoughts on that?

你對此有何看法？

Yeah.

是啊

You know, it's totally natural to think about family history when we're talking about cancer.

要知道，當我們談論癌症時，考慮家族史是很自然的事情。

But here's the thing with osteosarcoma.

但骨肉瘤就是這樣。

It's not like some other cancers that have those really strong genetic links.

它不像其他一些癌症有很強的遺傳聯繫。

So it's not like inheriting your mom's curly hair or something.

所以，這並不像遺傳媽媽的捲髮什麼的。

Exactly.

沒錯。

Not even close.

差遠了。

Osteosarcoma arises from different factors.

骨肉瘤產生的原因多種多樣。

OK, so then what is actually going on?

好吧，那到底是怎麼回事呢？

If it's not from our parents, what causes it?

如果不是父母造成的，那是什麼原因呢？

So Dr. Wu, he lays out these three primary paths you can think about.

是以，吳博士列出了你可以考慮的三種主要途徑。

Three paths, OK.

三條路，好的。

Yeah, and I think that's a really helpful way to look at it.

是啊，我覺得這樣看很有幫助。

I like that.

我喜歡這樣。

Makes it easier to digest the information, for sure.

當然，這樣更容易消化資訊。

So let's take them one by one.

那麼，讓我們一個個來看看。

What's that first path?

第一條路是什麼？

Path number one centers on gene mutations.

第一條路以基因突變為中心。

Gene mutations, all right.

基因突變

And specifically, we're talking about these mutations in genes that are supposed to control how cells grow and develop.

具體來說，我們說的這些基因突變應該是控制細胞如何生長髮育的基因突變。

OK, so those genes are pretty important.

好吧，這些基因非常重要。

Think of them like the instruction manual for a cell, right?

把它們想象成手機的說明書，對嗎？

So when these instructions get messed up, they get typos.

是以，當這些說明被弄亂時，就會出現錯別字。

Those are what we call mutations.

這些就是我們所說的變異。

And sometimes that can lead to cells growing out of control, which is how the risk of osteosarcoma can increase.

有時這會導致細胞生長失控，從而增加骨肉瘤的風險。

So instead of the cell getting a message to stop growing, it's just got this messed up instruction manual.

是以，細胞並沒有收到停止生長的資訊，而是得到了這本亂七八糟的說明書。

Precisely.

正是如此。

It's like the stop sign is all blurry.

就好像停車標誌都模糊了。

Oh, that's a good way to put it.

哦，說得真好。

It's really fascinating, by the way, because Dr. Wu also brings up a connection between these gene mutations and retinoblastoma, which is a type of eye cancer.

順便說一下，吳博士還提到了這些基因突變與視網膜母細胞瘤（一種眼癌）之間的聯繫，這真的很吸引人。

I never would put those two things together.

我從來不會把這兩件事放在一起。

It's amazing.

太神奇了

It just shows how interconnected our bodies really are, that a single gene can be involved in multiple different processes.

這恰恰說明了我們的身體是多麼相互關聯，一個基因可以參與多個不同的過程。

And if that gene gets a mutation, it can have all these ripple effects.

如果該基因發生突變，就會產生各種連鎖反應。

Yeah, wow.

是啊，哇

OK, so that's the first path, gene mutations.

好了，這是第一條路，基因突變。

What about this second path that Dr. Wu describes?

那麼，吳博士描述的第二條道路又是怎樣的呢？

So the second path is all about the transformation of a pre-existing benign bone tumor.

是以，第二種途徑是將原有的良性骨腫瘤轉化為良性骨腫瘤。

OK, so in this case, we're talking about someone who already has a tumor.

好吧，在這種情況下，我們說的是已經患有腫瘤的人。

That's right.

這就對了。

But it's not cancerous yet.

但還沒有癌變。

Not yet, and hopefully never.

還沒有，希望永遠不會有。

But that's where the transformation part comes in.

但這正是轉型的關鍵所在。

So benign, in this situation, it just means the tumor is non-cancerous, and usually it's not going to be life-threatening.

是以，在這種情況下，良性腫瘤只是意味著腫瘤不是癌症，通常不會危及生命。

But, and this is important, in some instances, these benign tumors can actually transform and become cancerous.

但重要的是，在某些情況下，這些良性腫瘤實際上會轉化為癌症。

And that's where osteosarcoma comes in.

這就是骨肉瘤的由來。

So it's like this hidden potential, almost.

是以，這就像是一種隱藏的潛力。

Kind of, yeah.

算是吧

I mean, it's a little scary to think about, honestly.

老實說，想想都有點後怕。

But how common is that, really?

但這種情況到底有多普遍呢？

It's definitely less common than the gene mutation path we talked about.

這肯定比我們說過的基因突變途徑更不常見。

But it's super important to understand.

但瞭解這一點超級重要。

Especially if you've already been diagnosed with a bone tumor in the past.

尤其是如果你過去已經被診斷出患有骨腫瘤。

You've got it.

你可以的

And to illustrate this point, Dr. Wu includes a couple of really compelling case studies on his web page.

為了說明這一點，吳博士在他的網頁上提供了幾個非常有說服力的案例研究。

Oh, yeah.

哦，是的

What kind of cases?

什麼樣的案件？

He talks about this nine-year-old girl, right?

他說的是這個九歲的女孩，對嗎？

And she experienced this exact transformation seven years.

七年來，她經歷了這樣的轉變。

Seven years after she went through treatment.

在她接受治療七年後

Seven years later.

七年之後

Wow.

哇

And then there's this other case about a pelvic tumor that transformed after a whole decade. 10 years.

還有一個病例，是關於盆腔腫瘤在整整十年後發生了轉變。10年

That just goes to show, like, monitoring is so important.

這恰恰說明，監控是如此重要。

Absolutely.

當然可以。

Early detection can be a game changer.

早期檢測可以改變遊戲規則。

No kidding.

別開玩笑了

It makes you think twice, even if you've been told you're in the clear.

這讓你三思而後行，即使你已經被告知你是清白的。

OK, so we've got these two paths so far, right?

好了，目前我們已經有了這兩條路，對嗎？

Gene mutations, pre-existing tumors transforming.

基因突變、原有腫瘤轉化。

What about that third path that Dr. Wu mentions?

那吳博士提到的第三條路呢？

This is the one I think that a lot of us are curious about, exposure to carcinogens.

我想我們很多人都對接觸致癌物質這個問題感到好奇。

Yeah, that's the big one, isn't it?

是啊，這才是最重要的，不是嗎？

When we talk about things in the environment that can increase our risk of cancer.

當我們談論環境中會增加我們患癌風險的事物時。

Exactly.

沒錯。

So what does Dr. Wu say about that?

那麼，吳博士是怎麼說的呢？

Well, for osteosarcoma, the big one, the most significant carcinogen that's been identified so far is radiation exposure.

那麼，對於骨肉瘤來說，最大的致癌物質，也是迄今為止發現的最重要的致癌物質就是輻射。

OK, radiation exposure.

好吧，輻射暴露。

That makes sense.

這就說得通了。

We know that radiation can be dangerous.

我們知道輻射是危險的。

But how does that play out in real life?

但在現實生活中又是如何實現的呢？

Like, what are the connections to osteosarcoma specifically?

比如，與骨肉瘤有什麼具體聯繫？

Right, so there are a couple of ways this happens.

沒錯，這種情況有幾種發生方式。

One is radiation therapy.

一種是放射治療。

Which is used to treat lots of different cancers, right?

它被用來治療許多不同的癌症，對嗎？

Exactly.

沒錯。

And it can be life-saving, truly.

它真的可以救命。

But the thing is, long-term exposure to radiation does, unfortunately, increase the risk of developing osteosarcoma later on.

但不幸的是，長期暴露於輻射中確實會增加日後罹患骨肉瘤的風險。

Oh, wow.

哦，哇

So it's like this double-edged sword in some cases.

是以，在某些情況下，這就像一把雙刃劍。

Yeah, kind of.

算是吧

It's a trade-off that doctors and patients have to weigh very carefully.

醫生和患者必須仔細權衡利弊。

And then, of course, there are those large-scale events, like nuclear accidents.

當然，還有一些大規模事件，比如核事故。

Exactly.

沒錯。

Tragic examples of just how devastating radiation exposure can be.

這些悲慘的例子說明了輻照的破壞性有多大。

And speaking of which, Dr. Wu mentioned some really interesting research from the Radiation Effects Research Foundation.

說到這裡，吳博士提到了輻射效應研究基金會的一些非常有趣的研究。

I think they're based in Japan.

我想他們的總部在日本。

Right, Japan.

對，日本。

And they did this really extensive study on survivors of the atomic bombs.

他們對原子彈的倖存者進行了廣泛的研究。

And their findings about osteosarcoma risk, they're hard to ignore.

而他們關於骨肉瘤風險的研究結果，是很難被忽視的。

Absolutely.

當然可以。

It was a long-term study, too.

這也是一項長期研究。

They looked at, I think it was over 80,000 survivors and found 19 cases of osteosarcoma, with many of them developing decades after that initial exposure.

他們對 8 萬多名倖存者進行了調查，發現了 19 例骨肉瘤病例，其中許多人是在初次接觸後幾十年才發病的。

Decades.

幾十年。

Wow.

哇

That really puts things in perspective.

這真是讓人豁然開朗。

I bet.

我敢打賭。

You know, it's interesting, because Dr. Wu also briefly mentions beryllium oxide as a potential risk factor, too.

有趣的是，吳博士還簡要提到氧化鈹也是一個潛在的風險因素。

He doesn't really go into a ton of detail, but it makes you wonder.

他並沒有說得很詳細，但卻讓人感到好奇。

Yeah, I agree.

是的，我同意。

It's definitely a reminder that this is an ongoing area of research.

這無疑提醒我們，這是一個持續的研究領域。

What we know about these things is constantly evolving.

我們對這些事物的瞭解在不斷髮展。

So it's like we're always learning new things about osteosarcoma, what causes it, how it develops.

是以，我們一直在學習有關骨肉瘤的新知識，瞭解它的病因和發展過程。

For sure.

當然。

So to quickly go back over what we've covered about those causes.

是以，我們要快速回顧一下我們已經介紹過的這些原因。

But there was those gene mutations that mess with normal cell growth.

但有一些基因突變會干擾細胞的正常生長。

Then there's the possibility of pre-existing bone tumors becoming cancerous.

此外，原有的骨腫瘤也有可能癌變。

And then, of course, exposure to carcinogens with radiation exposure being a major one.

當然，還有接觸致癌物質，其中最主要的是接觸輻射。

It's a lot to think about.

要考慮的事情太多了。

But I got to say, it is reassuring to know that you can't directly inherit osteosarcoma, right?

但我得說，知道骨肉瘤不會直接遺傳給後代，這讓人感到欣慰，對嗎？

It's not something you just pass down to your kids, which I think helps to lessen some of the anxiety around this diagnosis.

我認為，這有助於減輕對診斷結果的焦慮。

Yeah, 100%.

是的，100%。

It's so important to remember that.

記住這一點非常重要。

And I think it can really help to separate out those feelings of guilt or fear that might come up.

我認為這確實有助於消除可能出現的負罪感或恐懼感。

Totally.

完全是

You know, while I was reading through Dr. Wu's web page, I noticed that he mentioned being affiliated with a bone tumor treatment center and a support association.

我在閱讀吳醫生的網頁時注意到，他提到自己與一個骨腫瘤治療中心和一個支持協會有聯繫。

And it got me thinking, even if we're not personally affected by osteosarcoma, could connecting with these kinds of resources be a good thing?

這讓我想到，即使我們沒有受到骨肉瘤的親身影響，與這些資源建立聯繫是否也是一件好事呢？

Could it offer valuable insights or support to anyone who wants to learn more?

它能為想要了解更多資訊的人提供有價值的見解或支持嗎？

Oh, that's a great point.

哦，說得好。

It really speaks to the importance of community and sharing knowledge, especially when it comes to something as complex as osteosarcoma.

這確實說明了社區和知識共享的重要性，尤其是當涉及到像骨肉瘤這樣複雜的疾病時。

Right.

對

Because you've got the treatment centers who are obviously on the front lines of providing care.

因為治療中心顯然是提供醫療服務的第一線。

But then support associations, they offer a whole other level of understanding and connection.

但是，支持協會可以提供另一個層面的理解和聯繫。

Because they're often run by patients and families and survivors, right?

因為它們通常是由病人、家屬和倖存者管理的，對嗎？

Why are they?

為什麼會這樣？

Yeah, exactly.

是啊，沒錯。

They can speak to what it's really to live with osteosarcoma, to go through the treatment options, and to cope with those emotional and physical challenges.

他們可以講述患骨肉瘤的真實感受、治療方案，以及如何應對這些情感和身體上的挑戰。

So it's like having this whole network of people who get it.

是以，這就像擁有了一個瞭解它的人際網絡。

They've been there.

他們去過那裡。

Right.

對

And they can offer guidance and support based on real lived experience.

他們可以根據真實的生活經驗提供指導和支持。

Which is invaluable, really.

這真的非常寶貴。

Yeah.

是啊

OK, so we've debunked that myth of osteosarcoma being directly inherited.

好了，我們已經揭穿了骨肉瘤會直接遺傳的神話。

We explore those three main paths that can lead to it.

我們將探討通往它的三條主要途徑。

And we even touched on that surprising connection between gene mutations that can cause both eye cancer and bone cancer.

我們甚至談到了基因突變與眼癌和骨癌之間的驚人聯繫。

Yeah.

是啊

And we talked about how important ongoing research is and how each individual case can be really complex.

我們還談到了正在進行的研究有多麼重要，以及每個病例都可能非常複雜。

And of course, we just talked about the importance of finding support.

當然，我們剛才也談到了尋找支持的重要性。

It's out there.

它就在那裡。

Wow, that's incredible.

哇，太不可思議了

And to think, we got all of that from just one web page and a good conversation.

想想看，我們從一個網頁和一次愉快的談話中獲得了這一切。

See?

看到了嗎？

Told you.

我就說嘛

There's so much good information out there.

外面有這麼多好資訊。

It's just about knowing where to look sometimes.

只是有時要知道去哪裡找。

So true.

說得太對了。

So for everyone listening today, we asked what seemed like a simple question.

是以，對於今天在座的各位，我們提出了一個看似簡單的問題。

What causes osteosarcoma?

骨肉瘤的病因是什麼？

And as we've learned, it's not always a simple answer.

正如我們所瞭解到的，答案並不總是那麼簡單。

Not at all.

完全沒有。

It's this whole mix of things, like genes and what's going on in our bodies, environmental stuff.

這是一個整體的混合體，比如基因、我們體內的情況以及環境因素。

And honestly, there are probably even some things we haven't even figured out yet.

老實說，有些事情我們可能還沒搞清楚。

Right.

對

It's like a medical mystery we're trying to solve.

這就像我們要解開的醫學之謎。

Perfect analogy.

完美的比喻

We got to carefully examine all the evidence, you know?

我們必須仔細檢查所有證據，你知道嗎？

Talk to the experts.

請教專家。

And importantly, never stop asking those questions. 100%.

重要的是，永遠不要停止問這些問題。100%.

That's how we keep learning and making progress.

這樣我們才能不斷學習，不斷進步。

Which brings me to my final thought for everyone listening today.

這也是我今天想說的最後一句話。

We've covered a lot of ground, but doesn't have to end here.

我們已經講了很多，但不一定到此為止。

We talked about those great resources, like support associations.

我們談到了那些很好的資源，比如支持協會。

But what about all that research out there?

但是，外面的那些研究又是怎麼回事呢？

If you're curious, where could you go to dive even deeper into this topic?

如果你很好奇，可以去哪裡更深入地瞭解這個話題呢？

What about those cutting-edge breakthroughs happening right now in osteosarcoma research?

那麼，骨肉瘤研究領域目前取得的那些前沿突破又是怎麼回事呢？

You know, maybe there are ways to get involved, even if you're not a scientist.

即使你不是科學家，也許也有辦法參與其中。

It's worth thinking about.

這值得深思。

Knowledge is a journey, right?

知識是一場旅行，對嗎？

Sometimes those aha moments, those big discoveries, they happen when we step outside our comfort zones and explore new territory.

有時，那些 "啊哈時刻"、那些重大發現，都是在我們走出舒適區、探索新領域時發生的。

Absolutely.

當然可以。

And who knows?

誰知道呢？

Maybe one of our listeners will be the one to make the next big breakthrough.

也許我們的聽眾中會有人實現下一個重大突破。

Wouldn't that be something?

這不是很好嗎？

So until next time, keep those brains buzzing.

所以，在下一次之前，請保持頭腦清醒。

Stay curious, everyone.

保持好奇心，各位。