Bone Cancer Treatment Options - OmniMedicalSearch.com

Conditions & Diseases: Cancers

Bone Cancer

Treatment Options

Bone cancer treatment depends on the cancer stage and location, tumor size, the patient's age and general health state, and can include surgery, chemotherapy, or radiotherapy.

Surgery
In many cases, surgery is a primary treatment for bone cancer. Surgery is a medical procedure where the tumor and sometimes the surrounding bone tissue and muscles are removed. If the surgery is performed on the arm or leg bone, the surgeon tries to save the limb, or to replace the removed bone with bone tissue from other parts of the body or with an artificial prosthesis.

There are two main surgeries performed in bone cancer patients:

1. Treatment type surgery, which includes limb-salvage surgery, amputation, curettage and cryosurgery.

Limb-salvage surgery: This is a complex surgery where the cancer is removed preserving the bone's limb, tendons, nerves and blood vessels. The removed bone is replaced with a bone graft or artificial replacement - endoprosthesis (an internal prosthesis from metal or similar materials).

The side effects of this surgery are infections, and grafts or rods that break or get loose. Few others surgeries are needed in the following 5 years, and eventually, some patients may need bone amputation.

A patient with limb-salvage surgery needs one year to recuperate and has to participate actively in his own rehabilitation in order to make the bone (especially the arm or leg bone) functional again.

Amputation: This is another types of surgery where the tumor is removed with the bone to stop the cancer from spreading. Usually, amputation is chosen when the tumor has spread to the bone's nerves and blood vessels, and the limb cannot be saved. During the surgery, the doctor constructs a cuff from the muscles and skin to protect and cover the amputated bone. The removed bone is than replaced with a prosthesis limb. Amputee patients need to recuperate with special physical therapy.

Curettage: This is a medical procedure where the tumor is "scooped out" from the bone without removing the surrounding bone. Usually, the area is then treated to kill any remaining cancerous cells.

Cryosurgery: This is a type of curettage procedure where the tumor is removed without the bone, and the tumor cavity is treated with liquid nitrogen. The liquid nitrogen freezes the tumor cavity which kills the remaining cancerous cells. The frozen bone is re-stabilized by filling the tumor cavity with cement, bone grafts or rods and screws to prevent a future bone fracture. This procedure decreases the chance for the bone cancer to reoccur.

2. Reconstructive surgery, which includes rotatinoplasty.

Rotatinoplasty is a reconstructive surgery used when amputation was performed on:

1). The mid-thigh leg bone - the lower leg and the foot are rotated and reattached to the thigh bone, and the ankle functions as a knee joint. After the surgery, the patient's leg is extended with a prosthetic device.

2). The upper arm bone - the lower arm is reattached to the amputated bone, and the patient will have a shorter but functional arms.

3). The lower jaw bone - the entire lower half of the jaw bone is removed and later replaced with a bone from other parts of the body.

Chemotherapy

Chemotherapy is another bone cancer treatment method. Chemotherapy uses anti-cancer drugs to stop the growth of the cancerous cells by either killing them or halting the dividing process. These drugs enter the bloodstream and are carried around the body reaching all the areas and organs. Bone cancer patients receive chemotherapy 1) as a primary treatment (when the cancer spread to distant organs), or 2) in addition to surgery (as a adjuvant treatment - to enhance the results of the surgery by destroying possible cancerous cells that could have been left behind, and reducing the risk of cancer relapse) or 3) before surgery (as a neoadjuvant treatment - to reduce the size of the tumor).

Some of the chemotherapy drugs used in bone cancer treatment are: doxorubicin (Adriamycin), cisplatin (carboplatin), etoposide, ifosfamide, cyclophosphamide.

Chemotherapy has several side effects which include:

Nausea and vomiting
Mouth sores (chemotherapy can cause sore sensations in your mouth and small ulcers can develop).
Hair loss (chemotherapy do not only attach and kill cancerous cells, it also kills healthy cells causing you hair to fall out.)
Bruising and bleeding (after minor injuries)
Anemia
Low resistance to infections
Tiredness

Radiation Therapy

Radiation therapy or radiotherapy is another bone cancer treatment, and uses high-energy rays or particles to destroy cancerous cells. Bone cancer patients receive radiation therapy: 1). in addition to surgery (as a adjuvant treatment - to enhance the results of the surgery by destroying possible cancerous cells that could have been left behind and reducing the risk of cancer relapse), 2). before surgery (as a neoadjuvant treatment - to reduce the size of the tumor) or 3). as a primary treatment (when the cancer spread to other organs and cannot be removed surgically, or to relieve the cancer symptoms).

There are two types of radiation therapy:

1. External-Beam Radiation Therapy is a common form of treatment used in bone cancer patient. It uses an external device called linear accelerator to generate high-energy rays that focuses on the targeted area. External beam radiation can be administrated before or after surgery.

2. Internal Beam Radiation Therapy or Brachytherapy uses small radioactive pellets (needles, seed, wires or catheters) implanted into the affected area. This treatment can be administrated 1) during surgery (when the doctor inserts few catheters in the tumor cavity with radioactive seeds) or 2) after surgery (the catheters are inserted during surgery in the tumor cavity, but the radioactive "seeds" are received a few days after surgery). In both cases, when the treatment is completed, the catheters and radioactive seeds are removed.

Radiation therapy has a number of side effects. These include: skin pain, red skin, itching and burning skin sensations, desquamation (the exterior layer of the skin sheds), atrophy (the skin tissues die), low blood counts, swallowing problems, nausea and vomiting, and hair loss. These side effects depend on the area of the body where the radiation therapy is administrated, the radiation dose, and the number of radiation sessions needed.

Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com

Sources

Cancer Research UK.org, Bone cancer (osteosarcoma) at a glance, August 2006
National Cancer Institute, Bone Cancer: Questions and Answers, May 2006
MedlinePlus Medical Encyclopedia, Bone tumors, May 2006
Memorial Sloan-Kettering Cancer Center, Bone Cancer, February 2006
American Cancer Society, Detailed Guide: Bone Cancer, May 2006