Bone Cancer treatment
Since the 1960s, when amputation was the only treatment for bone cancer, new
chemotherapy drugs and innovative surgical techniques have improved survival with intact
limbs. Because osteosarcoma is so rare, patients should
consider undergoing treatment at a major cancer center staffed by specialists familiar
with the disease.
A treatment plan for bone cancer, developed after the tumor has been diagnosed and
staged, may include:
- Amputation. Amputation may be the only therapeutic option for large tumors involving
nerves or blood vessels that have not responded to chemotherapy. MRI scans indicate how
much of the diseased limb must be removed, and surgery is planned to create a cuff, formed
of muscles and skin, around the amputated bone. Following surgery, an artificial
(prosthetic) leg is fitted over the cuff. A patient who actively participates in the
rehabilitation process may be walking independently as soon as three months after the
amputation.
- Chemotherapy. Chemotherapy is usually administered in addition to surgery, to kill
cancer cells that have separated from the original tumor and spread to other parts of the
body. Although chemotherapy can increase the likelihood of later development of another
form of cancer, the American Cancer Society maintains that the need for chemotherapeutic
bone-cancer treatment is much greater than the potential risk.
- Surgery. Surgery, coordinated with diagnostic biopsy, enhances the probability that
limb-salvage surgery can be used to remove the cancer while preserving nearby blood
vessels and bones. A metal rod or bone graft is used to replace the area of bone removed,
and subsequent surgery may be needed to repair or replace rods that have loosened or
broken. Patients who have undergone limb-salvage surgery need intensive rehabilitation. It
may take as long as a year for a patient to regain full use of a leg following
limb-salvage surgery, and patients who have this operation may eventually have to undergo
amputation.
- Radiation therapy. Radiation therapy is used often to treat Ewing's sarcoma.
- Rotationoplasty. Rotationoplasty, sometimes performed after a leg amputation, involves
attaching the lower leg and foot to the thigh bone, so that the ankle replaces the knee. A
prosthetic is later added to make the leg as long as it should be. Prosthetic devices are
not used to lengthen limbs that remain functional after amputation to remove osteosarcomas
located on the upper arm. When an osteosarcoma develops in the jaw bone, the entire lower
jaw is removed. Bones from other parts of the body are later grafted on remaining bone to
create a new jaw.
Follow up Bone Cancer treatment
After a patient completes the final course of chemotherapy CAT scans, bone scans, x
rays, and other diagnostic tests may be repeated to determine if any traces of tumor
remain. If none are found, treatment is discontinued, but patients are advised to see
their oncologist and orthopedic surgeon every two or three months for the next year. X
rays of the chest and affected bone are taken every four months. An annual echocardiogram
is recommended to evaluate any adverse effect chemotherapy may have had on the heart, and
CT scans are performed every six months.
Patients who have received treatment for Ewing's sarcoma are examined often - at
gradually lengthening intervals - after completing therapy. Accurate growth measurements
are taken during each visit and blood is drawn to be tested for side effects of treatment.
X rays, CT scans, bone scans, and other imaging studies are generally performed every
three months during the first year. If no evidence of tumor growth or recurrence is
indicated, these tests are performed less frequently in the following years.
Some benign bone tumors shrink or disappear without treatment. However, regular
examinations are recommended to determine whether these tumors have changed in any way. |