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Treatment Options for Bone Cancer

(This article has been continued from the previous post, 'Bone Cancer Treatment Options')... Amputation–If the person has a large tumour that has spread to important nerves or blood vessels, removing these vital structures would leave a limb that would not work well or would cause long-term problems. Amputation may be the only option for some people with bone cancer. In this case, a limb amputation may be the best option. An amputation may also be needed if the bone cancer has come back in the same limb after limb-sparing surgery.

The surgeon looks at imaging tests and the pathology report to help determine how much of an arm or leg needs to be amputated. Some muscle, soft tissue and skin are used to form a cuff around the amputated bone (stump). For a while after the amputation, the stump is covered with a tight-fitting bandage to help shape it. Once the tissues of the stump are healed enough, the person can be fitted for an artificial limb (prosthesis).

Reconstructive surgery – to help restore the structure and function of the bone. If the leg must be amputated mid-thigh, the lower leg and foot can be rotated and attached to the thigh bone. The old ankle joint becomes the new knee joint. This surgery is called rotationplasty. A prosthesis is used to make the new leg the same length as the other (healthy) leg.

If the bone tumor is located in the upper arm, the tumor may be removed and then the lower arm attached again. This leaves the patient with an arm that works but is much shorter.

2) Chemotherapy

Chemotherapy is commonly used as anticancer (cytotoxic) drugs to kill cancer cells. It is usually a systemic therapy that circulates throughout the body and destroys cancer cells, including those that may have broken away from the primary tumour.

Patients who have bone cancer usually receive a combination of anticancer drugs. However, chemotherapy is not currently used to treat chondrosarcoma. Drugs, doses and schedules vary from person to person.

Chemotherapy may be used:

  • as the primary treatment with or without radiation therapy to destroy cancer cells if the tumour is in a place where it cannot be removed with surgery (such as the spine and pelvis).
  • before surgery or radiation therapy to shrink a tumour (neoadjuvant chemotherapy)
     
  • after surgery to destroy cancer cells left behind and to reduce the risk of the cancer recurring (adjuvant chemotherapy)
     
  • to relieve pain or to control the symptoms of advanced bone cancer (palliative chemotherapy)

3) Radiation Therapy

Radiation therapy also called radiotherapy, involves the use of targeted energy (e.g., X-rays, radioactive substances) to destroy cancer cells and often designed to work on a patient in combination with surgery.

When chemotherapy is not effective to treat chondrosarcoma as well as ESFTs, radiation therapy is used. Patients who refuse surgery are also often treated with radiation therapy.

Hence radiation therapy works as a primary treatment, in combination with other treatments. before another treatment to shrink a tumor, after any other treatment to stop the growth of any remaining cancer cells, relieve pain and also to relieve symptoms of advanced cancer.

Some radiation therapy delivery methods include:

  • External beam radiation therapy – radiation is directed from a machine outside the body onto cancerous cells within the body. (Examples: 3D conformal radiation therapy, IMRT, IGRT, TomoTherapy, Stereotactic Radiosurgery)
     
  • Internal radiation therapy – radioactive material is placed (via a catheter or other carrier) directly into or near a tumor. (Example: high-dose rate brachytherapy)
     
  • Systemic radiation therapy – a radioactive substance (that is swallowed or injected) travels through the blood to locate and destroy cancerous cells. (Example: radioactive iodine therapy)

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