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Various Treatment Options for Bone Cancer

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4) Curettage: Scraping the tumour from the bone without removing a section of the bone. This is the most common treatment for chondroblastomas. During this procedure, the tumour is scraped out of the bone with a special instrument called a curette that has a scoop, loop or ring at its tip. Curettage can be categorised in the following main types. 

Two types of curettage

a) extended curettage: In some cases, our orthopedic surgeons perform an “extended” curettage using a special instrument to remove additional layers of cells around the chondroblastoma. This is done to reduce the risk of recurrence.

b) en bloc resection: Doctors may need to surgically remove bone containing the tumour if the tumour is located in the pelvis or certain other sites. They may insert pins and other hardware (internal fixation) to restore the structural integrity of the bone.

5) Cryotherapy

Cryotherapy or cryoablation (Cryo is a Greek word used for frost or extreme cold and ablation refers to removal or elimination). This therapy is a technique where liquid nitrogen is used to freeze and kill cancer cells. For this treatment, liquid nitrogen is poured into the hole that is left in the bone after the tumour was removed. This extremely cold material kills tumor cells by freezing them.

Cryotherapy can be performed during an open (fully invasive) surgery or the probes can be inserted through the skin in a minimally invasive procedure.

Cryotherapy is localised treatment as doctors focus on a specific area, which does not affect cancer cells present in other parts of the body. This technique is designed to reduce damage to nearby healthy tissue, help reduce pain, bleeding and recovery time.

One advantage of cryosurgery is that the procedure may be repeated if necessary because it is less invasive than traditional surgery.

Uses of Cryotherapy

For internal tumours: cryotherapy is used inside the body to treat tumours. For internal tumours, liquid nitrogen or argon gas flows through a long, thin, insulated tube. Using image guidance and endoscopy, doctors place a probe on the tumour or obstruction and freeze the cells. After the procedure, the tissue is absorbed by the body or removed.

For external tumours: Also it is used to treat tumors outside the body, such as skin cancer. For these external tumors, liquid nitrogen is applied directly to the cancerous cells.

Cryosurgery involves pouring liquid nitrogen into the hollow space or hole that is left in the bone after the tumour was removed.

6) Bone Grafting

The remaining cavity is usually filled with donor bone tissue (allograft), bone chips taken from another bone in the child's body (autograft). The graft takes two or three months to heal into the bone.

After cryosurgery, the hole in the bone can be filled by bone grafts or by bone cement. This technique can sometimes be used instead of conventional surgery to destroy the tumour.

Because bone is removed, it often needs to be reconstructed with a bone graft or replaced with an internal prosthesis (endoprosthesis). Bandages or a splint may be used to support the arm or leg and give the bone graft or endoprosthesis time to heal and join to the remaining bone in the limb.

Cryosurgery involves pouring liquid nitrogen into the hollow space or hole that is left in the bone after the tumour was removed.

7) Bone Cement PMMA (polymethylmethyacrylate)

Bone cement (PMMA) is a liquid that hardens over time and acts like bone cement (cementation). As it hardens, it gives off a lot of heat. The heat helps kill any remaining tumour cells, which allows PMMA to be used without cryosurgery for some types of bone tumours.

Metal pins or screws may also be used with the bone cement to correct the defect and strengthen the bone following curettage.

8) Clinical Trials

Clinical trials investigate new and better ways to prevent, detect and treat cancer. These experiments are a critical step in the development of new methods of treatment. Doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease.

These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials can be some of the first to get a treatment before it is available to the public.

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