Bone cancer (Sarcoma): Facts & Treatment

 Awareness article on Bone Cancer (Sarcoma) as Part of Sarcoma Awareness Month (JULY)

Bone cancer (Sarcoma) is rare in adults (nearly 2 % of all cancers), but account to 20 % of all solid cancers in children. Bone cancers are known for their aggressive nature, often destroying the limb and spreading to other organs. Hence, it is important to identify these cancers early to prevent loss of limb and life.

  • What is the cause for bone cancers?

The cause of bone cancers is not well understood.

Several factors like socio-economic environment, poor dietary habits, genetic factors, exposure to radiation have been proposed but not conclusive.

What is known by the available census is that it commonly affects adolescents and young adults.

Limbs are commonly involved, whereas spine, pelvis and other flat bones in the body have lesser predilection.

  • How does one know that he is suffering from Bone cancer?

A high index of suspicion is required when an individual has the following symptoms or signs

Bone Pain-Which is worsening at night or during rest

Swelling (Lump) – Which is more than “Size of Lemon” and growing rapidly

Fracture- Due to trivial fall or injury

Any paralysis, weakness, decrease appetite or loss of weight (advanced cases)

One need not panic if any of above signs are observed, but visit nearest doctor for evaluation.

  • What are types of Bone Cancer?

Osteosarcoma (most common), Ewing’s Sarcoma and Chondrosarcoma are different types with specific behaviour and progress.

It is important to identify the different types to provide appropriate treatment at earliest.

  • What are the tests to diagnose Bone Cancer?

X ray (Plain Radiograph)

Relevant blood tests

MRI and or CT scan

Biopsy (Minimally Invasive Tissue Sampling)

Staging by Whole body Scan (Bone scan or PET CT)

  • What is the treatment for Bone Cancers?

Once a diagnosis of Bone cancer is made, the treatment process is initiated and directed by multi-disciplinary team.

Individuals with bone cancers have several treatment choices depending on the type of cancer/sarcoma and extent of the disease.

Osteosarcoma and Ewing’s sarcoma require combination of Chemotherapy, Surgery and/or radiotherapy as per protocol. Chondrosarcoma often are treated by surgery alone. Secondary sarcomas often require combination treatment.

  • Is amputation the only surgery for Bone cancers?

No, Amputation is not the only treatment option available currently.

More than 90% of bone cancers can be treated by Limb Saving Surgery due to advances in chemotherapy and surgical techniques.

Better results are achieved when they present in early stage.

  • What is Limb Saving Surgery?

The goal of any limb saving surgery is to completely remove the tumour while preserving and maximizing extremity mobility and function.

It is possible currently to provide a customised limb saving surgery plan based on age, bone maturity, type of bone involved and functional demands of the individual, so that they can not only save their limb but use it well too.

Different types of limb saving surgeries are as follows:

  • Tumour Megaprosthesis
  • Custom Made Prosthesis Composite Reconstruction
  • Biological Reconstruction (Use of Recycled Tumour Graft OR Bone Bank Allograft)
  • Paediatric (Growing Tumour prosthesis)
  • Pelvic, Sacrum and Spinal Tumour Surgeries
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