Good-to-know facts about Malignant Bone Tumours
Bone Tumours are developed when cells within a bone divide
uncontrollably, leading to a lump or mass of abnormal tissue being
formed. Not all Bone Tumours are cancerous i.e. benign. Generally,
Benign Tumours do not spread to other parts of the body and are not
life-threatening. On the other hand, there are Bone Tumours that
are cancerous, referred to as Malignant Bone Tumours. The earliest
symptoms of Malignant Bone Tumour are pain and swelling in the
area where the Tumour is located. The pain may come and go at first;
then it can become more severe and steady later.
Malignant Bone Tumours can metastasize which means the cells can
spread throughout the body. Depending upon the type of Tumour,
treatment options are wide-ranging. In most cases, treatment for
Malignant Tumours involves a combination of Chemotherapy, Surgery
and Radiation.
An Orthopaedic Oncosurgeon assesses the individual case for feasibility
of limb preserving surgery. Then the surgeon would plan and execute
a biopsy and team up with a Medical Oncologist for Chemotherapy.
Generally, it is advocated that the surgeon performing the fi nal limb
salvage procedure should be the one performing the biopsy. The first
surgeon has the best chance of cure.
During surgery the cancerous section of bone is removed, keeping
nearby muscles, tendons, nerves, and blood vessels intact wherever
possible. The surgeon will take out the Tumour and a portion of
healthy tissue around it. From the point of view of Oncologic Principles,
it is necessary to resect the bone in a manner that at least 3 cm of
disease-free marrow margin and 2cm of soft tissue margin is obtained
for a successful outcome. Reconstructing the Tumour defect with
mechanically sound prosthesis or adequate Osteosynthesis follows.
The Orthopaedic Oncosurgeon not only does the surgery but also
oversees functional rehabilitation whilst planning Chemotherapy for
distant metastatic control. A prosthetic limb can aid function in cases
that involve amputation. The pattern of reconstructions done varies
from case-to-case.
Dr. Haresh Manglani
Sr. Consultant
Orthopaedic Oncologist
Nanavati Super Speciality
Hospital, Mumbai