Reclaiming the Limbs
Successful treatment of Grade 2 Osteosarcoma in
a young boy
A 18-year old boy diagnosed with Osteosarcoma of right lower femur
was referred from Kolkata to Nanavati Super Speciality Hospital in
Mumbai for medical management and further treatment.
Upon admission in Nanavati Hospital, a needle biopsy was done which
revealed intermediate Grade 2 Osteosarcoma. He was given 3 cycles
of Chemotherapy before surgery. This comprised of medication for 3
days followed by a 21 day medicine free period. After Chemotherapy
is instituted, a waiting period of 21 days was maintained for the WBC
count to return to normal, which drops during Chemotherapy. After
the waiting period got over, the second cycle of Chemotherapy was
administered. During this time, the patient was counselled for surgery,
the risk involved and the financial implications.
After 3 cycles of Chemotherapy, which was around 60-65 days,
the surgeon removed the tumour with safe margins all around it
(en bloc resection) following the oncology principles. Once the defects
were reconstructed, the soft tissue closures were shaped and the
patient was sent back for physiotherapy. The tumour that is resected
was assessed for the completeness of resection and also the onset of
necrosis resulting from Chemotherapy.
After the surgery and physiotherapy session, the patient experienced
almost full range of flexion. He is now able to return to his full functional
capacity and has the ability to squat on floor even after a major length
resection (19 cms). The patient is comfortable, sits on the floor, and has
resumed all his normal activities.
Carcinoma of limbs which was treated very dismally in the past is
being treated very well now. Patients have moved on from the place
of seclusion to a life full of function. They are socially active, have
resumed their jobs and live a normal life. With regular follow-up and
Chemotherapy sessions, almost 70% patients when diagnosed early
with Osteosarcoma have high (10-year disease free) survival rate.
With Chemotherapy advancements, outcomes have improved in the
last 15-20 years.