BONE CANCER TREATMENT IN NCHRC NEPAL
Bone cancer is a malignant tumor resulting from the atypical growth of cells either in the bones or any other body part. A significant number of bone cancer cases are metastatic, wherein the tumor originates in remote parts and infects bones. While the causes of bone cancer are yet to be uncovered, there are specific risk factors, such as exposure to radiation and alkylating agents, specific gene mutation and so on. The prominent symptom of the medical condition is a constant pain in the bones, which may worsen with time. As the chances of recovery increase with the early presentation, it makes sense to seek medical help on the onset of pain.
Department of orthopedic Oncology at Nepal Cancer Hospital Nepal has the right combination of technology and workforce to ensure world-class bone and soft tissue tumor treatments to domestic and offshore patients. Adopting a multi-modality approach for your bone tumor treatment, we put together a multispecialty team for complete cancer care. A typical bone tumor management team will include orthopedic oncologists, radiologists, pathologists, medical oncologists, reconstructive surgeons, surgical and radiation oncologists, counsellors, nurses and physiotherapists. As each aspect is catered to with professionalism and compassion, better patient outcomes are always anticipated.
We are well-equipped to manage all types of Orthopedic Oncological conditions. Whether you are suffering from Primary Bone Cancers like Sarcomas or Metastatic Bone Disease, we can take care of it all. We are also positioned to deliver treatments for several other bone malignancies, such as Myeloma and Lymphoma, along with Soft Tissue Sarcomas and Spine tumors. Benign tumors like Giant Cell Tumors, Aneurysmal Bone Cyst and Chondroblastoma are also managed. Besides bone cancer treatment, we can also support non-oncological orthopedic needs of patients hospitalized for other medical conditions.
We have the technology and skills to carry out super specialized surgical procedures for bone tumor treatment. We put our best foot forward to conduct limb salvage surgery with endoprosthetic replacement, vascularised bone autografts and extracorporeal radiotherapy. Our limb salvage surgery portfolio also includes re-implantation of tumor bone and total femur and total humerus replacement. We also perform specialized soft tissue sarcomas, internal hemipelvectomy, en bloc resections of primary spinal tumors and extended curettage of benign aggressive bone tumors.
Though the nature and scope of surgeries differ vastly, we conduct each with a common objective – to get rid of the malignant tumor while keeping the limb in the best possible shape. Our bone cancer treatment relies on the evidence-based principles supplemented by technology, research and personalized care. As a part of bone tumor management, we also provide counselling services to aid the recovery process.
Following are the different types of bone cancer:
- Osteosarcoma and Ewing sarcoma: Both of them are the most common types of bone cancer. These types of cancer occur in children, as well as young adults.
- Chondrosarcoma: This is the cartilage cancer and it’s more common in adults.
- Chordoma: This cancer begins in the lower spinal cord.
The exact causes of bone cancer are not known. However, bone cancer is also associated with hereditary factors, whereas others are related to radiation exposure. In bone cancer, cells begin to grow rapidly and while growing, the healthy cells die; whereas the abnormal cells begin accumulating in a specific body part leading to a tumour. The formed tumour can be benign (non-cancerous) or malignant (cancerous)
While the causes of bone cancer are unknown, doctors have determined the given risk factors that increase the chances of cancer:
- Genetic syndromes: There are certain inherited genetic syndromes, such as hereditary retinoblastoma and Li-Fraumeni syndrome, are passed down to the family lines. This increases the risk of bone cancer in the entire family line.
- Paget’s disease: This condition usually occurs in older patients and increases the risk of bone cancer.
- Radiation therapy: Exposure to higher doses of radiation for treating any type of cancer may also develop the risk of bone cancer after certain years.
Lungs and Bone are the two most common sites of spread for Primary bone sarcomas. Your doctor would advice screening of these sites before commencing treatment of bone sarcomas.
Doctor may recommend one or more imaging tests to evaluate the area of concern which include radiographs, MRI and/or CT scan.
Accurate diagnosis is the key in the management of bone cancers. Doctor may recommend a procedure to remove a sample of tissue (biopsy) from the tumour for laboratory testing. It is recommended that biopsy should be performed by the same surgeon who is going to do the final tumour surgery. A wrong biopsy may cause cancer to spread.
Once diagnosis of a cancer is confirmed, your doctor will ask for some further investigations to rule out the spread of disease which can include a bone scan, PET scan, CT scan of chest etc.
Surgery: It is the most common type of bone cancer treatment. It involves the removal of cancerous bone tissues via a surgical procedure. After surgery, radiation or chemotherapy may be performed for clearing any remaining cancer cells.
Radiation therapy: In this procedure, high doses of radiation therapy are used for shrinking tumours or cancer cells. However, radiation therapy can even damage surrounding healthy cells during the recovery procedure.
Chemotherapy: In the procedure, certain drugs are used for killing the multiplying cells, such as cancer cells, as well as cells lining the gastrointestinal tract. This treatment option also has certain side effects.
Outcome depends upon several factors like type of cancer, stage of disease, previous surgical treatment, adequacy of treatment and many more.
For Stage I/II bone sarcomas, 5 year survival of upto 70-75% can be expected. For Stage IV disease, survival is better when the disease spread is limited to lungs (IVa) as compared to other body sites (IVb).