Overview
For the happy and healthy existence of the human body, many factors should get aligned – just right. While mental health and physical health are equally important, there is one discipline in medicine that keeps us going – quite literally. Orthopaedic Oncology is a medical speciality where an expert physician or a surgeon diagnoses and treats benign and malignant tumours of the musculoskeletal system, including bones, fibrous tissues, muscles, nervous tissues, soft tissues, cartilage and blood vessels.
With more osteosarcoma or bone cancer cases getting recorded every year, this unique speciality demands world-class experts to deal with it deftly.
Orthopaedic Cancers in India
Bone tumours can be a challenging and overwhelming condition to treat. Osteosarcoma is one of the most common malignant tumours among children and adults in our country. It accounts for 4% of childhood cancers across the globe and in India; the malignancy varies between 4.7% and 11.6%.
Types of Orthopaedic Cancers
Bone cancers can happen at any age. It is defined as an abnormal growth of a tumour, which can either be benign or malignant. While benign tumour doesn’t spread to the other parts of the body, can be easily treated, malignant tumours metastasise to other places in the body, often destroying the cortex of the bone.
1. Osteosarcoma:
One of the primary types of bone cancers, osteosarcoma develops in the connective tissues of the body. Though very rare, it can occur both in children and adults; it affects muscles, fat, tendons, cartilages, nerves, bones and blood vessels. It primarily forms in the knee joints but can also occur in other bones of the body like upper arms, near the shoulders and very rarely in the soft tissue outside the bone. If the tumour is diagnosed in the bone, it is medically referred to as a central tumour or medullary tumour. The ones that occur on the surface are called peripheral tumours.
2. Ewing Sarcoma:
Tumours that appear in the bone or the soft tissue in the legs, arms, ribs, spine, pelvis are known as Ewing sarcoma. It is an extremely rare type of tumour, an aggressive type of cancer that needs immediate medical attention and treatment for preventing it from spreading to other parts of the body.
3. Chondrosarcoma:
This type of cancer affects adults and occurs in the cartilage, the connective tissue from where the bones develop. It is a rare type of cancer amounting to 20% of the bone cancer cases.
4. Chordoma:
Also referred to as notochordal sarcoma, chordoma is slow-growing cancer that occurs anywhere along the spine. In most cases, it is diagnosed at the tailbone or on the top of the spine where it meets the skull. If diagnosed at the tailbone, it is called a sacral tumour, and if it is at the skull, it is referred to as a clival tumour.
There are other soft tissue sarcomas:
1. Undifferentiated Pleomorphic Sarcoma:
It is a very rare type of bone cancer found in the knee joints of adults.
2. Fibrosarcoma:
A soft tissue sarcoma that affects the thigh bone and is often diagnosed in the middle-aged.
3. Sarcoma Of Paget’s Disease of Bone:
More common in the elderly, this tumour presents as an overgrowth of bony tissues, in the skull region. In certain rare cases, it can develop into osteosarcoma.
Treatment for Orthopaedic Cancers
Bone cancers can affect any age group, and just like in the case of all tumours, early diagnosis plays a pivotal role, in achieving a positive outcome. The treatment protocol in the majority of the cases is as follows:
a. Surgery: The main goal of surgery is the removal of cancer cells, and it is done through various procedures, including wide excision, limb-salvage surgery. In certain cases, amputation of the arm or leg remains the only option to stop the further spread of cancer and avert fatality.
b. Chemotherapy: Using chemo drugs for killing cancer cells forms a major part of the treatment protocol. These drugs that are administered intravenously destroy cancer cells in the body. It is often recommended while dealing with osteosarcoma, Ewing sarcoma, undifferentiated pleomorphic sarcoma, chordoma and chondrosarcomas.
c. Radiation Therapy: Radiation is aimed at killing cancer cells by projecting intense, high-energy x-rays at the target. It is done either through:
- Intensity-modulated Radiation Therapy
- Stereotactic Radiosurgery
- Proton-beam Radiation Therapy
Orthopaedic Oncology at HCG
HCG is a pioneer in advanced cancer care. With a dedicated team of orthopaedic surgeons, ortho-oncologists, ortho-oncosurgeons, reconstructive surgeons on the Sarcoma board, HCG offers a multidisciplinary approach while dealing with bone cancers.
The experts ensure to deliver tailor-made treatment services upon considering factors like the age, type of cancer and overall condition of the patient with a special focus on post-treatment quality of life.
For patients, who had to have a full amputation or partial, limb preservation and reconstruction is a sure-shot way that ushers in new life and confidence. For more information on treatment options and follow-up care for orthopaedic cancers, please get in touch with HCG specialists.
Frequently Asked Questions
1. What does an orthopaedic oncologist do?
Orthopaedic oncologists are extensively trained medical experts who have vast experience in diagnosing and treating bone cancers. Orthopaedic oncology is a highly advanced speciality that demands world-class expertise for repairing, restoring and preserving the functioning of the musculoskeletal system due to cancer.
2. What are the risk factors for developing a sarcoma?
Sarcoma is a type of cancer that emerges either in bones, cartilage or other soft tissues of the body. There is no definite known reason or a cause behind sarcoma. Major risk factors however include previous exposure to radiation therapy, genetics, poor immunity or immune system abnormalities, lymphedema and chemicals.
3. Are orthopaedic cancers treatable?
Orthopaedic cancers are treatable, especially if they are diagnosed early and are localised. The longevity of an orthopaedic cancer patient increases significantly after receiving proper care and treatment.
4. How are orthopaedic cancers diagnosed?
Orthopaedic cancers are diagnosed after running a series of imaging tests, including bone scan, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET-CT) besides blood work, surgical or needle biopsies. The doctor would coordinate various test results before diagnosing and zeroing in on the stage of bone cancer.
5. Which are the common symptoms of orthopaedic cancers that patients should not ignore?
Bone cancer often presents with excruciating pain, inflammation and tenderness in the affected region, sudden fractures, weak bones, unintended weight loss and persistent weight loss. If you are experiencing any of these symptoms, do see the doctor immediately.
6. Where does bone cancer normally start?
Osteosarcoma, the most common type of bone cancer, starts in bone, where cancer cells are produced and are often seen in children. Chondrosarcoma happens in the pelvis, legs and arms and is seen in older adults. Ewing sarcoma is also seen in young adults, children and is found in the pelvic region.
7. Can orthopaedic cancers be prevented?
No. At this point of time, orthopaedic cancers cannot be prevented. Early diagnosis is the key to treating orthopaedic cancers successfully, and if you are a high-risk individual, you should talk to your doctor to learn the best practices to reduce the risk of this disease.