Depending on the stage of the bone cancer, different treatment modalities are administered.
The treatment of bone cancer is complex and almost always involves a team of surgeons, oncologists and radiation therapists.
Prior to surgery, the possible treatment options are discussed. Even though removal of the cancer is the goal, the aim is always to spare the limb.
Types of Treatment
Surgery is the first choice treatment for bone cancer if there is no evidence of spread. Surgery has traditionally involved an amputation. If the bone cancer is confided below the knee, then an above knee amputation is performed. The aim of surgery is to excise the entire tumor and leave a piece of healthy tissue. Even though amputations are the classic treatment for bone cancer, this treatment also carries a certain morbidity. Individuals who have above knee amputations can rarely ambulate again.
Today, prior to undertaking an amputation, chemotherapy may be undertaken to shrink the tumor. Neoadjuvant therapy (before surgery) can help one avoid a major amputation. In almost all case, adjuvant chemotherapy (after surgery) is also administered to most patients. To spare the limb, some type of combination radiation and/or chemotherapy is almost always offered to the patient.
When bone tumors are excised without an amputation, some type of reconstruction is generally done to help the individual use the extremity after surgery. This may involve use of a prosthetic device or transfer of bone from another part of the body.
In some cases of osteogenic sarcoma, the treatment may involve excising or amputation of the extremity plus surgical removal of the metastasized tumor (example from the lung).
Ewing’s cancer generally tends to spread fast and the treatment may involve a combination of chemotherapy, radiation plus surgery.
Radiation therapy is never the sole therapy for bone cancer. It may be used at the same time as chemotherapy or after surgery. Radiation therapy is also quite effective at relieving pain, pressure or shrinking the tumors.
Chemotherapy is generally administered when spread of cancer is documented or suspected. The chemotherapeutic drugs are designed to kill cancer cells all over the body. Chemotherapy is never administered with a single drug but with a combination of potent agents.
The possible benefits of chemotherapy include the following:
- May help shrink the primary tumor
- May help control spread of cancer
- May relieve symptoms and improve the quality of life
- May prolong life
The comprehensive treatment for bone cancer depends on the stage and grade. In any case, bone cancer treatment is usually undertaken at specialized centers where there are physicians who have expertise in the treatment of such cancers.