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Orthopaedic Surgical Oncology in India

Orthopedic Oncology

Orthopedic oncology specializes in the treatment of men and women with bone cancer, sarcoma or cancer that has spread to the bone from other areas of the body.

Orthopaedic Oncology Diagnosis and Treatment

Benign Bone Tumor

Benign bone tumors are tumors that form in bone and typically do not grow or spread beyond bone. These tumors generally are not life threatening, but because they replace healthy bone tissue with abnormal tissue, they can cause bones to weaken. Some benign bone tumors aggressively destroy bone. Pain or a lump in the area of a benign bone tumor is the most common symptom. surgical treatment is done  to remove the tumor and thereby restoring the bone health.

Types of Benign Bone Tumors

    • Osteochondromas
    • Nonossifying Fibroma Unicameral
    • Giant Cell Tumors
    • Enchondroma
    • Fibrous Dysplasia
    • Aneurysmal Bone Cyst
    • Chondromyxoid Fibroma
    • Osteoblastoma

Malignant Bone Tumor

Malignant bone tumors are much less common than benign tumors. They are also much more dangerous. The term “malignant” indicates that there is moderate to high probability that the tumor will spread beyond the site where it initially develops. These tumor cells can travel through the blood stream or through lymph vessels. The most common site where malignant bone tumors spread is the lungs. Radiotherapy and chemotherapy are the treatments required either before or after the surgery. The aim of the surgery is to remove the entire diseased bone in order to avoid amputation and thereby restoring the appearance and function of the diseased area.
Types of malignant bone tumorare-

        • Osteosarcoma
        • Chondrosarcoma
        • Ewing’s Sarcoma
        • Multiple Myeloma
        • Metastatic Carcinoma
        • Malignant tumors of bone

Lesions of Joints

They appear in the form of capsules of joints like shoulder, foot, hip, knee, elbow or wrist. lesions can develop and harm or create pain in the joint. The surgical procedure is done to remove the lesion of the joint and thereby restoring the health and function of the diseased area

Types of Lesion

        • Tenosynovial Giant Cell Lesion
        • Pigmented Villonodular Synovitis
        • Synovial Chondromatosis

Soft tissue sarcoma

Soft tissue sarcoma is a cancer that starts in soft tissues of the body, including muscle, tendons, fat, lymph vessels, blood vessels, nerves, and tissue around joints. The tumors can be found anywhere in the body but often form in the arms, legs, chest, or abdomen. Treatments include Radiotherapy and chemotherapy that are done either before or after the surgery.

Types of Soft tissue sarcoma are

  • Fibrosarcoma
  • Liposarcoma
  • Rhabdomyosarcoma
  • Malignant fibrous histiocytoma
  • Synovial cell sarcoma
  • Malignant soft tissue lesions

Bone Cancer Treatment

Cancer begins when normal cells in the bone change and grow uncontrollably, forming a mass called a tumor. A bone tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can spread to other parts of the body. A benign tumor means the tumor will not spread. Even though a benign tumor does not spread outside the bone, it can grow large enough to press on surrounding tissue and weaken the bone. A malignant tumor can destroy the cortex and spread to nearby tissue. If bone tumor cells get into the bloodstream, they can spread to other parts of the body, especially the lungs, through a process called metastasis

Symptons

  • Pain. The earliest symptoms of bone cancer are pain and swelling in the area in which the tumor is located. The pain may come and go at first, then become more severe and steady later. The pain may get worse with movement, and there may be swelling in the soft tissue nearby.
  • Joint swelling and stiffness. A tumor that occurs near or in joints may cause the joint to swell and become tender or stiff, which means a person may have a limited and painful range of movement.
  • Limping. A break, also called a fracture, in the bone with the tumor may cause a pronounced limp if the leg is affected. This is usually a symptom of later-stage bone cancer.
  • Other less common symptoms. Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low red blood cell level.

Types of Bone Tumor

Osteosarcoma, which arises from osteoid tissue in the bone. This tumor occurs most often in the knee and upper arm. Osteosarcomas can grow anywhere in the skeleton

Ewing tumor, also known as Ewing’s sarcoma, typically starts in the bones, but can also start in other tissues and muscles. It is the third most common form of primary bone cancer. It occurs most frequently in children and teenagers, and is rarely seen in adults over the age of 30.

Chondrosarcoma forms in cartilage cells and is the second most common form of the disease. This type of bone cancer have chances of developing it increase with age.

Giant cell tumor of bone can have benign and malignant forms, although the malignant form is less common. It usually occurs in the arm or leg bones of young and middle-aged adults, and rarely spreads to distant parts of the body.

Chordoma affects bones in the spine and the base of the skull. This type of bone cancer occurs most frequently in adults 30 or older, particularly men. It tends to be a slow growing tumor with a low risk of spreading to distant sites, but may return at the original site if not removed completely during surgery, and may eventually spread to the lungs, liver or lymph nodes.

treatment options

Treatment for bone tumors depends on the specific type of tumor, its size, its location, and age. Sometimes, surgery is not necessary. For instance, some tumors will often resolve and heal after a fracture.The treatment includes medical treatment and surgical treatment. Surgical treatment includes both removing the tumor and the regeneration of new healthy bone at the site of the tumor

Bone Grafts

Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. A bone graft can be taken from the patient’s own healthy bone (this is called an autograft). Or, it can be taken from frozen, donated bone (allograft). In some cases, a manmade (synthetic) bone substitute is used.During surgery, the surgeon makes a cut over the bone defect. The bone graft is shaped and inserted into and around the area. The bone graft can be held in place with pins, plates, or screws

Bone grafts are used to Fuse joints to prevent movement,Repair broken bones (fractures) that have bone loss and Repair injured bone that has not healed. When the body grafts are accepted by the body then it helps in providing the growth of new living bone

Robotic Surgery

Robotic surgery is a minimally evasive procedure and latest procedure  used for treating the cancer. As compared to  standard laparoscopy and open surgeries ,Robotic surgery is more precise with less blood loss. In this surgery the procedure needs small incisions which are held by robotic arm that can lessen the trauma to the tissues. Robotic surgery is very safe and involves less pain and complications. The recovery period is also faster and requires a short stay at the hospital.