What are Bone Tumours?
Tumours of the bone can be either benign or malignant, the malignant variety being more of a challenge to treat. Furthermore malignant tumours could either be primary tumours of the bone or secondary deposits from tumours elsewhere in the body. The most common bone tumours encountered are osteosarcomas and Ewing’s sarcoma. The most common sites of occurrence are around the knee joint – either distal femur or proximal tibia. The dramatic change of events from amputation to limb salvage surgeries has heralded a new hope to these patients who have this form of cancer.
When a person has cancer of the bone, surgery forms a part of the treatment. Formerly if the malignant Tumour was in the limbs, surgery meant amputation of the limb. The entire limb or part of it would be removed. This led to marked disability and disfigurement. The person also had to suffer social stigma. In order to overcome the functional, psychological and social problems associated with amputation, the concept of limb salvage was evolved. Here, despite the surgery and removal of the Tumour, the limb is spared.
The aim of limb salvage surgery in bone Tumour management is to eradicate the disease, retain the integrity of the skeletal system and preserve a limb with useful function.
Successful limb sparing procedures consists of three phases:
- Bone resection: After making an accurate assessment of the stage and spread of the Tumour the surgeon removes the affected part of the bone.
- Reconstruction: The second phase of the procedure involves replacing the missing part of the patient’s body. Prosthesis or implants are made of steel or titanium.
- Plastic surgery: This is performed to cover the area with muscle and soft tissues.
Then customized mega prostheses are tailor made for each patient. They conform to each and every patient and fit him or her perfectly.
The prosthesis is fitted only when the surgeon feels that the disease can be controlled by removing only one portion of the bone and not the whole limb; using an implant will give the person more comfort than removing the hand or leg and fitting with an artificial limb. A patient may or may not be able to get the full use of the limb, but a certain amount of functionality can be restored. The main advantage will be that the cancer would be treated without major disability.