Bone cancer specialist in Delhi
Bone cancer specialist in Delhi

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Whenever possible, it’s very important that the biopsy and the surgery to remove the tumor be planned together, and that an experienced orthopedic surgeon does both the biopsy and the surgery. The biopsy needs to be done in a certain way to give the best chance that less extensive surgery will be needed later on.

Bone cancer specialist in Delhi

The main goal of surgery is to remove all of the cancer. If even a small amount of cancer is left behind, it might grow and make a new tumor, and might even spread to other parts of the body. To lower the risk of this happening, surgeons remove the tumor plus some of the normal tissue around it. This is known as a wide excision.

Bone cancer specialist in Delhi

After surgery, a doctor called a pathologist will look at the removed tissue to see if the margins (outer edges) have cancer cells.

Bone cancer specialist in Delhi

If cancer cells are seen at the edges of the tissue, the margins are called positive. Positive margins can mean that some cancer was left behind.
Bone cancer specialist in Delhi
When no cancer cells are seen at the edges of the tissue, the margins are said to be negative, clean, or clear. A wide-excision with clean margins helps limit the risk that the cancer will come back in the place where it started.
Bone cancer specialist in Delhi
The type of surgery done depends mainly on the location and size of the tumor. Although all operations to remove bone cancers are complex, tumors in the limbs (arms or legs) are generally not as hard to remove as those in the jaw bone, at the base of the skull, in the spine, or in the pelvic (hip) bone.

Bone cancer specialist in Delhi

Surgery for bone tumors in the arms or legs
Bone cancer specialist in Delhi

Tumors in the arms or legs might be treated with either:

Bone cancer specialist in Delhi

Limb-salvage (limb-sparing) surgery: removing the cancer and some surrounding normal tissue but leaving the limb basically intact
Bone cancer specialist in Delhi
Amputation: removing the cancer and all or part of an arm or leg
Bone cancer specialist in Delhi
When discussing your options with the treatment team, it's important to consider the pros and cons of either type of surgery. For example, most people prefer limb-salvage over amputation, but it's a more complex operation and can have more complications. If a limb is amputated, the patient will need to learn to live with and use a prosthetic limb.

Bone cancer specialist in Delhi

Both types of operations have the same overall survival rates when done by expert surgeons. Studies looking at quality of life have shown little difference in how people react to the final result of the different procedures.

Bone cancer specialist in Delhi

And when researchers have looked at the results of the different surgeries in terms of a person’s quality of life afterward, there has been little difference between them. Still, emotional issues can be very important, and support and encouragement are needed for all patients.

Bone cancer specialist in Delhi

Bone cancer specialist in Delhi

Limb-salvage surgery
Bone cancer specialist in Delhi

Most people with arm or leg tumors can have limb-sparing surgery, but this depends on where the tumor is, how big it is, and if it has grown into nearby structures.

Bone cancer specialist in Delhi

The goal of limb-salvage surgery is to remove all of the cancer and still leave a working leg or arm. This type of surgery is very complex and needs to be done by surgeons with special skills and experience.

Bone cancer specialist in Delhi

The challenge for the surgeon is to remove the entire tumor while still saving the nearby tendons, nerves, and blood vessels to keep as much of the limb’s function and appearance as possible.

Bone cancer specialist in Delhi

If the cancer has grown into these structures, they will need to be removed along with the tumor. (In such cases, amputation might sometimes be the best option.)

Bone cancer specialist in Delhi

The section of bone that is removed along with the tumor is replaced with a bone graft (a piece of bone from another part of the body or from another person) or with an endoprosthesis (internal prosthesis), which is a device made of metal and other materials that replaces part or all of a bone. Some newer devices combine a graft and a prosthesis.

Bone cancer specialist in Delhi

Complications of limb-salvage surgery can include infections and grafts or rods that become loose or broken. Those who have limb-salvage surgery might need more surgery in the following years, and some might still eventually need an amputation.

Bone cancer specialist in Delhi

Amputation
Bone cancer specialist in Delhi

For some patients, amputation of part or all of a limb is the best option. For example, if the tumor is very large or if it has grown into important nerves and/or blood vessels, it might not be possible to remove all of it and still leave behind a functional limb.

Bone cancer specialist in Delhi

The surgeon determines how much of the arm or leg needs to be amputated based on the results of MRI scans and examination of removed tissue by the pathologist at the time of surgery.

Bone cancer specialist in Delhi

Surgery is usually planned so that muscles and the skin will form a cuff around the amputated bone. This cuff fits into the end of an artificial limb (external prosthesis). Another option might be to implant a prosthesis into the remaining bone, the end of which remains outside the skin. This can then be attached to an external prosthesis.

Bone cancer specialist in Delhi
Reconstructive surgery can help some patients who lose a limb to function as well as possible. For instance, if the leg must be amputated mid-thigh (including the knee joint), the lower leg and foot can be rotated and attached to the thigh bone, so that the ankle joint functions as a new knee joint. This surgery is called rotationplasty. A prosthetic limb would still be needed to replace the lower part of the leg.

Bone cancer specialist in Delhi

If the bone tumor is in the shoulder or upper arm and amputation is needed, in some cases the area with the tumor can be removed and the lower arm reattached so that the patient has a functional, but much shorter, arm.

Bone cancer specialist in Delhi

Rehabilitation after surgery on an arm or leg
Bone cancer specialist in Delhi

This may be the hardest part of treatment, and it cannot be described here completely. If possible, there should be a meeting with a rehab specialist before surgery so you will understand what this might entail.

Bone cancer specialist in Delhi

Rehab after amputation typically takes less time than after limb-sparing surgery. For a tumor on a leg bone, people are often walking again 3 to 6 months after leg amputation, whereas it takes about a year, on average, for patients to learn to walk again after limb-salvage surgery.

Bone cancer specialist in Delhi

Physical rehab is also much more intense after limb-salvage surgery than it is after amputation, but it’s still extremely important. If the patient doesn’t actively take part in the rehabilitation program, the salvaged arm or leg might become useless, and might require amputation.

Bone cancer specialist in Delhi

Surgery for bone tumors in other parts of the body
Bone cancer specialist in Delhi

Tumors in the pelvic (hip) bones can often be hard to remove completely with surgery. Some types of tumors can be treated with chemotherapy first to help shrink the cancer and make the operation easier. Pelvic bones can sometimes be reconstructed after surgery, but in some cases pelvic bones and the leg they are attached to might need to be removed.

Bone cancer specialist in Delhi

For tumors in the lower jaw bone, the entire lower half of the jaw may be removed and later replaced with bone from other parts of the body. If the surgeon can’t remove all of the tumor, radiation therapy may be used as well.

Bone cancer specialist in Delhi

For tumors in areas like the spine or the skull, it might not be possible to remove all of the tumor safely. Cancers in these bones could require a combination of treatments such as curettage (removal by scraping - see below), cryosurgery, and radiation.

Bone cancer specialist in Delhi

Bone cancer specialist in Delhi

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