Bone Cancer Primary Treatment Surgery

Surgery for bone cancer to remove the tumor is the most common primary bone cancer treatment.

Surgeons generally use the wide-excision technique, which involves removing the tumor and some surrounding tissue that might contain stray cancer cells. These cells can cause the cancer to reoccur, so this is an important part of the procedure. The surgeon then replaces the bone removed during surgery with a piece of bone from another part of the body, or with a prosthesis made of metal or other material.

In the past, arm or leg cancer often required amputation. Thanks to newer limb-salvage surgery techniques, however, less than 10 percent of patients now require amputation (American Cancer Society, 2010).

Rehabilitation and Reconstructive Surgery

Wide-excision surgery for bone cancer does require an intense rehabilitation (rehab) period afterward. According to the American Cancer Society, patients who undergo this surgery need an average of one year to learn to walk again (2010). Without rehab after this bone cancer treatment, a patient may lose the use of the salvaged limb.

If leg amputation at mid-thigh is required, reconstructive surgery can rotate the lower leg and foot, attach the lower leg to the thigh bone and use a prosthesis to make the new leg as long as the other leg. In this type of surgery, the patient’s ankle joint becomes the knee joint. For a bone tumor in the upper arm, the surgeon can remove the tumor and reattach the lower arm, leaving the person with a shorter–but working–arm.

Bone Cancer Treatment: Curettage

Wide-excision surgery is not possible in all areas of the body, such as the spine or skull. Cancers in these areas typically require additional treatment with techniques that include curettage, cryotherapy and radiation.

Curettage involves scooping the tumor out of the bone without removing a section of the bone, leaving a hole in the bone. The surgeon may fill this hole with a bone cement called polymethylmethacrylate (PMMA). As the cement hardens, it releases a lot of heat, which attempts to kill any remaining cancer cells.

Bone Cancer Treatment: Cryotherapy

Cryotherapy (also called cryosurgery) is sometimes an alternative to traditional surgery for bone cancer. “Cryo” refers to the use of liquid nitrogen or argon gas on the tumor to create extreme cold that kills cancer cells.

The surgeon makes a small incision and inserts a hollow instrument called a cryoprobe. Using an ultrasound or MRI, he guides this probe and places it in contact with the tumor. As liquid nitrogen or argon gas circulates through the cryoprobe, ice crystals form around the probe, freezing nearby cells. After cryosurgery, the frozen tissue thaws, and the body naturally absorbs it.

Cryosurgery is less invasive than traditional surgery for bone cancer, sometimes requiring only a local anesthetic. Cryotherapy often has fewer complications, such as the pain and bleeding associated with traditional surgery. Additionally, cryosurgery costs less than other bone cancer treatment options and has a shorter recovery time, as well as less or no time in the hospital.

According to the National Cancer Institute, the long-term effectiveness of cryosurgery is uncertain; this bone cancer treatment may miss stray cancer cells that can lead to the cancer coming back (2003).

Resources

American Cancer Society. (2010). Bone cancer. Retrieved September 23, 2010, from http://www.cancer.org/Cancer/BoneCancer/DetailedGuide/bone-cancer-pdf.

Mayo Clinic. (2009). Bone cancer. Retrieved September 23, 2010, from http://www.mayoclinic.com/print/bone-cancer/DS00520/DSECTION=all