Orthopaedic Oncologists Can Help Avoid Amputation

Dr Rajeev Reddy,

D Ortho (Manipal); DNB Ortho (Mumbai);

Fellow in Orthopaedic Oncology, Limb Salvage & Sarcomas (FOLS), Mumbai;

Fellow in Musculoskeletal Oncology (FMO); Italy

Consultant Orthopaedic Oncosurgeon

Apollo Health City, Jubilee Hills, Hyderabad

Instances of cancer are increasing every day. Whether they are malignancies of the lung, thyroid, breast, prostate or kidney, cancer has, unfortunately, become ubiquitous. Yet, not many are still unaware that cancer can occur in the bones, muscles and joints too. Though they are treatable if detected early, these cancers are difficult to spot and most people who are suffering from it, realise only too late. They are called bone sarcomas.

Sarcomas in the muscles and fat of the limbs (hands, legs) or back(spine) or pelvis are called soft tissue sarcomas. Sarcomas of the bones are of various types — osteosarcoma, Ewing’s sarcoma, chondrosarcoma etc. There are several soft tissue sarcomas as well, liposarcoma being one of the most common. Then there are tumours which occur in the bone that are not cancer. These can cause problems in the bone and surrounding area, but they do not spread to other parts of the body or cause danger to life. They are called benign tumours — giant cell tumour, osteoid osteoma, fibrous dysplasia, bone cysts and many others.

Until the later part of the last century, bone sarcomas meant a death sentence to the patient. Medical and surgical procedures to correct sarcomas were not developed. The legs or hands had to be removed (amputation) in order to prevent spread of cancer and danger to life. However, with specialised fellowships from both India and abroad, we now have orthopaedic oncologists/ orthopaedic onco-surgeons available in our country and also in the city. Due to the difficult nature of these cancers, an orthopaedic oncologist is the correct person to consult in such cases. Mostly, the difference between being able to save a limb or cutting it off depends on the expertise of the surgeon and how much exposure he/she has had to these tedious and long surgeries. The chances of the cancer coming back or spreading elsewhere are minimised with the correct combination of surgical expertise medical drugs (chemotherapy) and radiation therapy. These decisions are taken by the orthopaedic oncologist along with the medical and radiation oncologist.

An orthopaedic oncologist also treats and if necessary, operates on other cancers that have spread to the bone and have weakened the bone causing pain or fracture. Any cancer — commonly breast, prostate, thyroid, kidney, lung, intestine cancers — can spread to the any of the 206 bones in the human body. Hence it is advisable to get a bone scan or PET Scan to look for spread to the bones, in patients who are diagnosed with these cancers.

Don’t ignore sudden. spontaneuos pain or swelling in the limbs (arms, forearms, hands, thighs, legs, feet) or back/pelvic area. It could occur to anyone from a 4-year-old to a 70-yearold. To improve chances of your limb being saved and to control the recurrence of bone cancer, choose a specialist with expertise in orthpaedic onco surgery.