Tumor Surgeries
Bone cancer develops when healthy cells in the bone grow out of control, forming a mass of abnormal tissues called a tumor. A bone tumor may be benign (cancer cells do not spread to other parts of the body) or malignant (cancer cells spread throughout the body). A tumor in the bone will destroy the healthy tissues and weaken them, making the bone more susceptible to fractures. Though the treatment options vary from non-surgical treatments to surgical methods depending on the type of tumor, surgery is often considered the best treatment for bone cancer.
What is bone tumor surgery?
Bone tumor surgeries are those surgical procedures where the cancerous cells are removed and replaced with artificial grafts. In some cases, amputation is also necessary. Unlike other normal cells, cancer cells can continue to grow and develop a tumor if any are left behind after a procedure. Hence, tumor surgeries aim for the complete removal of cancer cells. Wide excision, a technique used in tumor procedures, ensures that both the tumor and some nearby normal tissues are removed.
Each tumor surgery differs in the technique used for tumor removal. The important techniques that are used in bone tumor surgeries are:
- Curettage: Curettage involves scooping the tumor out of the bone, leaving a hole in it, and filling the hole using bone cement.
- Cryosurgery: Cryosurgery involves freezing the tumor cells to subzero temperatures using liquid nitrogen to destroy the residual microscopic tumor cells.
- Resection: Resection is the removal of a large section of the affected bone tissue without disturbing the neighboring tissues.
- Amputation: Amputation refers to the surgical removal of the entire extremity without replacing it.
What are the types of bone tumor surgeries?
Bone tumor surgeries are of different types. The type of surgery depends on the location of the tumor, its type, its grade, its size, and its ability to come back after it is removed.
Tumor surgeries based on the location of the tumor
The bone tumor surgeries vary based on the location of the tumor; some of the surgeries are discussed below:
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Tumors in the arms and legs
If the tumor is in an arm or leg, the surgeries performed are limb salvage (mostly preferred) and amputation. Both methods require reconstruction surgery, where artificial implants like metal plates or bone grafts are used to replace the missing bone and provide strength to the leftover bone.
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Limb-salvage surgery
This surgery aims to remove all the cancer cells without damaging the nearby tissues, nerves, or blood vessels. It is a complex surgery and most often requires a bone graft (bone from another part of your body or from a donor) to replace the bone that's lost. It is also known as limb-sparing surgery, as tumors of the leg or arm can be removed without harming the limb.
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Amputation
It is the surgical removal of a part or the entire limb for the complete removal of tumor cells. When the tumor is large, has penetrated the tissues surrounding the bone, includes nerves, or involves blood vessels, amputation surgery is advised. In order to restore the severed limb's functionality, reconstruction surgery is also necessary during this process.
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Tumors in other areas
Apart from the arms and legs, bone tumors are also found in the pelvis, lower jaw bone, and spine or skull. Wide excision surgery is used to treat pelvic tumors in order to ensure that all cancer cells are eliminated. Reconstructive surgery is performed after the treatment.
Tumors in the lower jaw are treated by the surgical removal of the entire lower half of the jaw, and a prosthesis is placed.
Tumors in the spine and skull require a complex surgical procedure, as wide excision surgery is not possible in those areas. A combination of curettage, cryosurgery, and radiation is used for the removal of tumors in the spine and skull.
Tumor surgeries based on the type of cancer
Bone tumor surgeries can also be differentiated based on the type of cancer, i.e., benign and malignant tumors.
The benign tumors, which are non-cancerous, are usually treated with non-surgical methods; in some cases, surgeons may recommend surgical techniques. They are treated with less aggressive surgical methods like wide-excision surgery, as benign tumors have a lower chance of recurring after being treated.
Malignant or metastatic tumors are usually treated with aggressive surgical methods like limb salvage and amputation, as there are chances of distant spread of bone cancer even after treatment. The cancer that develops through the metastasis of primary cancer is known as secondary cancer. Mastectomy refers to the procedure used to eliminate secondary cancer. The most typical location for the spread of bone cancer is the lungs. In such cases, complete excision of lung metastases is typically advised. These operations are difficult to perform surgically.
Rehabilitation after tumor surgeries
Rehabilitation is an important part of any tumor surgery. Rehabilitation aims to help each patient return to their normal daily activities. Tumor treatments cause physical and psychological side effects, and it is important to consider all these factors during the recovery period. A team of healthcare professionals will guide you during the recovery period. The team may include:
- Physiotherapists: They will help the patient regain their fitness after the surgery. They will teach some exercises that will help keep the muscles strong and flexible and restore their normal movements.
- Occupational therapists: They will help in facilitating and enabling the patient to resume their daily routine by reducing the effects of disabilities caused by the surgery or psychological dysfunction. They aim to give patients a positive outlook after the surgical procedures.
- Psychologists: They will help to cope with the various psychological problems experienced by cancer patients, such as anxiety and stress. Psychologists will have counseling sessions with the patients where they will guide them on how to cope with emotions.
- Surgeons: They will help in the overall management after the surgery; they will guide the patient to understand what to expect after the procedure. Frequent hospital visits after the surgery are required, where the surgeon will examine the surgical site, evaluate health conditions, and ensure that the prosthesis is fitted properly in the exact position.
Outlook
Tumor surgeries aim for the complete removal of the cancerous tissues in the body. The surgical methods differ for each patient depending on the severity, type, and location of the tumors.
Rehabilitation is important after tumor surgeries. Recovery time differs for each person and will depend on the type of treatment, the patient’s age, their overall health, and many other factors. It's important to go to all the follow-up appointments for successful outcomes after the surgery. The artificial implants are designed for a longer run. One may require revision surgeries if there is any infection or wear and tear on the prosthetic.
