DONATEMusculoskeletal Oncology Services
Overview
The Department of Orthopedic Oncology at Rajiv Gandhi Cancer Institute & Research Centre, has dedicated Bone and Soft Tissue tumor services with specialists trained in the management of these tumors. All patients presenting with benign or malignant bone and soft tissue tumors are managed by a Multispecialty Team consisting of Orthopedic Oncologists, Radiologists, Pathologists, Medical Oncologists, Reconstructive Surgeons, Surgical and Radiation Oncologists, Physiotherapists, Counselors and Nurses.
What is Musculoskeletal Cancer ?
It includes tumors arising from bones and soft tissues of body.
Bone tumors develop.when cells within bone divide uncontrollably forming a lump or a mass of abnormal tissue.
Soft tissue sarcomas are malignant tumors that originate in the soft tissues of our body. Soft tissue sarcomas are rare tumors constituting 1% of all adult cancers but 15% of childhood cancers.
Musculoskeletal Oncology Services
Bone
cancer
- Primary Bone Cancers (Sarcomas, e.g. Osteosarcoma, Ewing Sarcoma and Chondrosarcoma)
- Benign tumors/ cysts of bone (eg. giant cell tumors, aneurysmal bone cyst, chondroblastoma etc)
- Other Malignancies of Bone (eg. Myeloma, Lymphoma etc)
- Metastatic Bone Disease (Cancers of other organs spreading to bone)
- Soft Tissue Sarcomas (Primary cancers of connective tissue other than bone)
- Tumors involving the spine
Signs and Symptoms of Musculoskeletal Cancer
- Limitation of movement.
- Pain- Intermittent or continuous, may become more at night, sometimes excruciating
- Swelling – Long duration for benign tumors. Rapid increase in size in malignant tumors. Skin changes may be seen over skin with prominent veins. Mobility of nearby joint may be affected.
- Varying degree of disability, weight loss, malaise, weakness, gait abnormalities, backache, paresthesia, paraplegia, urinary or bowel control affected.
- Low grade fever, night sweats and loss of weight
- Pathological fracture with trivial trauma
- Symptoms depend on type of tumor, speed of growth and site of tumor.
Screening and Diagnosis of Musculoskeletal Cancer
- History, family history and clinical examination
- X-Rays of affected part, X-Ray chest
- CT Scan/MRI of concerned part
- Bone Scan
- PET Scan in selected cases
- Biopsy (Core) of tumor to confirm the diagnosis.
- Incisional biopsy
- Blood test including Alkaline Phosphatase, Serum Calcium and other biochemical tests
Treatment of Musculoskeletal Cancer
Treatment is multimodal including surgery, radiotherapy, chemotherapy and targeted therapy. In large tumors chemotherapy/radiotherapy is given first. Incases of osteosarcoma of limbs, chemotherapy is given first followed by surgery with the aim of saving limb.
Goal of limb salvage surgery is to remove all cancer and still leave a working limb.
A large number of highly specialized surgeries are performed by the orthopedic oncology unit at Rajiv Gandhi Cancer Institute & Research Centre, all of which aim at adequately removing the tumor while preserving the form and function of the limb. These include limb salvage surgery with endoprosthetic replacement, cryo-freeze liquid nitrogen treatment, 3d printed customized patient specific metal implants, navigation assisted limb salvage surgery, vascularised bone autografts, extracorporeal radiotherapy and re implantation of tumor bone and total femur and total humerus replacement. Limb salvage surgery for soft tissue sarcomas, internal hemi-pelvectomies, en bloc resections of primary spinal tumors and extended curettage of benign aggressive bone tumors are some of the other specialized surgeries performed by the unit. A strict adherence to evidence based principles combined with innovations individualized to the needs of the patient form the basis of Orthopedic Oncology management at Rajiv Gandhi Cancer Institute & Research Centre.
It has been established beyond doubt that the outcome of bone and soft tissue tumors is best when managed at a specialized center dedicated to the management of these rare and complex diseases. At centers such as ours, more than 85 percent of patients having cancers of bone are treated with limb saving surgery. It is strongly recommended that the biopsy of a bone or soft tissue sarcoma should be performed at the center where the patient is going to be managed ultimately, because following an incorrectly performed biopsy; it may not be possible to save the limb if a curative surgery is planned. Hence, a timely consultation at an appropriate center is vital for optimal outcome of these diseases.
How is RGCIRC Different
The Department of Orthopedic Oncology at Rajiv Gandhi Cancer Institute & Research Centre, has dedicated Bone and Soft Tissue tumor services with specialists trained in the management of these tumors. All patients presenting with benign or malignant bone and soft tissue tumors are managed by a Multispecialty Team.
A strict adherence to evidence based principles combined with innovations individualized to the needs of the patient form the basis of Orthopedic Oncology management at Rajiv Gandhi Cancer Institute & Research Centre. Slogan of musculoskeletal services is “SAVE LIMBS”
Risk Factors of Musculoskeletal Cancer
- Preexisting benign bone tumors increase the risk of chondrosarcoma.
- Chordoma is known to be familial.
- Paget disease of bone
- Previous radiation therapy
- Fibrous dysplasia has small risk of transforming into osteosarcoma
- Multiple exostoses is an inherited condition in which a person has many benign bone tumors called osteochondromas.
- Some inherited cancer syndromes like retinoblastoma, li-fraumeni syndrome, bloom syndrome have increased risk of developing osteosarcoma.
Prevention & Cure of Musculoskeletal Cancer
There are no lifestyle changes that can prevent musculoskeletal cancers
- Maintain weight and quit smoking are healthy lifestyles.
- Avoid unnecessary x-rays or radiation exposure.
- If there is strong family history of cancer consult a genetic counsellor.
- Any fracture occurring after trivial trauma could be pathological fracture
DO’s after Surgery
- Keep your wound clean
- Take medicines as prescribed
- Use waling aids if recommended
- Attend follow up check-ups
- Adequate fluid intake and nutrient rich diet
- Emphasize personal hygiene and adequate rest
- Undergoing rehabilitation and performed the exercised as advised by your physiotherapist
DON'Ts after Surgery
- Placing additional stress on the wound site
- Drive and work to soon
- Gym and sporting activities
- Smoking
Patient may ask to doctor
- How will you confirm the diagnosis and how will you stage it?
- What type of tumor do I have?
- What is the treatment for bone tumor?
- What are the chances of recovery?
- Will I have radiotherapy and chemotherapy for my tumor?
- Can my limb be saved?
- When can I walk and go to my work?
- What type of prosthesis will be put?
- What type of disability will I have after surgery?
- When will you say that I am disease free?
- Varying degree of disability, weight loss, malaise, weakness, gait abnormalities, backache, paresthesia, paraplegia, urinary or bowel control affected.
- Low grade fever, night sweats and loss of weight
- Pathological fracture with trivial trauma
- Symptoms depend on type of tumor, speed of growth and site of tumor.
