Tumours (Ortho Oncology)

Bones are made up of hard or compact osteoid, tough and flexible cartilaginous, and fibrous threadlike tissue, along with the elements of bone marrow. A lump or mass of tissue formed usually when cells divide uncontrollably results in a tumour. In such a condition, healthy tissues are replaced with abnormal tissues, causing the bone to fracture or break. Possible causes of bone tumour include inherited genetic mutations, exposure to radiation and trauma and so on.

These tumours can be noncancerous (benign) or cancerous (malignant). Benign tumours are not life threatening, whereas malignant tumours can spread cancer cells throughout the body via the blood or lymphatic system.

There are many types of benign bone tumours. The more common types are non-ossifying fibro-maunicameral (simple) bone cyst, osteochondroma, giant cell tumour, enchondrama and fibrous dysplasia. Primary bone cancer is a condition when malignant tumours are found in the bone tissue. Common types of primary bone cancer include

  • Osteosarcoma, that arises from the osteoid tissues in the bone. Such a tumour is common in the knee and upper arm.
  • Chondrasarcoma, arises in the cartilaginous tissue. It occurs most often in the pelvis region, upper leg and shoulder areas.  It’s found affecting usually patients between 40-70 years of age.
  • Ewings sarcoma occurs in the soft tissues of the bone. They occur commonly along the backbone and in the arms and legs of the patients. It usually is found occurring in children and adolescents under the age of 19. Boys are found to be affected more than girls.

Symptoms and diagnosis

The most common symptom of bone tumours is pain, which increases gradually over time. Persistent fever, night sweating, dullness and body ache and unusual swellings should be paid immediate attention.

Tumours can be identified with basic X-rays, MRI scans, bone biopsy, bone scan, alkaline phosphatase blood level, Positron Emission Tomography (PET) scan and such tests.

Treatment

The treatment options depend on the type, size, location and stage of the tumour growth, as well as the patient’s health, age and so on. Treatment for bone cancer includes surgery, amputation, medication, chemotherapy, radiation therapy, and cryosurgery. Amputation surgery removes the entire tumour with negative margins. Chemotherapy is the use of anticancer drugs to kill the cancer cells. However, chemotherapy is not used to treat Condrosarcoma. Radiation therapy techniques use high energy x-rays to kill cancerous cells.  Cryosurgery is when liquid nitrogen is used to freeze and kill the cancer cells. These techniques can be used independently or as a combination for the treatment of bone tumour. Post-treatment care is to be observed in such situations. Tumours have high rates of re-occurrence and relapses should be monitored and brought to the notice of the surgeons/doctors immediately.

Research is being performed on the use and design of metallic implant. Advancements in ortho oncology research will help provide improved medication and new combinations of surgical techniques, improving the survival outcomes from these tumours.