Orthopedic Oncology

Orthopedic oncology (also called musculoskeletal tumor) is an orthopedic specialty that includes the evaluation and treatment of musculoskeletal tumors. Treatment of musculoskeletal tumors depends on the tumor type. Many benign tumors can be simply followed and do not require any surgery. Others benefit from a simple excision. Malignant tumors, commonly known as sarcomas, require greater surgery and reconstruction, and sometimes additional radiation or chemotherapy. For metastatic bone disease, the goal of surgery is to relieve pain and prevent fracture of the bone. Sometimes this can be done with radiation alone and sometimes it requires surgery.

Bone Tumors

A bone tumor is an abnormal growth of cells within the bone, which can be benign or cancerous. In most cases, a malignant bone tumor occurs when cancer has spread from another part of the body. The most common cancers that spread to the bone are:

  • Breast
  • Lung
  • Prostate
  • Kidney
  • Thyroid

Benign bone tumors may not require treatment, but doctors often want to evaluate the tumor periodically to check for progression or regression. In some cases, surgery may be required to remove the tumor.

Treatment of a malignant tumor depends on the tissue or organ involved. Radiation therapy with chemotherapy or hormone therapy is commonly used. Primary, malignant bone tumors require chemotherapy and surgery, and radiation may be required after surgery.

Tissue Tumors

Soft tissue tumors arise in tissues such as fat, muscles, nerves, tendons, and blood or lymph vessels. Malignant soft tissue tumors are called sarcomas. Sarcomas are rare and represent about one percent of all cancer cases.
Surgery combined with radiation therapy or chemotherapy (or both) is the primary treatment for the removal of soft tissue sarcomas.

After appropriate and correct reconstructions, most of the patients can return to their normal lives. In some patients, deficiencies (short limbs/deformity, etc.) may require additional interventions over time.

These surgeries involve many organ systems. While there may be general risks related to conditions such as bleeding, and embolism (clot formation), sometimes it may be necessary to remove a very important tissue (vessel – nerve – bone – joint) to get rid of the tumor. A significant part of these losses can be repaired or reconstructed later.

The tumor, which can be removed at the beginning, may spread to the vital tissues (vessel – nerve – joint) or wrap them in time and can be removed only by sacrificing the limb. The probability of spreading to distant organs increases. It can burst outward, causing burgeoning wounds to open. It causes unbearable pain. Ultimately, it causes death from either local or systemic complications.

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