5.DEC.2019 4 MIN READ | 4 MIN READ

Dr Gurpal Singh, an orthopaedic surgeon at Mount Elizabeth Hospital explains why early detection is key to treating and managing bone cancer.

What is bone cancer?

The body is made up of many tiny structures called cells. Throughout our lifetime, these cells continuously grow, divide, and make new cells to replace old and damaged cells. In a healthy person, the body is able to control the growth and division of cells according to the needs of the body. Bone cancer occurs when the cells in your body do not behave normally and multiply uncontrollably.

Bone cancer can affect people of all ages, and may originate in the bone, or spread from cancer in another area of your body. The formation of cancerous tumours in your bones is known as sarcoma. Bone cancer that spreads from another area of your body is referred to as secondary bone cancer.

Symptoms of bone cancer

Paying attention to your body and potential symptoms is important in detecting bone cancer early. Unfortunately some people do not experience many or any symptoms at all until much later. Some of the symptoms you should look out for include:

  • Feeling a lump or swelling around a joint or bone
  • Fever
  • Joint pain or ache
  • Redness on your skin
  • Loss of appetite or unexplained weight loss

If you or any of your family members experience any of the above symptoms, it is very important to see a musculoskeletal oncologist. Dr Singh says, “Never be dismissive of the symptoms. What one may think is a simple joint pain could be something more serious.”

Why early detection is vital

Early detection
The last few decades have seen rapid advancements in the field of musculoskeletal oncology. In the past, a single orthopaedic surgeon would carry out all your treatment. Management of bone cancer is more effective today, and involves a multidisciplinary team of medical oncologists, general surgeons, plastic surgeons, radiologists, radiation oncologists and musculoskeletal pathologists.

It is only possible to truly benefit from the expertise of all of these experts with early treatment. “If you find yourself or a loved one having any of the symptoms mentioned previously, it is not only important to go to a musculoskeletal oncologist, but to go early,” urged Dr Singh. “If you were to go when the tumour has spread or grown out of control, this could result in an amputation of the limb or danger to the patient’s life.“

Treatment of bone cancer

The primary aim of a musculoskeletal oncologist used to be simply in saving a patient’s life. Amputations were done frequently in order to remove bone tumours. “The advancements of better imaging technology, more effective chemotherapy, improved radiotherapy techniques, a better understanding of the human body, refinement in surgical techniques and advances in prosthesis design and materials have allowed function preserving alternatives to become more common,” says Dr Singh. To put it simply, there are more ways to treat bone cancer without compromising the overall quality of the patient’s life, now that the possibility of having an amputation has vastly decreased.

Treatment options include:

  • Chemotherapy, which kills cancerous cells via a course of powerful drugs.
  • Radiation therapy, which uses strong x-rays to kill cancer cells or shrink the tumours.
  • Limb salvage surgery, which prioritises saving the limb while removing the cancer. This can come in many forms, but the surgeon will replace the cancerous bone with an artificial implant.
  • Amputation of the limb, which is often considered the last resort.

Alternatives to amputation

Alternative treatment
“I recently treated a 12-year-old boy who came in with knee pains after a soccer game. He was found to have bone cancer around the knee, a rare tumour that affects 1 – 2% of the population.” says Dr Singh. “We were able to order a specially tailored allograft, a compatible bone obtained specially for the patient, from the USA. Simply put, this is a custom-made bone transplant. With the technological breakthroughs in recent years, we have reached a stage where we can transplant bone, an achievement that enables our patients to lead normal lives. This patient underwent a complex surgery and he is now back to school leading a normal life with his cancer cured.“

Dr Singh has also treated patients with the use of megaprosthesis, a highly complex joint replacement device made from metal alloys. In the past, joints were often difficult to treat and amputation would have been recommended. It is now possible to salvage the limb in cases like this.

If you experience symptoms

If bone cancer spreads to other areas of the body, treatment options become limited. A multi-pronged approach is the best chance of a full recovery, but this is only possible if it’s caught early enough.

With the breakthroughs in musculoskeletal oncology in recent years, survival rates of bone cancer should continue to improve. However, you should stay proactive about your health and pay attention to your body. Always see a doctor if you experience pain or other symptoms. You can also help lower your risk of cancer by eating a balanced diet, cutting out smoking and alcohol, and getting plenty of exercise.

 

Article reviewed by Dr Gurpal Singh, orthopaedic surgeon at Mount Elizabeth Hospital

References

Bone Cancer: Early Detection Key. Provided reference article by Dr Gurpal Singh.

Martin, L. (2017, Aug 28) Bone Tumours, retrieved 20 06 2019 from https://www.webmd.com/cancer/bone-tumors#3

5.DEC.2019
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Gurpal Singh
Orthopaedic Surgeon
Mount Elizabeth Hospital

Dr Gurpal Singh is an orthopaedic surgeon at Mount Elizabeth Hospital and Parkway East Hospital, Singapore.