DEFINITION OF BONE CANCER
Bone cancer is a malignant tumor that affects bone. Malignant tumor, or cancer, will destroy healthy bone cells and cancer cells will replace the destroyed bone cells.
Bone tumors are not always dangerous. Most cases of tumor that affects bone including benign tumors. Benign tumors will not spread to other parts and does not destroy the healthy bone. However, if that happens is a malignant tumor, tumor cells will spread to organs and can cause cancer in other organs.
TYPES OF BONE CANCER
This is a type of cancer that develops in growing new bone tissue. Usually this type of cancer occurs in the femur and fibula. Generally, this type of cancer suffered by teenagers or young adults.
2. EWING'S SARCOMA
This is a type of cancer that develops in immature nerve tissue in bone marrow. Ewing's sarcoma usually appears at the femur, calf and pelvis. Patients with Ewing's sarcoma usually is a teenager.
It is a type of cancer that grows in cartilage. This cancer usually also attacked the femur, pelvis, ribs, scapula, and humerus. Chondrosarcoma Patients are usually adults aged 30 to 60 years.
BONE CANCER TREATMENT
Bone cancer is one cancer that is difficult to handle. This is because of bone cancer consists of many types and require different handling. In fact, doctors often give the wrong diagnosis of the disease suffered by bone cancer. This of course makes bone cancer treatment is given less precise.
For patients with cancer, are already familiar with the treatment of chemotherapy and radiation. The treatment is still the main option to kill cancer cells and cure. But apparently, chemotherapy is not only to be the only way of treatment of bone cancer. Here are some of the methods of treatment of bone cancer:
1. LIMB SALVAGE
This method can be done if the cancer has not spread too far and still be in the area of bone. Method of limb salvage can be done if the cancer is in the leg. With the method of limb salvage, then the patient will be spared from amputation. Limb salvage method will remove cancerous tissue without cutting the bone. If the bones had already affected by cancer, bone cancer then be irradiated and then returned to the original position.
2. BONE RECONSTRUCTION
The next option, if the bone cancer can not be saved then it could do bone reconstruction. Bone reconstruction can be done by cutting the bone affected by cancer and then replace it with an artificial implant or bone donor. To date, the donor bone in Indonesia is still very rare. So, the choice is to replace the bone with the implant of steel, titanium, chromium, or cobalt. Meanwhile, the polyethylene material can be used to serve as a liaison between the bone joints.
Immunotherapy can be therapeutic companion. The goal for bone cancer patients can tolerate the side effects of the treatment is being done. Currently, chemotherapy and radiation remain the primary method for treating bone cancer, in addition to the operations performed. In fact, chemotherapy and radiation often give adverse effects on the patient's body. For example, frequent nausea, vomiting, decreased appetite even get sick. For that immune therapy is needed as a companion to other treatments.
4. CONSUMTION OF HERBAL MEDICINE
Another way to treat bone cancer is herbal medicine. Although not really be proven medically, herbal remedies can be tried.
If the bone cancer had spread and damage blood vessels and nerves around it, then the method can be done is amputation. Amputation may be the last option for patients with bone cancer, because it causes physical disability. However, if this should be done, should no longer put it off. Because if left unchecked, it could be just the cancer spread to other organs that make the cancer becomes more severe.
Chemotherapy is a cancer treatment by delivering a variety of drugs. In patients with bone cancer, chemotherapy drugs will be inserted into the body through an infusion into a vein. Chemotherapy may be given in cycles. Patients may or may not be going into the hospital but may need to visit a day care center where the drug can be injected into their veins using an infusion.
Cycle involves taking chemotherapy drugs for a few days, followed by a gap of a couple weeks to allow the body to recover from the effects of treatment.
Low-grade cancer requires less number of cycles of chemotherapy than high-grade tumors.
Drugs used in chemotherapy of bone cancer include:
- Methotrexate with leucovorin
Common side effects include:
- Loss of appetite
- Hair loss
- Mouth ulcers
- The risk of infection
- Infertility etc.
Bone cancer affecting children and young people the risk of infertility after chemotherapy should be considered and patients or their carers should be counseled about options for storing sperm or eggs for the selection of future fertility.
The next method is radiotherapy. Radiotherapy is a method that is done using radiation. Same with chemotherapy, radiotherapy is also commonly done before or after surgery. Radiotherapy can help slow the symptoms of bone cancer if the cancer has entered the stage of acute bone. This method is also commonly performed on patients Chondrosarcoma, which can not be cured with chemotherapy.
Sessions radiotherapy can also be given in cycles of five days a week with a break from treatment at the weekend. The side effects of radiation therapy include skin burns, rashes, weakness, nausea, hair loss and more.
Cyrosurgery is a method that uses liquid nitrogen temperature is very low (approximately -200 ° C). This method aims to freeze and kill the cancer cells in the bones. This technique is performed as another option if you do not want to do the usual operation to destroy tumors in the bone.
Limb-saving surgery is preferable if the cancer has not spread beyond the bone, and the bone is affected the cancer itself is in a position that is easily accessible as it is in one of the arms, legs, shoulders, hips etc.
Surgery involves removing part of the bone that is affected and little surrounding healthy bone (just in case the cancer has spread to tissues) and the replacement of part of the bone with metal implants called prostheses.
As an alternative to bone grafts from other parts of the body can also be used as a substitute.
If the cancer has affected joint such as the knee, elbow or shoulder joint, an artificial may be placed. Artificial joint is usually a combination of plastic, metal, and ceramics.
Amputation is needed if the cancer has spread outside the bone and blood vessels are affected and nerves, skin or if the limb-saving surgery has failed. Amputation also choose if the affected bone is not as easily accessible as the ankle joint.
Patients who require amputation necessary counseling and may require the help of a therapist and counseling to choose an artificial limb.
RESULT OF BONE CANCER
Results of bone cancer is determined by survival for at least five years after diagnosis. For localized osteosarcoma and five-year survival Ewing sarcoma seen in approximately 60% and 70% respectively.
They are osteosarcoma or Ewing's sarcoma has spread out the possibility of five-year survival is only 10% and 30% respectively.
For those with low-grade chondrosarcoma 8 out of 10 people can survive five years after diagnosis and to high-grade chondrosarcoma only 3 out of 10 people can survive five years after treatment.
WHO IS DOING THE TREATMENT OF BONE CANCER?
Bone cancer is usually treated by a team of health care providers. The team includes:
- orthopedic surgeon who specializes in bone and joint conditions
- clinical oncologist or cancer
- a pathologist
- with a radiologist
- pain relief specialist or specialist palliative care
- a psychologist
- cancer nurse
- social worker
This is termed a multi-disciplinary team that helps people with bone cancer.