Surgery for primary bone cancer
Surgery is one of the main treatments for bone cancer.
Experienced surgeons who work in a specialist treatment centre will do the surgery. The aim is to remove the tumour from the bone while trying to keep as much function as possible.
It’s usually possible to remove the affected part of the bone and replace it with a custom-made metal fitting (endoprosthesis), or with a bone from another part of the body (bone graft). If the cancer affects a bone in or near a joint, the whole joint can often be replaced with an artificial one. These operations are called limb-sparing surgery. In some cases, the surgeon can remove the affected bone without replacing it with anything and without it affecting the way you move.
It is not always possible to use limb-sparing surgery, and occasionally the surgeons need to remove (amputate) a whole limb. This is to make sure the cancer has been completely removed. It may also be needed if your movement will be better after an amputation than after limb-sparing surgery.
Most bone tumours affect the limbs or pelvis. The surgery to these areas will usually be done by an orthopaedic surgeon. If the tumour is in a less common place, such as the bones of the face, skull or chest, the sarcoma team will work with surgeons who specialise in those areas.
The type of surgery you have will depend on a number of factors. Your surgeon will discuss the different types of surgery in detail with you before you make any decision about your treatment.
Surgery if the bone cancer has spread to the lungs
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If bone cancer spreads to the lungs it may still be possible to cure it with an operation to remove the part of the lung that’s affected. This operation is called a thoracotomy or metastectomy.
When deciding whether this type of operation is possible, the MDT will consider several factors including the type of primary bone cancer, the number of secondary cancers in the lungs, their size and where they are in the lungs. The MDT will also take into account your general health, as this is a major operation. Sometimes a course of chemotherapy is given first. This can help shrink the secondary cancers and may make an operation possible.
This operation shouldn’t affect your breathing. It’s still possible to breathe properly if part of a lung, or even a whole lung, is removed.
Other treatments if surgery isn’t possible
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Occasionally it’s not possible to remove a bone tumour using surgery. This is more likely to happen if the tumour is in:
a bone deep within the body, such as the pelvis
a bone that can’t be easily removed without causing serious disability, such as a bone in the spine.
In these situations other treatments will be used instead, such as chemotherapy or radiotherapy.