Surgery for secondary bone cancer
Secondary bone tumours may be treated with surgery for different reasons. Occasionally, surgery is used to remove a secondary cancer from a bone. More often it’s used to strengthen a weakened bone.
Removing the secondary cancer
Occasionally, if tests show that only one area of bone has cancer, it may be possible to remove the affected area. This is done under a general anaesthetic. The remaining bone may then be strengthened with a metal pin. Sometimes, the bone may be replaced with a false part (prosthesis). If a secondary tumour is near a joint - such as the hip, knee or shoulder - the joint and the area of bone containing the tumour are usually both removed. The joint is then replaced with an artificial hip, knee or shoulder (prosthesis).
If surgery is a possible option for you, your doctor will explain the operation to you and answer any questions you have.
Strengthening a weakened bone
Bones can sometimes be weakened by the secondary cancers. If this happens, it may be possible to strengthen or repair them using surgery.
Weak thigh or arm bones
Sometimes an x-ray shows that a secondary cancer has weakened a long bone such as the thigh bone (femur) or upper arm bone (humerus). If there’s a risk of the bone breaking, you may need an operation to strengthen it and prevent a break happening.
A metal pin or a nail with screws at each end (a locking nail) can be put down the middle of the weakened bone.
This secures and strengthens the bone, holding it firmly so that it won’t break. The pin or nail can stay in permanently.
The operation is carried out under a general anaesthetic. Whether this operation is suitable for you will depend on which bone is affected.
You may need to stay in hospital for up to a couple of weeks after the operation to recover fully. A physiotherapist will see you and give you exercises to do. Most people are able to start walking a couple of days after surgery.
Sometimes the weakness caused by the secondary bone cancer leads to a crack or fracture in the bone before a strengthening operation can been done. If this happens, it may still be possible to mend the bone. Your doctor or specialist nurse will discuss this with you.
Weak hip or shoulder joints
If secondary cancer has caused a lot of damage to your hip or shoulder joint, you may need to have an operation to replace the joint. You’ll need to stay in hospital for around 35 days and will have physiotherapy afterwards.
You may also have radiotherapy before and/or after your operation to try to destroy any cancer cells left in the area and help the bone to repair itself.
Another technique used to strengthen a weakened bone and relieve bone pain involves injecting a special type of cement into the bone.
The doctor puts a needle through the skin and, using x-rays or CT scanning to guide the way, injects the cement into the weakened bone. The operation is carried out either under a general anaesthetic or after you have been given a sedative to make you feel drowsy. This technique can be used to treat bones in the arm or leg. It can also sometimes be used when a tumour is affecting the spine (in this case, the treatment is known as vertebroplasty).
Your doctor can discuss whether percutaneous cementoplasty would be suitable for you.
This is another technique that may sometimes be used to strengthen and restore the height of a collapsed bone in the spine. This procedure is done through your back. A doctor uses a special instrument to insert a small balloon into the affected bone. The balloon is then inflated until the height of the collapsed bone is back to normal. The balloon is let down and removed from the bone and the space left by the balloon is filled with cement. No incisions or stitches are needed with this procedure.
Balloon kyphoplasty is a specialised technique that isn’t suitable for everyone. There are also other techniques that are similar to balloon kyphoplasty. Your doctor will be able to give you more information about these techniques and will let you know if they are suitable for you.