Surgery can be used to treat secondary bone cancer. It can be used to strengthen bones, or sometimes to relieve pressure on nerves in the spine.

About surgery for secondary bone cancer

Secondary bone cancer may be treated with surgery. You may have surgery:

  • to strengthen a weakened bone
  • to relieve pressure on nerves in the spinal cord
  • occasionally to remove a secondary cancer from a bone.

Strengthening a weakened bone

Bones can sometimes be weakened by the secondary bone cancer cells. 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 is a risk of the bone breaking, your surgeon may suggest an operation to help strengthen it.

Whether an operation is suitable for you will depend on:

  • which bone is affected
  • which part of the bone the cancer is in
  • other treatment you are having for the cancer
  • your general health.

The operation is usually done under a general anaesthetic. The surgeon puts a metal rod down the middle of the weakened bone or fixes a metal plate on the outside of the bone. This secures and strengthens the bone, holding it firmly so it will not break. The rods or plates stay in permanently.

A type of plastic bone cement is sometimes used to strengthen large areas of bone damage.

How long you have to stay in hospital afterwards depends on what operation you have and how well you are. If you have surgery to the upper limbs, you usually stay in hospital for up to 3 days. For surgery to the lower limbs, you may need to stay in hospital for between 5 to 7 days. You will see a physiotherapist who will give you exercises to do. Radiotherapy is often given after an operation to help strengthen a bone.

Sometimes the secondary bone cancer causes the bone to crack or break (fracture) before a strengthening operation can be done. If this happens, it may still be possible to mend the bone. Your doctor or specialist nurse will talk to you about this.

Weak hip or shoulder joints

If secondary cancer has caused a lot of damage to your hip or shoulder joint, you may need an operation to replace the joint. You will need to stay in hospital for between 3 to 7 days and will have physiotherapy afterwards.

You may also have radiotherapy before or after these operations (or both) to try to destroy any cancer cells left in the area and help repair the bone.

Percutaneous cementoplasty

You may have this procedure to strengthen a weakened bone and relieve bone pain. It involves injecting a special type of cement into the bone. It 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 called vertebroplasty.

You will have a general anaesthetic or a sedative to make you feel drowsy. Your doctor will put a needle through your skin. Using x-rays or CT scans to guide them, they will inject the cement into the weakened bone.

Your doctor can talk to you about whether percutaneous cementoplasty would be suitable for you.

Balloon kyphoplasty

Surgeons can sometimes use this procedure to help strengthen and restore the height of a collapsed bone in the spine. You will have a general anaesthetic or a sedative to make you feel drowsy. A doctor makes a small cut in your back. They then use a special instrument to insert a small balloon into the affected bone. The balloon is inflated until the height of the collapsed bone is back to normal. The balloon is then let down and removed from the bone and the space left by the balloon is filled with cement.

Balloon kyphoplasty is a specialised technique that is not suitable for everyone. There are other techniques that are similar to balloon kyphoplasty. Your doctor will be able to tell you more about these techniques and will let you know if they are suitable for you.

Relieving pressure on the spinal cord

Surgery is only suitable to treat a small number of people with spinal cord compression. It depends on many factors, including the type of cancer you have, where it is and how unstable your spine is.

The aim of surgery is to remove as much of the tumour as possible and relieve pressure on the spinal cord.

It may also involve stabilising the spine further by using metal rods. Your doctor or nurse will explain the operation in more detail if surgery is appropriate for you.

Removing the secondary cancer

Occasionally, if the secondary bone cancer only affects one bone and has not spread to other parts of your body, it may be possible to remove the affected area. The remaining bone may then be strengthened with a metal implant. Sometimes, the bone may be replaced with a false part (prosthesis). The operation is usually done under a general anaesthetic.

If surgery is a possible option for you, your doctor will explain the operation to you and answer any questions you have.

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