How is bone cancer treated?
Surgery to remove the cancer is the first resort for bone cancers. More importantly, surgical techniques can eliminate the tumor without the need for amputation of the limb involved. But when affected muscles and other tissues that surround the region need to be removed, reconstructive surgery along with cancer resection brings back the limb to optimum functioning.
Cancer types like Ewing Sarcoma and osteosarcoma may require both surgery and chemotherapy. However, radiation therapy also treats chondrosarcoma.
Chemotherapy in the Treatment of Bone Cancer
Doctors recommend the treatment of Osteosarcoma and Ewing Sarcoma. Nonetheless, it is not sufficient for other types of bone cancers. They are not sensitive to the drugs. Also, read about chemotherapy here.
Primarily, chemotherapy uses the technique of using anti-cytotoxic drugs to kill cancer cells. A few of its primary functions are to starve cancer cells, impede their cell division, and triggering their suicide. While side effects remain, there is an attempt to research drugs that will minimize adverse effects, which are, nausea, weakness, fatigue, bowel-related issues, and blood-related issues, etc.
Conventional drugs for osteosarcoma include:
- Cisplatin (Platinol)
- Doxorubicin (Adriamycin)
- Ifosfamide (Ifex)
- Methotrexate (multiple brand names)
Conventional drugs for Ewing sarcoma include:
- Vincristine (Oncovin, Vincasar)
- Doxorubicin (Adriamycin)
- Cyclophosphamide (Cytoxan, Neosar)
- Ifosfamide (Ifex)
- Etoposide (Toposar, VePesid)
- Dactinomycin (Cosmegen)
Radiotherapy is for patients whose tumors are unresectable (they cannot be treated with surgery).
Types of Radiation Therapy
Particular kinds of radiation therapy are most commonly used to treat bone cancer.
1. Intensity-modulated treatment is a sophisticated technique of radiation therapy in which a computer matches radiation beams to the size and the severity of the tumor. In this case, the radiation aims at the tumor from different angles.
2. Proton beam radiation uses beams of positively charged particles of atoms instead of regular X-rays. It is popular in treating skull, spine, rib, or sternum chondrosarcomas and chordomas.
3. Extracorporeal used as part of limb-salvaging surgery which involves taking the infected bone out of the body, treating it with cancer and putting it back. However, side effects like fatigue, nausea, loss of appetite, low blood counts prevail after the radiotherapy.
Surgery is another essential part of the treatment. The aim is to obliterate cancer cells. Different types of surgery exist for various types and grades of cancer, depending on its size and severity; namely, limb-salvaging surgery, amputation surgery, reconstructive surgery, and surgery for metastasis.
Side effects include infection around the wound, bleeding, urinary issues, shortness of breath, rehabilitation from physical and emotional distress, etc.
When Ewing sarcomas are not particularly sensitive to chemotherapy, it may require radiation therapy and perhaps even stem-cell transplants. Stem cell transplants kill bone marrow cells of the affected region, and new cells are induced through the veins to replace destroyed cells through a blood transfusion. Eventually, these new cells adapt to settling down to make healthy bone cells. This process is known as engrafting.
There are two types of stem-cell transplants:
1) Autologous stem-cell transplants
Autologous transplant is primarily used to treat certain leukemias, lymphomas, and multiple myeloma. Also, there are no risks of new cells attacking the body (known as the graft-versus-host cancer effect)
2) Allogeneic stem-cell transplants
In allogeneic stem-cell transplants, there may be two kinds of donors. Firstly, a close family member. And secondly, a donor from the general public called the MUD or matched unrelated donor. MUD type of transplants is usually riskier than those from a relative of the patient’s.
Targeted uses drugs to treat cancers but is different from conventional chemotherapy. It works by targeting specific proteins and genes to impede the growth and spread of cancer. The U.S. Food and Drug Administration (FDA) has authorized targeted therapies for many types of cancer. Furthermore, these drugs:
- disable the growth and division of cancer cells
- prevent cells from living longer than usual
- and then, destroy cancer cells
Denosumab (Xgeva) is a monoclonal antibody that acts to block the activity of osteoclasts. Used in the treatment of giant cell tumors of bone that has relapsed after surgery or that cannot be removed, it has proved effective.
Clinical trials are research studies that doctors use to find new ways to improve medical techniques and technology. Also, health professionals must talk to the patient and the patient’s family about the nature, extent, and safety of the trial. Clinical trials:
- find and diagnose cancer
- then, treat cancer
- also, prevent cancer
- and finally, help cope with symptoms of cancer and handle its side effects