Bone cancer

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Treatments for bone cancer

If you have bone cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for bone cancer, your healthcare team will consider:

  • the type of bone cancer
  • the stage and grade
  • your lifestyle and what you prefer or want
  • your overall health

You may be offered a combination of the following treatments for bone cancer.

Surgery

Most people with bone cancer will have surgery. The type of surgery you have depends mainly on where the tumour is, the size of the tumour, the stage of the cancer and the type of bone cancer. You may have one of the following types of surgery.

Wide resection removes the bone tumour and a wide margin of normal bone and tissue around the tumour. This type of surgery is also called an en bloc resection.

Limb-sparing surgery removes the tumour without removing (amputating) the whole arm or leg (the limb). Surgeons remove all of the tumour and any of the soft tissues where the bone cancer has spread. After this type of surgery, the limb is reconstructed using bone and skin grafts.

Amputation removes all or part of the arm or leg with the tumour. Most people who have an amputation will use an artificial limb (prosthesis) after surgery.

Curettage uses a spoon-shaped tool with a sharp edge (a curette) to scrape a tumour out of the bone. This leaves a hole where the tumour was removed.

Bone cement is a type of chemical called polymethyl methacrylate that may be used after curettage to fix the hole left in the bone. This special cement heats up as it hardens, so it kills remaining cancer cells.

Cryosurgery uses very cold liquid to kill cancer cells. It may be used after curettage to kill any cancer cells left behind.

Chemotherapy

Chemotherapy is not used for low-grade bone cancers because it usually does not work well or make a prognosis better. It is usually given before and after surgery for high-grade osteosarcoma tumours. Chemotherapy may also be offered for chordoma tumours, mesenchymal and dedifferentiated chondrosarcoma and undifferentiated high-grade pleomorphic sarcoma.

Chemotherapy for bone cancer is usually given as a combination of 2 or 3 different drugs. The drugs used will depend on the type of bone cancer.

Radiation therapy

External beam radiation therapy may be used before and after surgery for bone cancer. It may be used to treat a bone tumour that can’t be removed with surgery. It may also be used to treat pain or lung metastases.

Intensity-modulated radiation therapy (IMRT) is a type of external radiation therapy that delivers radiation to the tumour from many different angles. It may be used to treat bone tumours in hard-to-reach areas like the skull, spine or pelvis.

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Follow-up care

Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first 5 years after treatment has finished. These visits allow your healthcare team to follow your progress and recovery from treatment. They will also check your reconstructed limb if you had limb-sparing surgery. If you had an amputation, they will check your prosthesis to see if it is working properly and if you have any problems using it.

Clinical trials

Talk to your doctor about clinical trials for bone cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Questions to ask about treatment

To make the decisions that are right for you, ask your healthcare team questions about treatment.

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