原發(fā)性骨腫瘤-Primary Bone Cancer

What are the treatment options for primary bone cancer?

The main treatments used for primary bone cancer are surgery, chemotherapy and radiotherapy. The treatment or combination of treatments advised in each case depends on various factors such as:

• The type of primary bone cancer.
• The exact site of the cancer.
• The stage of the cancer (how large the cancer is and whether it has spread).
• Your general health.

You should have a full discussion with a specialist who knows your case. They will be able to give the pros and cons, likely success rate, possible side-effects, and other details about the possible treatment options for your type of cancer.

You should also discuss with your specialist the aims of treatment. For example:

• In some cases, treatment aims to cure the cancer. (Doctors tend to use the word 'remission' rather than the word 'cured'. Remission means there is no evidence of cancer following treatment. If you are 'in remission', you may be cured. However, in some cases a cancer returns months or years later. This is why doctors are sometimes reluctant to use the word cured.)
• In some cases, treatment aims to control the cancer. If a cure is not realistic, with treatment it may be possible to limit the growth or spread of the cancer so that it progresses less rapidly. This may keep you free of symptoms for some time.
• In some cases, treatment aims to ease symptoms ('palliative treatment'). For example, if a cancer is advanced then you may require painkillers or other treatments to help keep you free of pain or other symptoms. Some treatments may be used to reduce the size of a cancer which may ease symptoms such as pain.

Surgery
The types of operation vary depending on the type and site of the cancer. If the cancer is in an arm or leg, it is often possible to remove it with 'limb-sparing' surgery. This means surgery where just the affected part is removed, and is replaced with an artificial metal fitting (prosthesis) or a bone graft. Amputation (removing a limb) used to be the main operation, but this is done less often these days due to the improved surgical techniques with limb-sparing surgery. However, amputation is still needed in some cases, depending on the size, spread, or site of the tumour.

Your specialist will advise on whether surgery is possible, and the types of operation which can be done.

Radiotherapy
Radiotherapy is a treatment which uses high energy beams of radiation which are focussed on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. (There is a separate leaflet which gives more details about radiotherapy.)

Radiotherapy may be used as an alternative to surgery for Ewing's sarcoma. For example, if the tumour is in the spine when surgery is not possible. Radiotherapy is not usually used for osteosarcomas or chondrosarcoma as they are not very sensitive to radiation.

Chemotherapy
Chemotherapy is a treatment which uses anti-cancer drugs to kill cancer cells, or to stop them from multiplying. (There is a separate leaflet which gives more details about chemotherapy.)

Chemotherapy may be given in addition to surgery or radiotherapy, depending on the type and stage of the bone cancer. This may be before surgery to shrink the size of the cancer which makes it easier to remove. Chemotherapy may also be given after surgery or radiotherapy, to make sure any cancer cells which may have been left in the body are killed.

What is the prognosis (outlook)?

It is difficult to give an overall outlook. Every case is different, and the success of treatment depends on the type, site and stage of the cancer - the earlier the stage, the better the outlook. In general, the outlook for primary bone tumours has improved in the last 10-20 years. This is due to improved surgical techniques and improved chemotherapy.

The treatment of cancer is a developing area of medicine. New treatments continue to be developed and the information on outlook above is very general. The specialist who knows your case can give more accurate information about your particular outlook, and how well your type and stage of cancer is likely to respond to treatment.

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