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Diagnosing bone cancer typically involves a combination of imaging, biopsy, and lab tests:
Imaging Tests:
X-Rays: Often the first imaging test done if bone cancer is suspected, revealing abnormal bone areas.
MRI (Magnetic Resonance Imaging): Provides detailed images and helps assess the extent of the tumor.
CT (Computed Tomography) Scan: Used to evaluate the size and spread of the tumor.
Bone Scan: Helps identify other areas of the bone that may be affected.
Biopsy: This is the definitive way to diagnose bone cancer. A tissue sample is taken and examined under a microscope to confirm the presence of cancer cells. There are two types of biopsies:
Needle Biopsy: A needle is inserted through the skin to collect a sample.
Surgical Biopsy: The surgeon removes a piece of the tumor for analysis.
Bone Marrow Biopsy: In cases where bone cancer is suspected to spread, a bone marrow biopsy may be performed to check for cancer cells in the bone marrow.
Treatment of bone cancer depends on the type, location, stage, and overall health of the patient. The main treatment options include:
Surgery: Surgery is commonly used to remove the tumor. The goal is to remove all cancer cells while preserving as much bone and function as possible. Options may include:
Limb-Sparing Surgery: Removes the cancerous bone segment while preserving the limb. The bone is often replaced with a prosthetic implant or bone graft.
Amputation: Rarely, when the cancer is too widespread within the bone, amputation may be necessary to control the disease.
Rotationplasty: A surgical technique used in young patients where part of the leg is rotated and reattached to allow the ankle to function as a knee, used with a prosthetic limb.
Chemotherapy: Chemotherapy uses drugs to kill cancer cells and is commonly used for types like osteosarcoma and Ewing sarcoma. It may be given before surgery to shrink the tumor or after surgery to reduce the risk of recurrence.
Radiation Therapy: High-energy beams target and kill cancer cells. Radiation is particularly used in cases of Ewing sarcoma and may be employed when surgery is not an option or as an adjunct to surgery.
Targeted Therapy: For some bone cancers, targeted therapies may be used to attack specific cancer cell proteins or genes. Denosumab is one example, especially for treating certain types of giant cell tumors.
Immunotherapy: Although not yet standard for bone cancers, immunotherapy is an area of active research. Certain immune-based drugs may help the body’s immune system recognize and attack cancer cells.
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