Bone Cancer is a rare disease, it is diagnosed in less than 1% cases.
However, the vast majority of malignant pathologies (breast cancer, prostate, thyroid, etc.) metastasize to bone tissue – and is appeared a secondary bone cancer.
Diagnosis of bone cancer in Israel
Diagnostics supposes providing the following methods in Israel:
- Medical consultation and medical history.
- Laboratory diagnosis.
- MRI uses radio waves which are created with the help of powerful magnet. Tissues absorb radio frequency energy which is released in a certain way. A computer transforms the released radio waves in the detailed view of a particular area of the body. MRI is the best method that detects bone tumor, which is used both in the decision of the diagnosis, and to verify the results of treatment.
- PET-CT helps to explore the area surrounding the tumor, the size of the formation and the presence of metastases.
- Angiography contrast agent checks the state of the blood vessels in the tumor. Its results help in the applying of the operation plan.
- Bone scan (radionuclide bone scan) diagnoses the spread of tumors to other bones. Before examining the patient intravenously is injected a radioactive substance that is "attracted" by cancer cells. These areas are visualized on the image as black or gray areas. However, this way looks arthritis or infection. Therefore, a biopsy is needed.
- Biopsy of tumor tissues is the extraction of a tissue sample that can be used to determine the type of infection and the rate of tumor malignancy.
Selecting the type of biopsy is due to different factors. For the diagnosis of certain types of tumors it is enough to explore sample, obtained by biopsy. To put a different diagnosis requires large samples of bone tissue tumors, which are obtained by surgical biopsy.
Needle biopsy
There are 2 types of needle biopsies: fine needle and core biopsy. Before the procedure is applied local anesthesia. For the fine needle biopsy is selected fine needle, which is attached to the syringe, and take it through a small amount of liquid. When the tumor is located deep in the tissue, a biopsy is performed under CT or ultrasound.
Core biopsy needle is performed by the general purpose of obtaining a sample of tissue (approximately 1 cm long and 0.3 cm in diameter) of cylindrical shape. There is a prevailing opinion that the diagnosis of primary bone cancer is more preferable with core biopsy.
Open biopsy
Surgical biopsy involves to make small incision on the skin to access the tumor and take small tissue sample. Excisional biopsy is performed if the tumor during its implementation is completely removed. Typically, the size of tumor is small.
Methods of treatment of bone cancer in Israel
Treatment program will be determined by the following factors: the kind of tumor, its size, the presence of secondary centers as well as the patient's age and general health. As with other types of cancer, when tumors are located in the bones is assigned a comprehensive treatment that combines the use of several therapeutic modalities that can successfully fight diseases such as cancer of the esophagus, skin cancer, lung cancer.
The surgery and amputation
Operation is the main method of treatment of bone cancer in Israel.
The main goal of surgery is the excision of the entire tumor, and also removing a certain amount of healthy tissue surrounding it. After removal of tissue it is subjected to histological examination. When tumor cells are at the edges of the excised tissue, this means that the tumor is not completely removed, and therefore the treatment is not yet completed.
Amputation involves full or partial removal of limbs. Today, it is carried out only if it is impossible to provide other therapy. Amputation may be required when the removal of the tumor lesion leads to major nerves, arteries or muscles, resulting in a substantial disruption of the limb. To determine the amount of tissue removed operation is accompanied by an MRI and histologic tissue test.
Organ-sparing surgery
Organ-sparing surgery involves the complete removal of the cancer and preserves body function. This operation is carried out in 90% of cases, with the defeat of the upper or lower bodies.
If the tumor has spread to nearby structures, they are removed together with the new formation. In some cases, it causes pain or inability, amputation is the best treatment option for bone cancer in Israel.
This type of surgery also uses wide excision of tissue for the removal of a malignant tumor. Removed part of the body after surgical treatment is replaced by bone graft or endoprosthesis.
Implants are complex structures made of metals and other materials. Endoprosthesis is used in treatment of children, because the prosthesis can lengthened as the child grows without an additional operation.
After organ-sparing surgery the patient should pay attention on intensive rehabilitation.
Tumors of other locations
Wide excision of diseased and healthy tissue is performed in the treatment of cancer of the pelvic bones. To restore the removed parts can be used bone grafts.
When the tumor is localized in under jaw it involves the removal of mandibular bone with subsequent reconstruction of other bones.
Chemotherapeutic treatment
Chemotherapy is an effective method of treatment of bone cancer in Israel especially for certain types of cancer, for example, Ewing's sarcoma, osteosarcoma, Kaposi's sarcoma. It is used with surgery or radiation therapy.
There are the following indications for chemotherapy:
- before surgery to reduce the size of the tumor;
- after surgery to prevent recurrence;
- as palliative therapy to alleviate the symptoms and improve quality of life.
As a rule, the treatment of bone cancer in Israel by chemotherapeutic medicines suggests the use of drugs` combination: it can be a tablet, capsule, intramuscular injections, intravenous drip. Treatment consists of individual sessions between which there is a break. Then a new cycle begins. The entire course of therapy includes several cycles - as a rule. Chemotherapy treatment can take place on an outpatient basis or in the hospital.
Chemotherapy drugs for the treatment of:
- Ewing's sarcoma: Adriamycin, Etoposide, Vincristine, Ifosfamide.
- Osteosarcoma: Cisplatin, Doxorubicin, Methotrexate.
- Recurences: Ifosfamide, Etoposide, Gemcitabine, Carboplatin, Cyclophosphamide.
Radiation treatment of bone cancer
Radiotherapy with the help of high energy beam destroys the malignant cells. It is rather an additional treatment for bone cancer in Israel, since the majority of tumors are difficult to treat with the help of this method.
Indications for radiotherapy:
- inoperable tumors;
- destroying the remaining cancer cells after surgery;
- reduce risk of recurrence after surgery.
Radiotherapy in the treatment sessions is carried out 5 times a week for 8 weeks.
There is evidence of high efficacy of proton radiotherapy in the treatment of chondrosarcomas and chordomas of bones of the skull base.
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