Musculoskeletal Oncology

WHAT WE DO

Surgical Oncology involves managing both malignant and benign bone and soft tissue tumors, utilizing various techniques such as limb salvage surgery, precision tumor removal, curettage, and non-surgical management. Limb salvage surgery is performed for malignant bone tumors like osteosarcoma, Ewing sarcoma, chondrosarcoma, and others, using prostheses, bone grafts, extracorporeal radiation, cryosurgery, and other methods. Benign bone tumors such as giant cell tumors, chondroblastoma, and osteoblastoma can be treated with curettage, while non-surgical management like sclerotherapy and radiofrequency ablation can be used for tumors such as aneurysmal bone cysts and simple bone cysts. Metastatic bone disease caused by cancer cells spreading from other organs is managed through therapeutic and prophylactic fixations with adjuvant therapy, which aids in early mobilization. Spine tumors, whether primary or metastatic, are treated with decompression and stabilization, and minimally invasive techniques like vertebroplasty and balloon kyphoplasty can also be employed.

In Medical Oncology, various chemotherapy protocols are used for bone and soft tissue sarcomas, including NeoAdjuvant and Adjuvant Chemotherapy for pediatric and adult patients. Palliative chemotherapy and targeted therapy are also used for advanced-stage diseases. High-dose chemotherapy with Stem Cell Transplantation is done in suitable cases, while an exclusive pediatric oncology unit is available for children with sarcomas. The approach in Medical Oncology is personalized and evidence-based, with an emphasis on optimizing solutions for each patient. Weekly DMG clinics and musculoskeletal tumor boards are held for effective management.

Radiation Oncology involves the use of Radiation Therapy (RT) for bone and soft tissue tumors, which can be performed in various settings like definitive, pre-op, intra-op, and post-op depending on the case. High-dose precision radiation therapy is used for bone tumors like Ewing's sarcoma, with or without surgery as per indication. For soft tissue sarcomas, interstitial brachytherapy is used during surgery with brachytherapy catheter placement in the tumor bed for high doses of radiation with fewer side effects. In some cases, Extra Corporeal RT (ECRT) can be performed, where the tumor bone is removed and given high dose radiation therapy outside the patient's body, then re-implanted as a customized prosthesis. Precision radiation therapy is practiced using focused techniques like 3DCRT, Intensity Modulated Radiation Therapy (IMRT), and Image Guided Radiation Therapy (IGRT), which help reduce adverse effects of treatment. Stereotactic Body Radiation Therapy (SBRT) is used for treating metastases from bone and soft tissue sarcomas, which delivers high radiation dose with minimal damage to surrounding organs.

Signs and Symptoms

Common symptoms of blood cancer include weakness, fatigue, shortness of breath, excessive or easy bruising, bleeding gums, recurrent infections or fever, bone fractures with minimal strain, night sweats, weight loss, frequent vomiting sensations, anorexia, lymph node enlargement, lumps or abdominal distension due to enlarged abdominal organs, abdominal, bone, and back pain, delirium and confusion, abnormal bleeding in gums, nose, and cuts, headaches with visual difficulties, occurrence of fine rashes on dark spots, decreased urination, and difficulty while urinating.

Causes of Blood Cancer

Although the exact cause of blood cancer is still not known, there are several factors that are linked to its development, including aging, family history, weak immune system, and certain infections. Additionally, there are various symptoms and causes of blood cancer, available treatments, early signs of leukemia, and possible effects of blood cancer treatments on fertility. It is also possible to find more information on blood cancer, including its treatment by chemotherapy, availability of treatments for multiple myeloma, and whether the immune system can cause lymphatic cancer.

What is a Bone Marrow Transplant?

A bone marrow transplant is a medical intervention used to replace damaged or diseased bone marrow with healthy stem cells. Bone marrow plays a crucial role in producing important components of the blood, including red blood cells, white blood cells, and platelets. When bone marrow is damaged or destroyed, it can result in conditions such as anemia, bleeding disorders, or susceptibility to infections. A bone marrow transplant involves transplanting healthy stem cells into the patient's body, which will then produce new blood cells and restore normal blood cell function. This procedure can be used to treat a variety of blood disorders, such as leukemia, lymphoma, or multiple myeloma, as well as other conditions affecting the bone marrow.

Reasons for Bone Marrow Transplant

Aplastic Anemia occurs when the bone marrow fails to produce new blood cells, while leukemia, lymphoma, and multiple myeloma are types of cancer that can affect the blood. Chemotherapy can also damage the bone marrow, leading to decreased blood cell production. Congenital neutropenia is an inherited disorder that can cause recurrent infections. Sickle cell anemia is an inherited blood disorder that causes abnormally shaped red blood cells, and thalassemia is another inherited blood disorder that affects the production of hemoglobin in red blood cells.

Types of Bone Marrow Transplant

Autologous transplants refer to the use of a person's own stem cells, which are harvested before treatment and then transplanted back into their body. On the other hand, allogeneic transplants involve the use of stem cells from a donor, who must be a close genetic match.

Treatment

Blood cancer hospitals in India provide various therapies for the treatment of blood cancer with the primary aim of complete eradication of cancer. These therapies include chemotherapy, bone marrow transplantation, biological therapy (immunotherapy), and radiation therapy. The Haemato-oncology department is dedicated to improving the outlook for patients with myeloma by developing novel therapeutic approaches based on a sound understanding of the disease's biology. A specialized team of Haemato-oncologists and radiation oncologists offers state-of-the-art treatment for various cancers, including lymphomas, leukemia, and multiple myelomas. The Bone Marrow Transplant unit is equipped with HEPA (High-Efficiency Particulate Air) filters and offers stem cell transplantation for both benign and malignant conditions in children and adults.