REPORT: MB #2835
BACKGROUND: Bone cancer. It's a frightening diagnosis that nearly 2,400 Americans will receive this year. Most of these patients will be children. Even scarier is that more than half of that number will die from the disease this year. Primary bone cancer forms in the cells of the bone. Secondary bone cancer is cancer cells that spread to the bone from cancer in another part of the body, like the prostate, breast or lung. Some types of primary bone cancer are osteosarcoma (which begins most often in the knee and upper arm), Ewing's sarcoma (which usually begins in the backbone, pelvis, legs and arms) and chondrosarcoma (which begins in the cartilage separating bone joints).
Most causes of cancer are unknown, but there are some risk factors that seem to contribute to the development of bone cancers. According to the National Cancer Institute, osteosarcoma occurs more frequently in people who have had high-dose external radiation therapy or treatment with certain anticancer drugs; children seem to be particularly susceptible. Additionally, people who have hereditary defects of bones and people with metal implants, which doctors sometimes use to repair fractures, are more likely to develop osteosarcoma.
TREATMENT: The most common treatment option for osteosarcoma is surgically removing the affected area. Special techniques may be used to minimize the amount of healthy tissue removed, but in many cases the entire limb must be spared. Physical rehabilitation after total limb amputation can be difficult -- both physically and emotionally. "When we were faced with this 10 or 20 years ago ... the artificial leg would have to fit onto a short stump of the leg and basically their function would have been very limited," Marc Barry, M.D., a pediatric orthopaedic surgeon in Las Vegas, Nev., told Ivanhoe. "They would have a difficult time with prolonged walking, endurance, they couldn't run or play with other kids."
Now, a revolutionary approach known as rotationplasty is giving doctors and patients more options beyond total limb amputation. During a rotationplasty procedure, surgeons remove a portion of a patient's limb below the affected portion. Then, the area containing the tumor is completely removed. The surgeon then rotates the healthy portion of the limb that was removed and reattaches it. Doctors are able to spare major arteries and nerves, maintaining feeling in the remaining limb. Then, the joint that was rotated and replaced can function as a new joint, powering the artificial limb. Dr. Barry describes the benefit for a patient undergoing a leg amputation:
"Instead of a thigh-high amputation, which is functionally not as optimal, we effectively get a below knee amputation, which gives them an extra joint to power an artificial leg," Dr. Barry said. "The other benefit is we do save the sciatic nerve, so these kids don't have phantom pains. Kids are able to walk better, have greater endurance. They are, in fact, able to run, jump, play and essentially lead very normal lives."
FOR MORE INFORMATION, PLEASE CONTACT:
Ashlee Seymour
Director of Media Relations
Sunrise Children's Hospital
ashlee.seymour@hcahealthcare.com
(702) 731-8288
