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ORTHOPAEDIC ONCOLOGY



OVERVIEW
Orthopaedic oncology is a specialised field that focuses on treating bone cancer, soft tissue sarcoma, pathological-related fractures, bone lesions and metastasis. Bone metastasis usually begins somewhere else in the body and eventually transgresses from the primary tumour to the bone.

Dr du Toit works alongside specialists in his field to tailor treatment plans, initiating a unique approach desirable to all patients. Before creating a treatment plan, Dr du Toit peruses the patient’s laboratory test results, x-rays and other imaging studies. Orthopaedic oncology surgery combined with palliative care is of the utmost importance to ensure a high quality of living when fighting the disease.

 

ORTHOPAEDIC ONCOLOGICAL CONDITIONS & TREATMENT
Dr du Toit addresses tumours affecting bone, muscle, ligaments and soft tissue. Surgery involves treating sarcomas, bone metastasis and benign lesions as a result of fractures, infections and tumours.

Common orthopaedic oncological conditions include:

 
1LIMB SALVAGE SURGERY

Limb salvage surgery is a procedure that removes damaged bone tissue and replaces it with a newly constructed limb made from metal or bone graft. The bone is typically taken from another person (donor) to make up for the diseased bone. Sometimes, a metal piece and bone graft are combined to create the prosthetic.

Regular follow-ups are conducted after limb salvage surgery to ensure the patient is doing well and has responded positively to treatment. X-rays and scans take place at regular intervals, and follow-ups are scheduled timeously. In addition, physiotherapy is crucial after limb-salvage surgery. By practising a range of motion exercises daily, the patient can regain mobility and function of their limb.

2BONE TUMOURS

A bone tumour forms when cellular division occurs within the bone uncontrollably, forming an abnormally large tissue mass. Bone tumours can be malignant and may, in some cases, metastasis. However, regardless of the nature of the tumour, it is still made up of abnormal cells, and these cells can multiply and destroy healthy bone tissue by replacing the normal bone with tumour cells.

Treating a benign bone tumour may involve surgery depending on the location and nature of the lesion or observing the condition by regularly conducting x-rays to see if the tumour grows and affects healthy bone tissue.

Malignant bone tumours, on the other hand, are removed surgically and treated with either chemotherapy and/or radiation therapy as needed.

3SOFT TISSUE SARCOMAS

Soft tissue sarcoma begins in the patient’s soft tissues such as the tendons, ligaments, fat, muscles, nerves and blood vessels. Soft tissue sarcomas can form in the arms, legs and abdomen. Soft tissue sarcoma symptoms depend on the location of the growth and may worsen as the sarcoma enlarges.

Soft tissue sarcomas may develop for numerous reasons such as age, genetic conditions and previous treatment like radiotherapy.

Treating soft tissue sarcomas involve removing these growths surgically and, if indicated based on the type of sarcoma, beginning radiotherapy and/or chemotherapy to destroy the remaining cancer cells.

4BONE METASTASES

Bone metastases is a form of cancer originating elsewhere in the body, such as the lung, thyroid, kidney, breast or prostate, spreading to the bone. In its late stages, patients diagnosed with advanced cancer are likely to develop a bone metastasis. This is often considered a chronic condition that needs to be managed appropriately.

Bone metastases are either (i) osteoblastic, meaning too many new bone cells are present or (ii) osteolytic that occurs when there is very little healthy bone left. Treating this type of cancer depends on the patient’s diagnosis, the type of underlying cancer, the stage of the condition and the patient’s overall health. Usually, multiple therapies are used to cure the cancer, including radiation therapy, chemotherapy, pain medication and surgery in order to prevent or repair a fracture when this occurs.

5BENIGN LESIONS/CONDITIONS

A ganglion is a lump on the hand or wrist that consists of fluid and originates from the tendons and joints. In contrast, lipomas are fatty lumps that develop beneath the skin in the upper parts of the body, arms and thighs. These growths are often removed when they become painful or unsightly to look at. Ganglion cysts and lipomas are surgically removed. A neuroma is a harmless nerve growth/enlargement that usually forms between the toes. Apart from pain, a neuroma causes a numb sensation or tingling in the toes and ball part of the foot. Schwannomas may form from bigger nerves and cause similar symptoms of pain and altered sensation in the limb. These lesions are usually removed surgically.

 


 

FAQ

  1. CAN A BONE TUMOUR INCREASE THE RISK OF A FRACTURE?
    Bone tumours can cause the bone to become more porous and susceptible to fracturing. In this situation, abnormal tissue replaces healthy bone tissue, making the bone prone to fracturing when a person falls or from trivial injuries.
  2. DOES A SOFT TISSUE SARCOMA HURT?
    A sarcoma forms underneath the skin, appearing lumpy and painless. Sarcomas are typically asymptomatic when they are small. However, symptoms usually occur as the sarcoma becomes larger.
  3. IS RECOVERY LONG AFTER BONE TUMOUR SURGERY?
    It takes three to six months to regain mobility of the limb after removing a tumour in the leg. Therefore, physiotherapy after limb salvage surgery is critical to maintain and use the limb as much as possible.

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