Orthopedic Oncology

Orthopedic oncology is the branch of medicine that deals with the treatment of tumors originating from bone and soft tissues. These tumors can be classified as benign, malignant or locally aggressive. They can also be categorized base on the tissue of origin such as bone cells, cartilage cells, fat tissue, vascular tissue or soft tissue.

Contents

• What is Orthopedic Oncology?
• What are the Symptoms of Orthopedic Oncology?
• How is Orthopedic Oncology Diagnosed?
• What is the Treatment for Orthopedic Oncology?
• What are the Diseases in Orthopedic Oncology?
• Concluison

What is Orthopedic Oncology?

Orthopedic oncology is a medical speciality focused on the diagnosis and treatment of tumors in the musculoskeletal system. This field deals with both benign (non-cancerous) and malignant (cancerous) tumors that can develop in any part of the musculoskeletal system, including bones, muscles, joints, nerves and soft tissues. This speciality often requires a multidisciplinary approach. Orthopedic oncologist work closely with radiologist, pathologist, medical oncologist and radiation oncologist to create treatment plans for their patients. Additionally, prosthetics and other rehabilitation methods are frequently used to improve the quality of life and minimize functional loss in patients.

What are the Symptoms of Orthopedic Oncology?

Pain: The most common symptom of bone or soft tissue tumors. Pain is usually felt in the area where the tumors is located and may worsen over time. Night pain is also frequently reported.

Swelling and Mass: A visible or palpable swelling or mass may develop in the area where the tumor is located. This mass can be painful or painless when touched.

Limited Movement: If the tumor is near a joint, it can cause restricted movement in the joint. This can make it difficult to perform daily activities.

Fractures: Malignant tumors in the bones can weaken the bone tissue, making it brittle. As a result, sudden fractures can occur due to minimal trauma or normal activities.

General Symptoms: In advanced stages of tumors, general cancer symptoms such as weight loss, fatigue, fever and night sweats may also be present.

Neurological Symptoms: Tumors located near the spine or nerves can cause neurological symptoms like numbness, tingling, weakness and sometimes paralysis due to nerve compression.

How is Orthopedic Oncology Diagnosed?

The diagnosis of orthopedic oncology involves a multidisciplinary approach and requires a series of clinical, radiological and pathological evaluations. Here are the main steps followed in diagnosing orthopedic oncology.

1. Patient History and Physical Examination: The first step is to take a detailed medical history and understand the patient’s symptoms. The orthopedic oncologist gathers information about the onset, duration and severity of symptoms along with other relevant factors. This is followed by a physical examination to assess the location, size and tissues affected by the tumor.
2. Imagining Techniques: Various imaging methods are used to confirm the diagnosis and determine the extent of the tumor:
   • X-Rays: A basic method for evaluating bone tumors.
     • Magnetic Resonance Imaging (MRI): Provides detailed images of soft tissues and bone marrow involvement.
       • Computed Tomography (CT): Offers a more detailed visualization of bone structure and the tumor’s spread.
         • Positron Emission Tomography (PET): Evaluates metabolic activity and helps determine whether a tumor is malignant.
3. Biopsy: To make a definitive diagnosis, a sample of tumor tissue needs to be taken. A biopsy can be performed surgically or via needle. A pathologist examines the tissue sample under a microscope to identify the type and grade of the tumor.
4. Laboratory Tests: Blood tests can support the diagnosis by measuring tumor markers and providing information about the patient’s overall health.
5. Genetic Tests: In some cases, genetic analysis is used to identify the molecular characteristics of the tumor and potential targeted therapy options.

After these steps, orthopedic oncologists and other specialist review the gathered data to make an accurate diagnosis and develop an appropriate treatment plan. Early and accurate diagnosis is crucial for the success of the treatment process.

What is Orthopedic Oncology Treatment?

Orthopedic oncology treatment is planned with a multidisciplinary approach, depending on the type, location, stage of the musculoskeletal tumor and the patient’s overall health. Treatment generally includes a combination of surgery, chemotherapy, radiation therapy and targeted therapies.

Surgical Treatment, The foundation of orthopedic oncology treatment is surgery. The goal is to remove the tumor, preserve healthy tissue and minimize functional loss. Reconstructive surgical techniques may be used to restore the structural and functional integrity of the affected area with prosthetic or grafts if needed.

Chemotherapy, Used before (neoadjuvant) or after (adjuvant) surgery for malignant tumors, chemotherapy aims to stop or destroy tumor cells. It can also eliminate microscopic tumor cells that may have spread to other parts of the body.

Radiation Therapy, This involves using high-energy radiation to kill or shrink tumor cells. It can be used as an alternative to surgery or to remove residual tumor tissue after surgery.

Targeted Therapies and Immunotherapy, These treatments are designed based on the tumor’s molecular and genetic characteristics. They specifically target tumor cells, aiming to be effective while sparing healthy cells.

In orthopedic oncology, patient follow-up and rehabilitation are crucial. Physical therapy and rehabilitation aim to improve the patient’s quality of life, ensure functional independence and minimize complications after treatment. Psychological support and nutritional counseling are also important components of the treatment process.

What are Orthopedic Oncology Diseases?

Orthopedic oncology deals with diagnosis and treatment of musculoskeletal tumors. These can be benign (non-cancerous) or malignant (cancerous). Common orthopedic oncology diseases include:

Osteosarcoma, The most common malignant bone tumor, often seen in adolescents, particularly in the metaphysis of long bones. It is aggressive and may metastasize if not treated early.

Chondrosarcoma, A malignant tumor originating from cartilage tissue, mostly affecting middle aged and older individuals. It grows slowly but requires surgical intervention because it is usually resistant to radiation and chemotherapy.

Ewing sarcoma, An aggressive tumor found in bones and soft tissues, typically diagnosed in children and adolescents. It is treated with a combination of chemotherapy, surgery and radiation therapy.

Soft Tissue Sarcomas, These originate from soft tissues such as muscles, fat, nerves and blood vessels. Subtypes include liposarcoma, rhabdomyosarcoma and synovial sarcoma. Treatment involves surgery, chemotherapy and radiation therapy depending on the tumor’s location, size and type.

Benign tumors like osteoma, osteochondroma, and giant cell tumors are also assessed in orthopedic oncology. These are typically treated successfully with surgical intervention. The treatment of orthopedic oncology diseases is planned with a multidisciplinary approach to preserve to patients quality of life and long-term health.

Conclusion

Early diagnosis in orthopedic oncology is crucial because tumors detected early can be treated more successfully. Therefore, orthopedic oncologist carefully evaluate patients’ symptoms and perform necessary diagnostic tests such as imaging and biopsy. Overall, orthopedic oncology provides a comprehensive treatment approach aimed at preserving long-term health and quality of life.