Other forms of bone cancer treatment are often used in conjunction with surgery, most notably chemotherapy and radiation therapy. In these cases, chemotherapy or radiation therapy may be used before the surgery to reduce the size of the tumor; these bone cancer treatments may also be used after surgery to rid the body of remaining cancer cells.
There are a number of different types of surgeries used in bone cancer treatment, all of which involve a "wide-excision." A wide-excision is when a surgeon attempts to remove a cancerous tumor from the bone. To ensure that every single cancer cell is removed and killed, the surgeon will remove both the tumor and additional surrounding tissue that appears to be healthy.
Amputation is a type of surgery often used to treat bone cancer. More specifically, amputation involves removing the tumor, an area above it, and everything below it. As a result, amputation leaves the patient with a lost limb (arm or leg). While amputation used to be the surgery of choice for bone cancer treatment, the appearance of limb-salvage surgery has significantly lowered the need for such a surgery.
Before the surgery, the pathologist and surgeon will utilize MRI scans and examination of the tissue to determine how much of the limb must be removed. After the surgery, the patient will often be fitted with a prosthesis, or an artificial limp. Using this prosthesis will require months of rehabilitation.
This type of surgery has been the surgery of choice of recent times. In this procedure, the surgeon's goal is to remove all of the cancer from the body while still allowing the patient to retain his or her limb. Now, the overwhelming majority of bone cancer patients requiring surgery can have their limb salvaged. Limb-salvage surgery is not simple, however, and requires specially trained and skilled surgeons. The challenge for this type of surgery is to preserve the tendons, vessels, and nerves surrounding the cancerous growth.
During the procedure, a wide-excision is done to remove the cancerous bone tumor. Afterwards, the surgeon will replace the missing bone with either a bone graft or an internal prosthesis (usually made out of metals or other materials). This type of surgery carries much more risk of infection or complications. Many patients may require surgery in the following years, and will be required to undergo very intense rehabilitation.
Reconstructive surgery is often required after the two surgical procedures listed above. Each type of reconstructive surgery involves the surgeon attaching a healthy joint to a removed joint. For example, if the upper arm is removed during surgery, reconstructive surgery will reattach the lower arm, leaving the patient with a shorter, but functional arm.
Curretage is a procedure that is commonly used when traditional wide-excision is impossible. In curretage, the surgeon will remove the tumor through a hole in a section of the bone. Often times, cryosurgery will be used. More specifically, the surgeon will pour liquid nitrogen into the small hole to kill and remove the tumor.