Surgery for Bone Mets
Developments in cancer treatments for bone metastases (mets) mean that life expectancy of patients with cancer that has spread to the bone is often measured in years. However, complications when cancer spreads to the bone may dramatically affect quality of life, making the careful look and right treatment choices of bone mets essential.
Surgery may help to strengthen weakened bones. The doctor may place a metal plate on the damaged area, seal the crack with bone cement, or replace part of the bone and joint with an endoprosthesis. These actions will help ease the pain.
The roles of orthopedic and spinal surgeons when cancer spreads to the bones generally fall into one of four categories:
Diagnostic – determining the extent of metastases
Preventative – the prophylactic fixation of metastatic deposits at risk of impending fracture preventative surgery
Stabilizing – stabilization or reconstruction of bones affected by pathological fractures
Reactive – the decompression and stabilization of the vertebral column, spinal cord, and nerve roots.
A multidisciplinary treatment team should assess the patient and options available for metastatic bone tumors. Detailed pre-assessment is essential to gauge a patient’s suitability for surgery – recovery from elective surgery must be shorter than the anticipated survival.
Staging and biopsies provide prognostic information.
Preventative surgery to fix a lesion before a fracture reduces length of hospital stay and improves quality of life. Regardless of a lesion or pathological fracture’s location, all regions of the affected bone must be addressed to reduce the risk of the fracture happening again.
Surgical implants should allow full weight bearing or return to function immediately. Post-operative radiotherapy should be used in all cases to minimize disease progression.
Spinal surgery should be considered for those with spinal pain due to potentially reversible spinal instability or neurological complications. The opinion of a spinal surgeon should be sought early, as this improves recovery and quality of life.
Patients who suffer a slowly progressive deficit, present within hours of complete neurological deficit, or have compression caused by bone alone are those most likely to benefit from surgery. Back pain in the presence of cancer that has spread to the bones should be regarded as impending spinal cord compression and investigated urgently to allow for surgery.
The surgeon strengthens the bone with metal plates. They make it harder and help reduce the risk of fractures, cracks, and other injuries.
Restoration with bone cement
With the help of bone cement, the doctor can restore the integrity of the fractured bone. This strategy helps to reduce the severity of pain.
Joint replacement with endoprosthesis
Endoprosthetics of the joint are used for fractures. Most often, this operation is prescribed to patients with metastases in the thigh bones. After the intervention, the condition of the patients improves slightly.
Surgery, when possible, will likely be used in combination with chemotherapy, immuno-oncology, radiation, and interventional radiology procedures. A multidisciplinary team approach is an absolute must!