Myths and Facts

Myth:

The best way to handle a cancer of bone is to just remove it completely rather than going for a biopsy.

Fact:

Performing a biopsy first is the best way to approach a cancer of bone because it gives us the exact nature (diagnosis) of the cancer. This has many implications:
• It may not be cancer at all
• It may be a tumor which can be tackled by curettage (cleaning) rather than completely removing the bone
• It may turn out to be a cancer where the first or the only treatment required is medicines. In fact it may be something that does not require surgery at all

Myth:

Surgery causes cancer to spread. Hence the best way to remove bone cancer is amputation.

Fact:

There is no proof that a properly performed limb saving surgery causes spread of cancer. In fact, there is no difference in the survival of patients undergoing limb saving surgery vs those undergoing amputation.

Myth:

Everyone with the same kind of cancer gets the same kind of treatment.

Fact:

The treatment of bone cancer, as for all cancers, depends on the type and stage of the cancer. While myeloma/ lymphoma may need no surgery at all, osteosarcoma needs both chemotherapy and surgery and chondrosarcoma is usually treated only with surgery.

Myth:

I am sure my patient can’t withstand cancer treatment.

Fact:

All cancer treatment is offered to a patient only after the physician or surgeon is sure that the patient has the reserves to withstand that treatment, and the risks of treatment are significantly outweighed by the benefits of treatment. The patient will undergo detailed evaluation to ensure this, and any risks will be conveyed.

Myth:

The treatment of bone cancer is only by amputation.

Fact:

At centers specialized in treating bone cancer, up to 90% patients undergo a limb salvage surgery (or limb saving surgery). It is now established beyond doubt that the survival outcomes of patients undergoing limb saving surgery is no different from those undergoing amputation.

Myth:

Amputation means permanent cure from a cancer of the bone, so no chemotherapy is required.

Fact:

There might be small microscopic disease (not visible on any tests) already spread out of the affected bone in many patients. Chemotherapy is the only way to tackle these, and it is a must in the treatment of bone cancer like Osteosarcoma and Ewing Sarcoma.

Myth:

A needle biopsy can disturb cancer cells, causing them to travel to other parts of the body.

Fact:

A properly performed biopsy does not accelerate or alter the growth of cancer in any way.

Myth:

Children can’t have cancer, it’s a disease of the elderly.

Fact:

Unfortunately, even children can be affected by cancer. Bone cancer is one of the commoner cancers affecting children.

Myth:

Biopsy is a small procedure that even someone not trained in bone cancer can perform. We should go to a specialized centre only once the biopsy report confirms cancer.

Fact:

An improperly performed biopsy can make it difficult even for the specialized team to save the limb of the patient and can lead to amputation. Biopsy should always be performed at a centre where limb salvage surgery is routinely performed.