Bone tumors: How does life change?
I will talk about a situation that often happens to me. I know that when I report a tumor, whether benign or malignant, my patients have only heard half of what I have said from that moment on, and have a mindset that is open to different interpretation of what is being told. This situation is very normal and not an unhealthy reaction.
Here it is necessary to take a little breath and leave some time to all the questions. Moreover, if my patient is unfortunately at a young age, this situation is extremely difficult for the parents.
It is important to know that whatever is required to be confirmed will be done as quickly as possible. The world stops!
Tumor often sounds very scary. 'Tumor' is a Latin word meaning bump, swelling, protrusion. In other words, cancer is not meant only when tumor is mentioned; we use it more when we want to describe a bump that shouldn't be. Tumor is used to describe the protruding conditions of both benign and malignant masses. When we say there is a bone tumor, we explain that there is an abnormal structure in the bone, but this does not necessarily mean that it is bad.
By the way, we doctors like to use the word mass more than tumor.
When confronted with a swelling or mass at first glance, it is important to remain neutral about the tumor's temperament until confirmed. Extreme convenience and excessive fuss are both equally inconvenient. At that stage, words that could be malignant or benign will not help much. Here, doctors want the confirmation to be the most accurate and the most robust way of this is biopsy.
With MRI, we can only understand if a tumor is malignant by 84%, so this is not 100%. However, we try to increase this rate with physician experience, clinical findings, X-ray, tomography, and scintigraphy.
Most of the time, it is so evident from the examinations that the tumor is good that we have the confidence to quickly relieve our patient.
Very rarely is the tumor bad and it is necessary to examine it closely to understand how bad it is.
There are also subtypes of bad tumors, that is, cancers, we are used to thinking about it with statistics, even if we say it roughly like the good of the bad, the bad of the bad, etc.
So, Cure (being completely free of tumor),
We need to determine the treatment with statistics such as disease-free survival, disease survival time, and recurrence rates after destroying the tumor.
The characteristics of bone tumors are as high as their types. There are many types of bone tumors. The behavior patterns, structures of these masses, the responses to many different tried treatments and the process that we call prognosis have been studied and advanced classifications have been made with the accumulation of knowledge. Unclassified tumor behavior probabilities are also noted.
However, I will explain their habits under 3 categories as they are practical:
Benign bone tumors (Selim-benign): Although some of them have a very large protrusion, they are very unlikely to be cassed to human structure and life. They can grow but do not spread and are very, very unlikely to recur after treatment. To name a few, osteochondroma, osteoma, nonosseous fibroma, enchondroma, simple bone cyst are a few of them.
Locally aggressive (abusive masses where they exist): These species are very unlikely to spread elsewhere, but it is not impossible for some species. By distorting the shape of the bone it is out of, it affects its function and causes pain. They can seriously distort the shape of the bone. There is a possibility of recurrence after treatment. Some types can become malignant.
Malignant bone tumors (Malignant): These types are extremely rare. Usually a single treatment is not enough and they are more likely to spread to the body, ie metastasize.
How to tell if it is a bone tumor:
Let's say it from the beginning; When a tumor is detected, don't bother with figuring out whether it's good or bad. The Internet, Google, will stand out with bad news that will ruin the world.
Since bad events generate more interest, they are written and read more.
Although bone tumors are very benign, they can sometimes cause pain and even fever.
Sometimes there may be no complaints in malignant tumors.
Alarms
The body's warning system is important, if any
Palpable swelling,
Pain, (often described as blunt)
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Night-waking pain
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Pain that continues more than the normal duration, even if mild, after a fall and impact; Although the bumps and falls do not cause a tumor, they can start pain in a place where there is a silent tumor.
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Fever for no reason
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Joint stiffness, swelling
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More vascularization in the painful area compared to other symmetrical parts of the body
Not all bumps are cancer or bone tumors!
Infections,
local edema,
muscle spasms,
muscle tears,
bursites,
healing cracks / fractures
Many causes, such as allergic reactions, can cause hard swelling in the body, which can sometimes lead you to think you have a bone tumor
What should we do?
Let's stop for a while ...
When we find out that there is a mass, it is very important to know at that moment whether it is malignant or not.
It is necessary to plan immediately to sleep comfortably at night and get rid of it.
Regardless of whether they are good or bad, some people have a great belief that nothing serious is happening, while others are the opposite.
It is very important to be positive, to rest well, and if a war is to be fought, it is best to start against it.
Fuss and extreme worries only make things harder to do.
After the first examination, we try to understand whether it is a truly malignant tumor with imaging tests such as X-ray, MRI, CT, Scintigraphy and some blood tests.
However, even if it seems to be a simple sebaceous gland, the most important treatment will be decided after the biopsy result.
The answer to the question of what should we do is the result of biopsy.
The most important decision in tumor treatment is the decision of pathology.
Without this, the presumed work could lead to enormous damage.
Especially in malignant tumors, treatment is not performed with a single doctor. With a holistic interdisciplinary coordination, the known, tried and statistical treatments of the mass are started with all the possibilities we have. Departments such as musculoskeletal oncologist, pathologist, radiation oncology, extremity conserving orthopedic surgery, plastic and reconstructive surgery start the treatment by dividing work.
Biopsy is Very Important!
Comes from the 'bio' of bio biology (life),
opsi also means to see.
So it is a word meaning seeing biology - life.
Biopsy means either the small part of the tumor, or sometimes the whole, to be examined by the pathologist in the laboratory. Sometimes it is necessary to do special painting in order to fully understand the character of the mass and it may take time. In biopsies taken from bone tissue, a period of 10-15 days may be required for the bone to dissolve and the cells to be seen.
Biopsy highlights:
1. My suggestion is to take a biopsy by the physician who will perform the tumor surgery.
2. The entry point of the needle of the biopsy and the path of the needle should not complicate the surgical plan later.
3. The area of ​​the tumor to be biopsied should be determined in advance.
4. Sufficient amount should be tried to be taken.
5. It should be examined by the bone skeletal system pathologists.
6. The insertion point of the biopsy needle and the adequacy of the tissue taken and the removal area are important.
Biopsy types:
• Closed biopsies:
Needle biopsy - It is the procedure performed under local or short-term general anesthesia with special needles such as Tru-cut and Jamshidi. A tiny piece of needle is taken without cutting the skin and sent to the laboratory. It can be done with the help of ultrasonography or tomography.
Fine needle aspiration biopsy: It is usually obtained by aspiration of soft tissue or liquid masses.
• Open biopsies: In places and situations where the needle cannot be taken, it may be necessary to open the skin and take a piece. It is usually taken under short-term anesthesia.
• Excisional biopsy: It is the removal of the entire mass at one time and sending to pathology.
• Frozen Biopsy: It is the process of finding and examining the tissue by the pathologist in the operating room. Frozen biopsy is rarely used in bone tumors because of the difficulty in examining the bone or cartilage tissue. Sometimes frozen biopsy is performed to save time, if a clear examination is not possible, therapeutic surgery is performed after the operation is terminated and examined in the laboratory. It can also be checked whether there is a mass left in the area after the operation.
When the condition of the mass is determined, the orthopedist, medical oncologist, radiation oncologist, and pathologist determine the way for treatment.