Ortho Oncology: An Emerging Specialty

Introduction

The term oncology refers to a branch of medicine that deals with diagnosing and treating cancer. The term orthopedics denotes a medical specialty that deals with the conditions of the musculoskeletal system.

Orthopedic oncology, also known as ortho oncology, is a subspecialty of these two branches of medicine.

What Is Ortho Oncology?

Orthooncology, also known as musculoskeletal oncology, is a medical specialty that deals with diagnosing and treating bone and soft tissue tumors. It involves a multidisciplinary approach that includes orthopedic surgeons, medical oncologists, radiation oncologists, pathologists, and radiologists.

What Are the Goals of Ortho Oncology?

The goal of ortho oncology is to provide patients with the best possible outcome while preserving limb function and maintaining the quality of life. Some of the general goals of ortho oncology include the following.

1. Accurate Diagnosis: One of the primary goals of ortho oncology is to accurately diagnose bone and soft tissue tumors. This is done using a variety of diagnostic tests and imaging studies.

2. Treatment Planning: Once the diagnosis is confirmed, the next goal is to develop a treatment plan that is tailored to the patient's individual needs and preferences. The goal is to provide the most effective treatment while minimizing the risk of complications and side effects.

3. Preservation of Limb Function: In many cases, the goal is to preserve limb function and avoid amputation. This may involve limb-sparing surgery, which removes the tumor while preserving the surrounding healthy tissue. In some cases, limb reconstruction or prosthetic replacement may be necessary to restore function after surgery.

4. Pain Management: Pain management in ortho oncology is done through pain medications, physical therapy, and other interventions such as nerve block or spinal cord stimulation.

5. Supportive Care: Another goal of ortho oncology is to provide supportive care to help patients manage the physical, emotional, and social aspects of cancer treatment. This may include nutritional support, counseling, and rehabilitation services.

6. Disease Management: Ortho oncology aims to manage the disease over the long term, including monitoring for recurrence or metastasis and adjusting treatment as needed to maintain the best possible outcomes for the patient.

What Are the Common Types of Ortho Oncology Tumors?

The tumors affecting the musculoskeletal system may be bone tumors or soft tissue tumors.

• Bone tumors are again classified into primary and secondary bone tumors.

  1. Primary bone tumors originate in the bone itself and are relatively rare. The common types of primary bone tumors include osteosarcoma, chondrosarcoma, Ewing sarcoma, and giant cell tumor.

  2. Secondary bone tumors, on the other hand, originate in other parts of the body and spread to the bones common types of secondary bone cancers include breast, lung, kidney, prostate, and thyroid cancers.

• Soft tissue cancers develop in any of the soft tissue of the body, including muscle, tendons, ligaments, and cartilage. They can be benign or malignant.

  1. Benign soft tissue tumors are noncancerous growths that do not spread to other parts of the body. The most common types of benign soft tissue tumors are lipoma, fibroma, and schwannoma.

  2. Malignant soft tissue tumors are cancerous and spread to other parts of the body. The common malignant soft tissue tumors include sarcoma, liposarcoma, leiomyosarcoma, and rhabdomyosarcoma.

What Are the Various Diagnostic Procedures Done in Ortho Oncology?

The diagnosis of ortho oncology involves a range of tests and procedures to identify the type and stage of the tumor. Some of the key components of the diagnostic process in ortho oncology include

• Medical History: The first step in the diagnosis is to take a detailed medical history of the patient, including any previous medical conditions, family history, and current symptoms.

• Physical Exam: A thorough physical examination is conducted to evaluate the patient's overall health and to look for any signs of bone and soft tissue tumors. The examination may include palpation of the affected area, range of motion testing, and neurovascular examination.

• Imaging Tests: A variety of imaging tests may be used in the diagnosis of bone and soft tissue tumors, including X-rays, CT (computed tomography) scans, MRI (magnetic resonance imaging) scans, bone scans, and PET (positron emission tomography) scans. These tests help to identify the location, size, and extent of the tumor.

• Biopsy: It is a procedure to remove a small sample of tissue from the tumor for laboratory analysis. This helps to confirm the diagnosis and determine the type of tumor. A biopsy may be done with a needle or by surgical removal of the tumor.

• Genetic Testing: Genetic testing may be used to identify any genetic mutations that may be associated with the development of bone or soft tissue tumors.

• Blood Tests: Blood tests may be conducted to check for certain tumor markers that can indicate the presence of cancer.

• Second Opinion: It is important for patients to seek a second opinion from a qualified ortho oncologist or other specialists, especially for complex cases. A second opinion can help to ensure an accurate diagnosis and develop a comprehensive treatment plan.

What Are the Various Treatment Procedures Done in the Ortho Oncology Specialty?

The treatment of musculoskeletal tumors involves a combination of different approaches, including surgery, radiation therapy, chemotherapy, and targeted therapy.

• Surgery: Surgery is often the primary treatment for bone and soft tissue tumors. The goal of surgery is to remove the tumors while preserving as much healthy tissue and limb function as possible. Depending on the location and size of the tumor, limb-sparing surgery, amputation, or bone reconstruction surgery may be necessary.

• Radiation Therapy: This uses high-energy X-rays or other types of radiation to kill cancer cells. It may be used alone or in combination with surgery or chemotherapy. Radiation therapy may be given before surgery to shrink the tumor or after surgery to kill any remaining cancer cells.

• Chemotherapy: This involves the use of drugs to kill cancer cells. It is also used in combination with other treatment procedures.

• Targeted Therapy: This uses drugs that specifically target certain proteins or molecules that are involved in the growth and spread of cancer cells.

• Immunotherapy: Immunotherapy uses the patient's own immune system to fight cancer cells. It is a newer approach to cancer treatment and is still being studied in the context of ortho oncology.

Why Is Ortho Oncology an Emerging Specialty?

Ortho oncology is an emerging specialty because of several factors like

• Increasing incidence of bone and soft tissue tumors.

• The development of new diagnostic and treatment options.

• The growing recognition of the importance of specialized care for patients with these tumors.

Conclusion.

Ortho oncology is an important and emerging specialty. Musculoskeletal tumors can be complex and require a multidisciplinary approach to care. With advances in diagnostic and treatment options, as well as the need for specialized care for patients with musculoskeletal tumors, the field of ortho oncology is evolving and advancing, providing hope and improved outcomes for patients.