If you are diagnosis with a bone cancer, it can bring you with many questions and the most common might be – Will I need chemotherapy? For patients and families, understanding why chemotherapy is recommended can make the treatment procedure a little easier to understand.
Chemotherapy is an important part of treatment for some primary bone cancers. It uses anti-cancer medicines. Andthese medicines travel through the bloodstream and work to destroy cancer cells. However, chemotherapy is not the same for every patient. The type of bone cancer, age, treatment plan and response to treatment all matter.
Chemotherapy uses certain medicines called cytotoxic drugs, which is used to destroy cancer cells. Because these medicines travel through the bloodstream, they can reach cancer cells in different parts of the body.Chemotherapy is used particularly for Ewing sarcoma and is also commonly used for osteosarcoma and may also be used for some other types of primary bone cancer. Chemotherapy may be given before surgery, after surgery, along with radiotherapyor even when the cancer needs to be controlled for as long as possible.
When chemotherapy given before surgery it is called neoadjuvant chemotherapy.One reason for giving chemotherapy before surgery is to try to shrink the tumour. And this helps the surgeon to remove all of the cancer. In some cases, shrinking the tumor may allow the surgeon to perform limb-sparing surgery instead of amputation.It may also help in relieving some of the symptoms and getsurgeons some more time to plan the operation.
If chemotherapy is given after surgeryit is called adjuvant chemotherapy.The goal is to reduce the chance of cancer returning. Chemotherapy may be used in some cases where all of the bone cancer could not be removed to shrink cancer cells that remain. However, even when the cancer responds and becomes much smaller, there can still be a risk of it returning later.The treatment team will decide whether chemotherapy is needed based on the individual’s situation.
There are several chemotherapy medicines thatare used to treat bone cancer. Doctors often use a combination of them rather than just one drug.Some commonly used drugs include:
The combination and duration of treatment depend on the type of bone cancer and the individual treatment plan.
VDC/IE is a common chemotherapy regimen used in Ewing sarcoma. It contains vincristine, doxorubicin, cyclophosphamide, ifosfamide and etoposide. Treatment is divided into Induction and Consolidation phases with surgery or radiotherapy in between. The treatment commonly involves 14 cycles, usually with about two weeks between cycles, although this can sometimes be extended depending on the patient’s situation.
Osteosarcoma may also require chemotherapy before and after surgery.A commonly used combination is called MAP, which includes high-dose methotrexate, doxorubicin and cisplatin. For some patients who cannot have high-dose methotrexate, an AP combination of doxorubicin and cisplatin may be used. The treatment usually takes around 6 to 9 months when chemotherapy is given before and after surgery.
Chemotherapy may be given through a small tube called a cannula placed into a vein in the arm. It can also be given through a longer tube placed into a large vein in the chest, such as a central line, PICC line or Portacath.Some chemotherapy medicines may also be given as tablets. Depending on the treatment, chemotherapy may be given at a day clinic, over several days or sometimes during a hospital stay.
Before each cycle, blood tests are usually done to check whether the blood counts have recovered enough for treatment to continue. Some patients may also need tests such as a hearing test or an echocardiogram.
Chemotherapy is designed to kill cancer cells, but during the procedure it can also affect some healthy cells. Side effects that may occur:
Side effects can be different, depending on what medicines are used, the dose and how an individual reacts. Some of the side effects lasts for a few days and your treatment team can help you manage them.It is necessary to tell your doctor about the side effects. If there are signs of infection, patients should contact their doctor or hospital immediately.
Dr. Love Kapoor is an Orthopaedic Oncologist and focuses on bone tumours, soft tissue sarcomas, metastatic bone disease and complex musculoskeletal cancers.If you or a family member of yours has been diagnosed with bone cancer, understanding the treatment plan is the first important step. Chemotherapy can be a major part of treatment for cancers such as osteosarcoma and Ewing sarcoma, but the exact medicines and schedule need to be decided according to the individual case.
With the right care and guidance, treatment becomes easy to understand.
Category: Chemotherapy
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