Most Popular Articles

Limb-Salvaging Surgery Benefits Those With Bone Cancer: Your Health

By Rallie McAllister, M.D., MPH

Emily Land was accustomed to experiencing aches and pains in her legs. As a Division I soccer player on scholarship at the University of Tennessee, Martin, she got more than her share of bumps and bruises.

After enduring nearly three months of severe, constant pain in her left thigh, however, she couldn't help thinking that the source of her pain might be something more serious. A visit to her orthopedist confirmed her suspicions that she was dealing with more than just a strain or sprain. An X-ray revealed a tumor in the thighbone above her left knee.

By Rallie McAllister, M.D., MPH

Emily Land was accustomed to experiencing aches and pains in her legs. As a Division I soccer player on scholarship at the University of Tennessee, Martin, she got more than her share of bumps and bruises.

After enduring nearly three months of severe, constant pain in her left thigh, however, she couldn't help thinking that the source of her pain might be something more serious. A visit to her orthopedist confirmed her suspicions that she was dealing with more than just a strain or sprain. An X-ray revealed a tumor in the thighbone above her left knee.

Following a biopsy of the tumor, Emily was diagnosed with osteosarcoma, a type of cancer that originates in the bones. Because it occurs primarily in growing bone tissue, osteosarcoma is most commonly diagnosed in children and young adults between the ages of 10 and 25.

Although bone cancer isn't unheard of in adults, it typically arises from a spread of cancer from another site in the body. In advanced stages, cancer of the breast, prostate gland, or lung may spread to the bone.

According to Mike Neel, M.D., an orthopedic oncologist at St. Jude Medical Center in Memphis, Tenn., "In children with osteosarcoma, the cancer typically occurs around the growth plates of the bones in the knee, hip, or shoulder joint."

Until recently, children and adolescents diagnosed with osteosarcoma almost routinely received amputations of the affected limb. The prospect of losing a leg was particularly painful to Emily, who had been playing soccer since she was 4 years old.

"When I first found out that I had osteosarcoma, I was devastated," she said. "Eventually, I decided that this cancer had picked the wrong body, and I was going to do whatever it took to beat it."

After receiving four rounds of high-dose chemotherapy to treat the cancer, Emily was ready for surgery. Instead of an amputation, she underwent a procedure known as limb-salvaging surgery.

"This is a challenging surgery," Neel noted. "Not only do we have to remove the tumor, we also have to remove a large cuff of bone and muscle tissue around the tumor."

Thanks to new technology, patients like Emily who lose substantial amounts of bone aren't left with lifeless, non-functioning limbs. In Emily's case, an internal prosthesis known as the Guardian Limb Salvage System was implanted in her left leg.

The prosthesis consists of two stems that are used to anchor the implant in the thighbone and shinbone, and a hinge apparatus which serves as a functional replacement for the knee joint. The entire device is covered with the patient's remaining muscle and skin tissue.

For younger children who are still growing, a similar type of internal prosthesis, called the Repiphysis Expandable Implant, is often used.

"A child who is diagnosed with osteosarcoma at the age of 10 may have six years of growing left," Neel explained. "After we take out the tumor and remove the growth plate of the bone, the child might end up with a discrepancy in leg length of several inches."

In the past, multiple surgeries were required to correct the limb-length discrepancy. Using the Repiphysis Expandable Implant, a simple, non-invasive procedure lengthens the prosthesis in the affected leg as the child grows.

To lengthen the device, the physician places a magnetic field outside the patient's body, which allows a compressed spring in the implant to expand in small increments. The entire procedure takes only about 10 minutes.

"The function of these prostheses is excellent," said Neel. "We don't want our patients to engage in activities that cause them to get knocked off their feet, but they can still enjoy non-contact sports like biking and golfing."

Less than a year after her surgery, Emily's cancer was in remission. Although she was unable to return to her mid-field position on the soccer field, she rejoined her team as an assistant coach and graduated with honors.

Today, Emily enjoys a successful career as an assistant sales coordinator and shares a passion for riding mountain bikes with her husband.

"I have excellent function of my leg, and I don't have any pain now," she said. "It feels as close as possible to having a normal leg."

In her free time, Emily works with other cancer patients, providing support, inspiration, and education. "So many people believe that a diagnosis of osteosarcoma means that they have to have an amputation," she said. "I want them to know that there are other options."

Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is http://www.rallieonhealth.com.
COPYRIGHT 2006 CREATORS SYNDICATE, INC.