Surgery is the most common treatment for bone cancers, aiming to remove all of the cancer. Most primary bone cancer surgeries require general anesthesia. This is a kind of drug that makes you sleep through the whole procedure so you don’t feel any pain. An anesthesiologist or a nurse anesthetist will give you the anesthesia. Before surgery, you’ll meet the anesthesiologist. You can ask questions about the anesthesia and how it will affect you.
After you are completely asleep, the surgery will be done. The type of surgery depends on the location and extent of the cancer. These surgeries can last anywhere from three to six hours or more. During the surgery, the doctor removes the whole tumor. The doctor will do everything possible to save as many nearby tendons, blood vessels, and nerves as possible, unless the planned surgery is an amputation (removing part or all of a limb).
If you are having a limb-sparing operation, once the surgeon has removed the tumor, he or she rebuilds the limb. There are three ways a limb can be rebuilt. The surgeon can use a bone graft, a metal prosthesis, or a combination of a bone graft and metal. A bone graft can be taken from another part of your body or from the bone bank. A bone from the bone bank is called an allograft. An allograft is a donated bone from a person who has died. The bone graft is held in place with a plate and screws.
In special cases where the tumor is in the thigh bone or around the knee, the surgeon may need to do an operation called a rotationplasty. If you need this, the surgeon will explain it to you in detail before the surgery. In this type of operation, the tumor is removed and the lower part of the leg is flipped 180 degrees and attached to the upper part of the leg, so that your ankle becomes your new knee joint. An external prosthesis is then used to replace the lower part of the leg. This operation sounds strange, but it can preserve your ability to walk. In very rare cases, a similar operation is done for arm tumors, which results in a shorter arm but allows you to keep your hand.
If the cancer is in your lower jaw, the surgeon can remove the part of your jaw where the tumor was located. Then, the surgeon will replace it with bones from other parts of your body.
Surgery to treat bone tumors in other parts of the body such as the pelvis are complex, but can sometimes be done.