Bone Cancer Treatment in India at Low Cost

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Bone cancer is a cancer of the cells that make up the bones of the body. When cancer is found in bones, it has usually started in another organ or another location in the body and has spread to the bones. Bone cancer can develop in all types of bone tissue and also in the blood-forming cells of the bone marrow (e.g., multiple myeloma, leukemia). bone cancer, where the bone cells themselves become malignant. Primary and metastatic bone cancers are often treated differently and may have a different prognosis.Cancer that originates in bone is called primary bone cancer. Most cancers that originate in bone tissue are sarcomas (i.e., cancer that originates in connective tissue).

Cancer often spreads (metastasizes) to the bones from other sites in the body (e.g., breast cancer, prostate cancer, lung cancer). When this occurs, the cancer cells resemble cells from the area they originated from, not bone cancer cells. This type of cancer is called metastatic bone cancer or secondary bone cancer. Bones are a specialized type of dense tissue (called osseous tissue) that comprises the framework of the body (the skeleton). Most bones are hollow and consist of bone cells (osteocytes) embedded in calcified tissue.

Bone tissue consists of two types of cells. Osteoblasts are responsible for bone formation and osteoclastsare responsible for dissolving bone tissue. Bone tissue is always changing: new bone cells are constantly forming and old bone cells are constantly dissolving. Bone marrow is soft tissue inside the bones that contains blood-forming cells and other cells (e.g., fat cells, plasma cells).

Types of Bone Cancer 

There are Three Types of Bone Cancer : -

·     Osteosarcoma : Osteosarcoma is the most common type of bone cancer. Osteosarcoma occurs most commonly in teenagers and young adults (ages 10-19) and is more common in males. Osteosarcoma in young people tends to develop at the ends of long bones in areas of active bone growth, often around the knee, either at the end of the femur (thighbone) or the proximal part of the tibia (shinbone). The next most common location is in the bone of the upper arm, but it is possible for an osteosarcoma to develop in any bone. Depending on the appearance of the tumor cells under the microscope, there are several different subtypes of osteosarcoma.

·     Chondrosarcoma : Chondrosarcomas, one of the most common types of bone cancer in adults over age 50, form in cartilage -- usually around the pelvis, knee, shoulders, or upper part of the thighs.

·     Ewing's Sarcoma : Ewing's sarcoma occurs most often in the middle part of bones, arising most often in the hip, ribs, upper arm, and thighbones. Like osteosarcoma, this cancer affects primarily children and young adults between the ages of 10 and 25.

·     Pleomorphic sarcoma :Pleomorphic sarcoma is a tumor formerly referred to as malignant fibrous histiocytoma or MFH. This term is still used frequently. Pleomorphic sarcomas are typically tumors of the soft tissues, but in up to 5% of cases they may arise in the bone. Pleomorphic sarcomas typically occur in adults and can be found anywhere in the body.

Stages of Bone Cancer

·     Stage I - At this stage, bone cancer is limited to the bone and hasn't spread to other areas of the body. After biopsy testing, cancer at this stage is considered low grade and not aggressive.

·     Stage II - This stage of bone cancer is limited to the bone and hasn't spread to other areas of the body. But biopsy testing reveals the bone cancer is high grade and considered aggressive.

·     Stage III - At this stage, bone cancer occurs in two or more places on the same bone. Biopsy testing shows this bone cancer is high grade and considered aggressive.

·     Stage IV - This stage of bone cancer indicates that cancer has spread beyond the bone to other areas of the body, such as the brain, liver or lungs.

Diagnosis of Bone Cancer

·     OPD Consultations

·     X-ray

·     Computerized tomography (CT)

·     Bone scan

·     Magnetic resonance imaging (MRI)

·     Positron Emission Tomography (PET)

·     Biopsy - A sample of tissue (Biopsy) from the tumor is removed for laboratory testing. Testing is done to know whether the tissue is cancerous and, if so, what is the type of cancer. Testing may also reveal the cancer's grade, which helps oncologists to understand how aggressive the cancer is.

Types of Biopsy Procedures used to Diagnose Bone Cancer Include 

·     Inserting a needle through skin and into a tumor. During a needle biopsy, surgical oncologist inserts a thin needle through the skin and guides it into the tumor. The needle is used to remove small pieces of tissue from the tumor.

·     Surgery to remove a tissue sample for testing. During a surgical biopsy, surgical oncologist makes an incision through the skin and removes either the entire tumor (excisional biopsy) or a portion of the tumor (incision biopsy).

Determining the type of biopsy patients need and the particulars of how it should be performed requires careful planning by the oncology team. Surgical Oncologists perform the biopsy in a way that will not interfere with future surgery to remove bone cancer.

Bone Cancer Treatment in India: Best Cancer Hospital in India 

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There are three standard forms of treatment for primary bone cancer: surgery, radiation therapy, and chemotherapy. Many times, more than one treatment method is required, such as surgery along with radiation therapy. Treatment varies based on type of bone cancer, if it has spread (metastasized), and other general health factors.

·     Surgery: Bone cancer is most commonly treated with surgery. Surgical treatment for bone cancer that has not spread involves removing the cancerous tissue and a small margin of healthy bone tissue surrounding it. Some tumors may require chemotherapy or radiation therapy in addition to surgical treatment.

·     Radiation Therapy: Radiation therapy uses specific type’s high energy beams of radiation to shrink tumors or eliminate cancer cells. Radiation therapy works by damaging a cancer cell's DNA, making it unable to multiply. Although radiation therapy can damage nearby healthy cells, cancer cells are highly sensitive to radiation and typically die when treated. Healthy cells that are damaged during radiation are resilient and are often able to fully recover.

·     Chemotherapy: Chemotherapy is an important part of the treatment for most osteosarcomas, spindle cell sarcomas and Ewing's sarcomas. Chemotherapy is usually given before you have surgery or radiotherapy. When given before surgery, it can shrink the tumour and make it easier to remove. It can also reduce symptoms such as pain and reduce the chances of the cancer spreading. If you have an osteosarcoma or Ewing's sarcoma, you will also have chemotherapy after surgery or radiotherapy. This is to destroy any remaining cancer cells that may have spread to other parts of the body. 

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How Are Brain Tumors Diagnosed? - Treatment of Brain Tumor

Symptoms of brain tumors vary according to the type of tumor and the location. Because different areas of the brain control different functions of the body, where the tumor lies affects the way symptoms are manifested.

Some tumors have no symptoms until they are quite large and then cause a serious, rapid decline in health. Other tumors may have symptoms that develop slowly.

A common initial symptom of a brain tumor is headaches. Often, they don't respond to the usual headache remedies. Keep in mind that most headaches are unrelated to brain tumors.

Other symptoms include:

·         Seizures

·         Changes in speech or hearing

·         Changes in vision

·         Balance problems

·         Problems with walking

·         Numbness or tingling in the arms or legs

·         Problems with memory

·         Personality changes

·         Inability to concentrate

·         Weakness in one part of the body

It's important to keep in mind that these symptoms can be caused by a number of different conditions. Don't assume you have a brain tumor just because you experience some of them. Check with your doctor.

How Are Brain Tumors Diagnosed?

To diagnose a brain tumor, the doctor starts by asking questions about your symptoms and taking a personal and family health history. Then he or she performs a physical exam, including a neurological exam. If there's reason to suspect a brain tumor, the doctor may request one or more of the following tests:

·      Imaging studies such as a CT(CAT) scan or MRI to see detailed images of the brain

·     Angiogram or MRA, which involve the use of dye and X-rays of blood vessels in the brain to look for signs of a tumor or abnormal blood vessels

The doctor may also ask for a biopsy to determine whether or not the tumor is cancer. A tissue sample is removed from the brain either during surgery to remove the tumor or with a needle inserted through a small hole drilled into the skull before treatment is started. The sample is then sent to a lab for testing.

HOW TO TREAT BRAIN TUMORS

• Tumors near the surface of the brain may be surgically removed. In many cases, however, it is only possible to remove a portion of a tumor, since taking it all out would cause unacceptable amounts of brain damage. Still, removing even part of it may afford a period of improvement by relieving pressure within the cranium.
• Tumors deep within the brain may be treated with microsurgery, laser surgery, or radiation therapy.
• For malignant primary tumors, surgery may be followed with radiation or chemotherapy. Surgery may also be preceded by radiation.
• Your doctor may prescribe corticosteroids to reduce swelling of brain tissue, anticonvulsant drugs to control seizures, and pain relievers.

Treatment for brain tumors is based on many factors, such as:

• Your age, overall health, and medical history
• The type, location, and size of the tumor
• How likely the tumor is to spread or recur
• Your tolerance for specific medications, procedures, or therapies

Treatment for these symptoms may include:

• Antiseizure/Antiepileptic Drugs (AEDs)
• Steroids
• Surgery

Often, low-grade tumors (grade I and II), which are not aggressive, are treated with watchful monitoring or surgery alone. Though all tumors are monitored with repeat scans, grade II tumors are watched more closely after surgery and over time to make sure there is no recurrence.

Higher grade tumors (grade III and IV), which are malignant and can grow quickly, are more difficult to remove and require additional treatments beyond surgery, such as radiation, chemotherapy, or a clinical trial if one is available. Microscopic tumor cells can remain after surgery and will eventually grow back. All treatments, therefore, are intended to prolong and improve life for as long as possible.

Additional treatment options for high-grade tumors include:

• Radiation therapy: X-rays and other forms of radiation can destroy tumor cells or delay tumor growth.
• Chemotherapy: The use of drugs to kill rapidly dividing cells. It can be taken orally or intravenously.
• Targeted therapy: The focus on a specific element of a cell, such as molecules or path
  
  
  
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Most Advanced Gallbladder Cancer Treatment in India - Low Cost Gallbladder Cancer Treatment and Surgery in India

Gallbladder Cancer

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Gallbladder cancer is a rare disease in which malignant (cancer) cells are found in the tissues of the gallbladder. The gallbladder is a pear-shaped organ that lies just under the liver in the upper abdomen. The gallbladder stores bile, a fluid made by the liver to digest fat. When food is being broken down in the stomach and intestines, bile is released from the gallbladder through a tube called the common bile duct, which connects the gallbladder and liver to the first part of the small intestine.

The wall of the gallbladder has 3 main layers of tissue.

·         Mucosal (innermost) layer

·         Muscularis (middle, muscle) layer

·         Serosal (outer) layer

Between these layers is supporting connective tissue. Primary gallbladder cancer starts in the innermost layer and spreads through the outer layers as it grows.

Symptoms and Signs Of Gallbladder Cancer

Gallbladder cancer is usually not found at an early stage because the gallbladder is located deep inside the body. Therefore, gallbladder cancer can be difficult to detect during routine physical examinations. Sometimes, gallbladder cancer is found unexpectedly after removal of the gallbladder for another reason, such as gallstones. When symptoms do occur, they include the following:

·         Jaundice (yellowing of the skin and whites of the eyes)

·         Abdominal pain

·         Nausea and vomiting

·         Bloating

·         Lumps in the abdomen

·         Fever

Diagnosis of Gall Bladder Cancer

·         Ultrasound. Ultrasound is a painless procedure in which a technician moves a wand-like device (transducer) over the surface of the abdomen. High-frequency sound waves form images on a screen that can identify a tumor in the gallbladder and bile ducts (Biliary tract).

·         Computerized tomography (CT) scans. CT scans generate cross-sectional images of the body that can show whether cancer has spread to other tissues or organs. All CT scanners at Mayo Clinic use spiral CT technology (an X-ray tube revolves around the patient) and several CT scanners use multi-detector row spiral technology, which creates three-dimensional images.

·         Magnetic resonance imaging (MRI) scans. MRI technology uses magnetic fields and radio waves to create detailed images of the gallbladder, bile ducts, liver and tumor. This highly sensitive technology can identify small abnormalities in the gallbladder.

·         Positron emission tomography (PET). To perform a PET scan, doctors inject sugar (glucose) and a very small amount of radiation into the bloodstream. The scan helps show if a tumor has spread, because tumors typically pick up the sugar and appear on the image as "hot spots."

·         Biopsy. In a biopsy, a pathologist removes a small tissue sample and looks under a microscope for cancer cells. Doctors may use fine-needle aspiration (FNA) to collect the tissue. During an FNA procedure a doctor will give you a local anesthetic and then gently guide a small needle through the skin and abdomen into the gallbladder. Ultrasound or CT scans help the doctor locate the tumor.

Stages of Gallbladder Cancer

The following stages are used for gallbladder cancer :

·         Stage 0 (carcinoma in Situ) : Abnormal cells are found in the inner (mucosal) layer of the gallbladder; these abnormal cells may become cancer and spread into nearby normal tissue

·         Stage I : Cancer has formed and has spread beyond the inner (mucosal) layer to a layer of tissue with blood vessels or to the muscle layer

·         Stage II : Cancer has spread beyond the muscle layer to the connective tissue around the muscle.

·         Stage IIIA : Cancer has spread through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ (eg, stomach, small intestine, colon, pancreas, or bile ducts outside the liver)

·         Stage IIIB : Cancer has spread to nearby lymph nodes and [#Section_218] beyond the inner layer of the gallbladder to a layer of tissue with blood vessels or to the muscle layer; or beyond the muscle layer to the connective tissue around the muscle; or through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ

·         Stage IVA : Cancer has spread to a main blood vessel of the liver or to 2 or more nearby organs or areas other than the liver. Cancer may have spread to nearby lymph nodes.

·         Stage IVB : Cancer has spread to either lymph nodes along large arteries in the abdomen and/or near the lower part of the backbone or to organs or areas far away from the gallbladder.

Treatment for Gall Bladder Cancer in India

Surgery, chemotherapy and radiotherapy are all used to treat gallbladder cancer. Many patients get a combination of treatments. For example, chemotherapy or radiotherapy can be used to shrink the tumour before surgery.

Your treatment will depend on the stage, grade and type of cancer cells you have. The stage looks at the size of your cancer and if it has spread from where it started.

The grade of the cancer can tell if your cancer grows quickly or slowly. You can have a low, moderate or high grade cancer.

Surgery

Surgery offers the best chance of curing early-stage cancer that has not spread beyond the gallbladder. To determine if surgery is possible, surgical oncologist at DHRC may order images of the gallbladder, bile ducts and the liver. Surgeons will use a camera and miniature instruments inserted through tiny incisions in the abdomen (laparoscopic surgery) to see if the tumor has spread (metastasized). Surgery options include:

·         Simple cholecystectomy If the tumor is very small and has not spread to the deeper layers of gallbladder tissue, the surgeon may use this procedure, which removes only the gallbladder. Occasionally this procedure can be done using laparoscopic surgery.

·        Extended cholecystectomy. This is the most commonly performed surgery, involving removal of the gallbladder, the liver tissue next to it, and nearby lymph nodes.

Chemotherapy

·         When the cancer has spread to other organs, medical oncologists may recommend chemotherapy.

·       Chemotherapy currently does not cure advanced gallbladder cancer, but sometimes slows the disease's progression.

Radiotherapy

Radiotherapy treats cancer by using high-energy x-rays that destroy the cancer cells while doing as little harm as possible to normal cells. It is occasionally used for cancer of the gall bladder. It can either be given externally from a radiotherapy machine or internally by placing radioactive material close to the tumour (brachytherapy).

Advanced Treatments of GallBladder Cancer

Advanced cancer means that your cancer has spread from the area where it started. If it spreads to the area around your gallbladder, it is called local spread. If it spreads to other areas of your body, it is called secondary cancer or metastatic cancer. It is usually not possible to cure advanced cancer. Treatment is given to control the cancer and to improve your quality of life. These treatments can involve surgery, chemotherapy and radiotherapy.

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