The Oncologists in Mumbai need to manage three types of clinical disciplines. These involve Medical Oncology, Surgical Oncology and Surgical Oncology.
Medical Oncology is involved in treating cancer with chemotherapy. Radiation Oncology involves the treatment of cancer with radiation therapy. The last one, i.e. Surgical Oncology, involves surgical removal of the tumour as well as other tissues in the surrounded areas. The diagnosis of the grade/stage of the tumours and individual case history of the patient helps the treating oncologist undergo an optimal treatment. This may be any one or a combination of the procedures thus mentioned.
Excessive growth of bone help in about 1% of all neoplasm diagnoses and about 2% of Orthopaedic diagnoses. Around 40% of these diagnoses diagnosed the presence of malignant bone tumours. Malignant bone tumours grow locally. Such growths are facilitated by expansion and flattening of tissues present in the surrounding. The other factor for such growth is the local infiltration of the soft tissues around the bone. Ablative surgery is the prima facie recommendation of the Oncologists in Mumbai due to the inexplicable size of the bone and surrounding tissues. Still, there would be metastases in more than 70 % of such patients due to spread via blood vessel and lymph areas. There are threats to patient’s life too.
With the advent of modern chemotherapy, the survival rate of cancer patients in areas like malignant bone tumours has considerably improved. he neoplasm could be better contained in both local and distant existence at the metastases site in lung cancer. This has led the doctor to focus on function preserving surgery. The resections which were initially very radical and compartmental have now become wide and marginal resections. From the point of view of Oncologic principles, it is necessary to go for resection of the bone. This would be done in areas where at least 5 centimetres of disease-free marrow margin be obtained. This is the measure of a successful outcome.
The challenge with the Oncologists surgeons in Mumbai pursuing the field of Orthopaedic Oncology becomes grave. These persons are left with the task to obtain oncologic perceived stage. At this stage, the preserving of the musculature, nerve and blood supply are done for adequate functioning of the tissues. This also involves the reconstruction of some defects. These defects have been created by some postulated means in order to restore the normal functioning as well as to withstand the stresses of wear and tear.
The job of an Oncologists in Mumbai is to assess the individual case for the feasibility of limb preserving surgery. He needs to plan and execute a successful biopsy. He may have to team with a medical oncologist for chemotherapy. He needs to perform the surgical method for successful removal of the tumour. He must demonstrate a wide margin for tumour control but at the same time might have to leave with enough tissue behind for a good functional outcome; He needs to reconstruct the tumour defect with the adoption of the mechanically sound prosthesis or adequate Osteosynthesis. The other responsibilities include the overseeing of functional rehabilitation whilst planning to apply chemotherapy for distant metastatic control. The pattern of reconstructions varies with the person as well as the nature of the cases involved.
The methodical researches of Cancer are progressing with time. The invention of evidence-based medicines has been able to transfer the results of those researches with the implications of new standards and methods that have transverse the practice of clinical practices. The involvement of new guidelines in the segment has helped to improve the informed consensus of the leading experts in this segment of the medical profession.
