This is story of Prasad a 17 year old boy who completed 12th standard exam and wanting to join a professional course. He noticed pain and swelling in his right arm which gradually increased in nature. He was taken to a clinic and prescribed pain killers. The pain did not subside so he was taken to an Orthopaedic surgeon in the neighborhood. An X ray was done and was referred to a cancer hospital in Bangalore. He was treated with chemotherapy drugs for 9 weeks and suggested shoulder disarticulation i.e. removal of the entire hand below the shoulder. Incidentally Prasads parents watched a live show on a local TV channel where Dr Srinivas C H, Orthopaedic Oncosurgeon showed example of patients with bone cancer who underwent a limb saving surgery. This raised hope in the Prasad’s parents. They then consulted Dr Srinivas C.H., Bangalore. Prasad was suggested to undergo a rare and a complicated surgery which would save his right hand. Prasad underwent a 6 hour procedure called as Extracorporeal Radiotherapy wherein the cancer affected bone would be surgically removed and sent for radiation therapy. The bone is immediately brought back and reimplanted into the patient’s limb. Following the surgery the bone which is dead would revascularise over 1 to 2 years. 3 weeks after the surgery Prasad was restarted on chemotherapy with a better regime. With the help of physiotherapy his arm movements recovered completely and he is now leading a normal life. Prasad is today is confident and pursuing diploma in mechanical engineering. Osteosarcoma is a rare type of cancer and it more prevalent among adolescents population. The current treatment modality is Chemotherapy along with surgical removal of the cancer affected bone and reconstruction. There are several forms of reconstruction surgeries. One recent advance is Extracorporeal radiotherapy which is surgical removal of the bone and sterilizing it with 50 Grays of Radiation therapy. This bone is then reimplanted back in to the defect. This enables the limb to be preserved and improve the quality of life of these Bone cancer patients. All this is today possible due to the recent developments in the treatment of Bone cancer. In the past amputation was the only option available to our patients. It is quite unfortunate that even today in metropolitan cities like Bangalore Bone cancer patients have limited access to advance cancer treatment. There is a need to emphasize and inform public about these recent advances.
A 36-year-old female patient from East Godavari was diagnosed with secondary
chondrosarcoma of the left proximal humerus (left side). She complained of a
swelling on her left shoulder and that found it difficult to move her left shoulder
since the past three years.
The patient was operated with wide excision and proximal humerus megaprosthesis.
Post operation care like drain removal and dressing was done to heal the wound. She
was discharged after her condition stabilised.
Surgical procedure: Wide Excision Proximal Humerus+ Proximal Humerus Megaprosthesis (SUSHRUT)
Procedure outcome: The patient’s surgery was successful and we prevented her arm from being amputated. Now the patient is comfortable, is able to move the limb and lead a normal and healthy life.