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By Dr. Vivek Verma in Cancer Care / Oncology , Musculoskeletal Surgical Oncology
Sep 14 , 2017 | 3 min read
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Three years ago, Meenakshi Malhotra (name changed) got married to Rajeev Malhotra (name changed), businessman. Meenakshi had pain in her right knee for few months which was progressively worsening. Initially, the pain lasted for about a day or two but slowly it became a constant dull aching pain. After 4-5 months of marriage, the pain became unbearable.
Rajeev is a businessman based in Srinagar, Uttarakhand, and lives in a joint family. As soon as the pain aggravated, the family immediately consulted their family doctor and a tumor was detected in her right knee. But as proper treatment wasn’t available, the family went to Muzzafarnagar.
The tumor was operated at a nursing home in Muzaffarnagar and Meenakshi resumed living her life as she was previously doing. In the meanwhile, the couple was blessed with a baby boy too. All was well when all of a sudden one day Meenakshi noticed the recurrence of pain and swelling in the same knee after a gap of two years in April 2017.
This time they consulted Musculo Skeletal Oncology (Bone and soft tissue cancer) services at Max Super Speciality Hospital, Delhi. A biopsy was done and diagnosis of recurrent ‘Giant cell tumor’ was confirmed, which is a type of locally aggressive bone tumor. Meenakshi was put on pre- surgical care immediately with a special medicine called ‘Denosumab’ to shrink the tumor size.
Rajeev remembers the challenges, emotional breakdown and all that he and his wife went through the first surgery. On top of that, being away from the family and child bogged them down. “Being with family and being near to them is somehow motivating. I don’t know how but yes it does make a huge difference!”
Thus Rajeev and Meenakshi together requested the doctors to make the surgery possible at Max Super Speciality Hospital Dehradun which was much closer to their home town. Being a network hospital, things became easier for the family to go ahead and take Meenakshi to Max Dehradun for treatment.
Musculoskeletal/Orthopaedic cancer specialty clinic was started at Max Hospital, Dehradun in July 2017. Musculoskeletal oncology is a subspecialty which involves the management of a wide variety of benign and malignant bone tumors, soft tissue tumors and metastatic bone diseases ( a spread of the tumor to the bone from other organs like thyroid, lung, kidney etc).
Dr Vivek Verma, Consultant, Orthopaedic Onco Surgeon further explained about tumor board, “In Tumor Board we discuss each and every tumor case with a multidisciplinary team of surgical, medical, radiation oncologist, pathologist, and radiologist and choose the best evidence-based treatment plan for our patients.” In Meenakshi’s case, the MRI scan evaluation revealed that the tumor had destroyed her joint and contaminated the thigh compartments. In her case decision was taken to remove the tumor while preserving the limb function.
According to Dr Verma, “We do limb-preserving surgeries in more than 90 percent of the bone or muscle cancer cases which were previously amputated. This success is owed to the advances in imaging technology like MRI scans, chemotherapy, radiation therapy, specialty trained surgeons and affordable implants. For a successful outcome, it is important to go to the specialized centers who are experienced in performing these procedures”.
According to Dr. Vivek Verma, “Meenakshi underwent successful tumor removal from the lower half of thigh bone and knee joint.
The distal thigh defect was reconstructed with size-matched mega prosthesis implant. He further added, “Meenakshi was able to stand and walk normally from the very next day of surgery and discharged on the fifth day of the surgery.” Meenakshi feels fortunate enough to have received treatment at Max Institute of cancer care, Dehradun. She loves cooking and spending her time with her family, especially the newborn blessing. This is one of the most complex surgical procedures, which require a team effort and is possible only at specialized institutes.
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