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Bone cancer Q&As

Published by Bupa's health information team, September 2008.

Answers to questions about bone cancer

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

How is limb sparing surgery going to affect me in my day-to-day life?

Around eight out of 10 people who have bone cancer in an arm or a leg have limb sparing surgery. Surgery usually works well and many people recover almost full use of their limb. Rehabilitation can help you to make as full a recovery as possible though there may be some issues, such as limited movement and wear and tear on new bones and joints, which may affect your day-to-day life.

Explanation

Around eight out of 10 people who have bone cancer in an arm or a leg have limb sparing surgery to remove the cancer from the bone but to keep the limb. New types of artificial joints and bones mean it's often also possible to do limb sparing surgery if the cancer is in your shoulder, hip or knee. During the operation your surgeon will remove the cancer from your bone along with some of the healthy tissue around it and replace it with a metal rod or a false joint. This kind of surgery usually works well and many people recover almost full use of their limb.

To recover as fully as you can you will need to go through a period of rehabilitation after your operation. This will involve having physiotherapy to help get back as much power and flexibility in your arm or leg as possible. You may also have occupational therapy to help you become as independent as possible. It can take some time and may be hard work, but being determined and persistent will help you get the most out of it.

After surgery and rehabilitation there are some issues that might affect your day-to-day life. Not everyone who has a limb sparing operation will have these problems - it will depend on your individual surgery and any other treatments you have, such as radiotherapy. Some of the main things that could affect you are listed below.

  • If you have had surgery to your leg, you will probably end up with a slight limp. This may mean you try to walk normally or compensate for the limp - this can sometimes cause pain in other places. Speak to your doctor if you do get more pain or pain in other parts of your body.
  • If you are young when you have surgery and your bones haven't yet finished growing, you may need more operations in the future to lengthen your bones. Some artificial bones are made to expand and if this is the case, you will still need an operation, but you won't need to have the joint or bone replaced, just extended. Some artificial bones can even be lengthened using a strong magnet without the need for an operation.
  • Although you should be able to do most things that you did before surgery, your doctor will probably recommend that you don't take part in contact sports like rugby or football. This is because you might damage or loosen the artificial bone or joint.
  • If you have your shoulder joint replaced, you should have good movement when your arm is below shoulder height. However, you probably won't be able to lift your arm above your shoulder.
  • Some joints loosen and suffer from wear and tear over time which can cause pain. If this happens, you will probably need to have the false joint replaced with a new one. Around 25 to 30 people in every 100 who have a knee replaced will need to have the joint replaced again within the next 10 years.
  • Some limb sparing surgery can mean having a major operation involving cutting into your tissues, muscles and skin. This can leave you with a long scar. This could make moving your limb more difficult to begin with but you can usually improve this with physiotherapy. A large scar can also affect how you look. You might feel self-conscious and unattractive and this can have an impact on your day-to-day life and on the relationships you have with the people close to you. You may find it helps to talk to your family and friends about how you are feeling. You can also talk to your nurse or GP about being referred for further help such as counselling.
  • Surgery and radiotherapy can also sometimes affect your lymph nodes, though this is rare. Lymph nodes are found all over your body but the ones that may be affected by your surgery are those at the top of your legs and in your armpits. Lymph nodes circulate fluid around the tissues of your body and if they stop working properly this fluid builds up and your arm or leg can swell. This is called lymphoedema. It can be well controlled if it's treated early on, so if you see any swelling, speak to your doctor as soon as possible.

Further information

Sources

  • Improving outcomes for people with sarcoma. National Institute for Health and Clinical Excellence (NICE), 2006. www.nice.org.uk
  • About surgery for bone cancer. CancerHelp UK. www.cancerhelp.org.uk, accessed 24 June 2008
  • Life after bone replacement surgery. CancerHelp UK. www.cancerhelp.org.uk, accessed 24 June 2008
  • Limb-sparing surgery. Cancerbackup. www.cancerbackup.org.uk, accessed 24 June 2008
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What will life be like after an amputation?

Amputation of a limb is a major life change and affects people in different ways. Many people lead full and active lives after amputation and are able to work, drive and play sport. You will be given an artificial limb which, along with rehabilitation, will help you to recover and adapt to your new life.

Explanation

Life after amputation is different for everyone. The kind of amputation you have and how much of your limb is removed will affect your recovery and how much you are able to do. Many people can lead full and active lives after having an amputation - for example they return to full-time work, take part in sport and drive. A team of health professionals will work with you to get the most out of your abilities and help you make as full a recovery as possible.

The recovery from amputation isn't easy and you will need to be committed and determined. A few days after your operation the physiotherapist will start to work with you to strengthen the muscles around the site of your operation, which will make wearing an artificial limb easier. Once your wound has healed you can be measured for your artificial limb. Your limb will be made specifically for you to make sure it fits as well as possible. You might need to have new limbs made in the future as the shape of your stump changes. Some artificial limbs are made using computer-aided design to make it a perfect fit for you. New technology and materials now mean that artificial limbs are very effective.

You should be able to walk, run and play sport.

More than half of people who have an amputation have something called phantom limb pain. This is pain in the arm or leg that has been amputated after it has been removed. It's as if the arm or leg is still there and for some people that pain can be quite severe. It's not known why this happens but it's possible that although part of your brain knows the limb has gone another part doesn't understand this. For most people the pain gradually decreases over a few months but some continue to find it painful.

Tell your doctor if you have this kind of pain - he or she may be able to prescribe you painkillers to relieve it. Massage, elevating the limb, rest and distraction can all help to reduce phantom limb pain. You might also get some pain in your stump which can make wearing your artificial limb uncomfortable. Your doctor can also prescribe painkillers for this.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

An amputation can be hard to come to terms with emotionally. You might feel angry, bereaved, distressed or shocked. It can be difficult to deal with the change in the way you look as well as your ability to live your life. For some people this affects their self-confidence and their relationships with the people around them. You may find it helps to talk to other people who have also had an amputation, as well as your family, friends and the health professionals who care for you.

The process of rehabilitation can seem daunting and may be frustrating. You will need to learn how to walk and balance again if you have an artificial leg or how to use your artificial arm for tasks such as writing, eating and getting dressed. The health professionals involved in your rehabilitation can help you to make changes to your home and work or give you aids that will make life easier for you. It might be difficult sometimes but it's important to try and stay positive about the future.

It commonly takes about a year for you to get back to your usual lifestyle and be wearing your artificial limb regularly.

Further information

Sources

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Will I still need to see my doctor after my treatment finishes?

You should visit your doctor regularly after your treatment finishes to check for any signs that the cancer has come back or spread, and to see how well you are recovering. It's important to go to your appointments to make sure you have the best chance of getting early treatment and making a good recovery if the cancer returns.

Explanation

After you have finished your treatment you will have follow-up appointments with your doctor. How often these are will depend on your individual circumstances. For the first two years after your treatment finishes you will probably see your doctor every three months. If everything goes well, these appointments will then be less frequent - every six months and then once a year. The gaps between your appointments get longer as time goes on because the chance of the cancer coming back gets less as time passes. If you notice any new symptoms or you are worried that the cancer has come back in between these appointments, make an appointment to see your doctor straight away.

You will have appointments with your doctor for a number of reasons, including:

  • to spot any early signs that the cancer has come back - this means you can have any further treatment quickly which gives you the best chance of a good recovery
  • to check for any complications of your treatment and see how you are progressing
  • to give you an opportunity to ask questions or talk about your worries

At every appointment your doctor will examine you. He or she may also ask you to have blood tests and X-rays done. Depending on the type of cancer you had your doctor might arrange regular chest X-rays for you. This is because some types of cancer can spread to the lungs. If the cancer does spread to your lungs, it can be successfully treated if it's spotted early.

For many people with bone cancer treatment is very successful. Overall about two out of three people with bone cancer will be cured of their cancer. However, for some people the cancer does come back or spread which is why follow-up appointments are so important.

Further information

Sources

  • Follow up treatment for bone cancer. CancerHelp UK. www.cancerhelp.org.uk, accessed 24 June 2008
  • Follow up treatment for bone cancer Cancerbackup. www.cancerbackup.org.uk, accessed 24 June 2008
  • Improving outcomes for people with sarcoma. National Institute for Health and Clinical Excellence (NICE), 2006. www.nice.org.uk
  • Statistics and outlook for bone cancer. CancerHelp UK. www.cancerhelp.org.uk, accessed 24 June 2008
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: September 2008

 

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