Orthopedic Oncology

What is Orthopedic Oncology?

The field of orthopedic oncology focuses in tumors of the musculoskeletal system - bones and soft tissue surrounding them such as: Muscles, fat, nerves, blood vessels, tendons, and cartilages. When benign, the tumors appear in different forms and locations in the bone and soft tissues, and when malignant they are called sarcomas and are categorized according to the source of the disease into groups of bone malignancies and soft tissue malignancies.
Another group of common orthopedic oncology diseases is metastatic bone diseases. They usually occur in the bones, and the treatment aims to restore the patient`s mobility and to prevent pain caused by the activity of bone metastasis.
Due to the relative rarity of primary bone and soft tissues tumors compared with other types of cancer, the number of specialists in orthopedic oncology is limited and therefore treatment by specialist in the field starting from the initial suspicion through diagnosis and treatment itself significantly increases the chances of receiving optimal treatment.

The Israeli Center for Orthopedic Oncology

The Center for Orthopedic Oncology specializes in the diagnosis, treatment and follow-up of patients with benign and malignant tumors in bones and soft tissues.
The Center`s doctors specialize in a wide variety of surgical methods for complete tumor resection, including reconstruction of bone deficiencies, joints and soft tissues, in order to preserve the limb and its function to the maximum possible extent, according to the required treatment framework in each case.
The Center`s staff includes the leading physicians in the field of orthopedic oncology in Israel.
The team of doctors is multidisciplinary, including surgeons specializing in orthopedic oncology, specialists in adult oncology, pediatric oncologist, radiologists specializing in muscle and skeletal imaging, a specialist in the pathology of muscle and skeletal tumors, and a sarcoma radiation expert.

Center experts who may be involved in the treatment:

Orthopedic surgeon - in charge of diagnosis (such as collection of biopsy sample), and surgical treatment for the removal of tumors in bone and soft tissues.
Oncologist - in charge of follow-up and treatment of cases when medicinal therapy is required.
Radiologist - performs initial diagnosis of the disease using a variety of means including: X-rays, MRI, CT scans, bone scans, and other imaging techniques used to diagnose cancer.
Radiation oncologist - specializes in the therapy of malignant diseases, usually before or after the planned surgery.
Pathologist - examines samples of the tumor to accurately determine its type of tumor. His diagnosis usually determines the course of treatment.

The Israeli Center for Orthopedic Oncology works in close collaboration with the Oncology Institute at Assuta Hospital, where post-surgical complementary treatments are provided, such as: Chemotherapy, radiotherapy and brachytherapy.

Services provided in the clinic

Primary clinic where a first appointment is held in order to outline a comprehensive treatment plan after determination of an accurate diagnosis.
An accurate diagnosis will be made in cooperation with multidisciplinary medical staff in order to formulate an optimal professional decision
Integrated clinics with experts from other fields.
Consultation and provision of a second opinion regarding treatment plans from other institutions.
All types of required surgeries, depending on the disease or medical condition.
A follow-up clinic for patients after surgery or other treatments

Primary follow-up clinic - the clinic monitors patients from surgery until the end of the treatment and initial recovery stage. In the follow-up clinic patients are meeting an orthopedic oncology expert from the department`s senior staff.
The purpose of the appointment is to assess the patient’s condition. It includes physical examination and review of recent imaging tests. At the end of the appointment, you will receive a letter and explanation summarizing the recommendations for treatment and follow-up.

Integrated sarcoma clinic - The clinic provides long-term follow-up of patients with soft tissue and bones sarcoma. The clinic combines the follow-up of an oncologist specializing in sarcomas and an orthopedic oncologist. Patients are followed up for 10 years or more after cancer treatment is completed. The clinic monitors the tumor and surgery area, checks for local recurrence and metastases, and provides functional rehabilitation follow-up.
Integrated professional clinic - The clinic provides diagnosis and interdisciplinary investigation performed by specialists in various fields such as sports medicine (knee), shoulder, hip joint, growth disorders and joint diseases. In the clinic patients meet with an expert in orthopedic oncology from the team of senior physicians and another expert from the relevant field, as applicable.

Medical conditions treated in the clinic

Diagnosis of bone or soft tissue cancer completely changes the patient`s life. The Center`s medical staff conducts an advanced investigation and diagnosis process in order to determine the type of disease, its location and the stage, and in order to formulate, together with the patient and his family, a customized treatment plan suitable for him.
The multidisciplinary team provides a therapeutic solution for the various types of bone and soft tissue tumors:

Benign and malignant tumors (bone tumors, bone cancer, soft tissue tumors, sarcoma).
Secondary malignant tumors (metastases).
Tumor-like diseases (infections or post-injury conditions).
Conditions requiring emergency surgery, even in the case of non-tumor diseases, such as severe infections and injuries after an accident.

These treatments are often provided together with preoperative chemotherapy to shrink the tumor, or after surgery to destroy all remaining cancer cells.

Types of surgeries

The experts in the Israeli Center for Orthopedic Oncology perform the following surgeries for the treatment of bone and soft tissue tumors:

Extensive of tumors from bone or cartilage origin, or from a soft tissue origin
Joint replacement (hip, knee and shoulder) after extensive resection
Bone/fracture fixation after resection, including insertion of intramedullary nails.
Custom implants/prostheses depending on the location of the disease
Restoring soft tissues by skin grafts or muscle flaps, depending on clinical need
Minimally invasive surgery for the treatment metastases and other bony lesions
Percutaneous ablation of soft tissue tumors

Bone cancer can lead to weakened and brittle bones, a condition that sometimes causes compression fractures of the spinal vertebrae.
Compression fractures can cause severe back pain, spinal deformity, and loss of height.
Surgical use of minimally invasive surgical techniques is intended to reconstruct cracked or shrunken vertebrae, may shorten recovery time, may relieve pain, strengthen the vertebra and restore its height.

Advanced and innovative treatment methods

In recent decades, rapid steps were taken in the field of musculoskeletal oncology. Early diagnosis helps to achieve improved outcomes in patients with musculoskeletal cancer. The primary purpose of the service is to engage in limb-preserving surgery and to eliminate the need for amputations, with the intention of achieving local control of malignant bone tumors, restoring the full mobility of an organ, and/or alleviating the symptoms and making a documented improvement in the patient’s overall quality of life.

The Center`s orthopedic program provides advanced orthopedic procedures for the following conditions:

Primary bone cancer
Soft tissue sarcomas
Metastatic cancer that spreads to the bone (breast, colon, lungs, prostate)
Orthopedic problems concomitant to cancer

The treatment uses innovative therapy methods and the most advanced technologies in the field:

Various types of implants, including the use of manually or electrically extending implants, bone transplants, and the use of innovative therapeutic methods, such as freezing.
In complex cases of amputation and reconstruction, 3D technology is used, and a preliminary planning and preparation of a patient- and surgery-specific surgical instruments are performed, including printing of surgical instruments and accessories.
Minimally invasive surgical procedure - ablation using radio waves under a navigation device for the treatment of benign tumors or MRI-guided freezing.