There are various treatment forms available to help manage<unk> . Common treatments include chemotherapy, radiation and surgical procedures. Photoradiation and hyperthermia are also used as treatment forms to kill or reduce malignant cells. A large portion of patients are at risk of death when diagnosed with<unk>  as the disease has usually progressed for a number of years before detection. Surgery Surgery can help manage or treat<unk>  by either removing the tumour, localising it and/or determining whether there has been a spread to other organs. When undertaking surgery for<unk> , there are six major objectives which are considered. These include "prevention of cancer, diagnosis and staging of disease, disease cure, tumour debulking, symptom palliation and patient rehabilitation". Surgical prevention of cancer largely consists of removing the organ at risk of developing<unk> . This would occur if an individual is predisposed to the formation of malignant cells as a result of inherited genetic mutations and, acquired diseases. Surgical diagnosis of<unk>  involves completing a biopsy. This process requires a sufficient amount of tissue to make a confident diagnosis and, the handling of specimen to expand information provided from testing. Biopsies are categorised into four different processes: "fine-needle aspirate (FNA), core needle, incisional and, excisional". Curative surgery (also known as primary surgery) can be conducted when the malignant tumour has only invaded one area of the body. The objective is to remove the entirety of the malignant cells without violating the tumour; if the tumour is violated, the risk of both tumour spillage and wound implantation would increase. The surgical procedure of tumour debulking can be undertaken to increase the effectiveness of postoperative forms of treatment. Symptom palliation and patient rehabilitation do not play a role in controlling or reducing<unk>  growth rather, they increase the patient's quality of life. Photoradiation Hematoporphyrin derivative (HPD) is a drug which was developed to be absorbed by malignant cells and only becomes active when exposed to light. It is commonly used to identify and localise cancers as when it is under activation of blue light the red fluorescence of the malignant tumour (due to the HPD) can be observed easily. The combination of HPD with red light (photoradiation) has been used on various malignant tumours including malignant melanomas and carcinomas on a range of different organs including the breast and colon. This form of treatment produces a singlet oxygen through the photodynamic process; where the oxygen molecule exists in an electronically excited state. The singlet oxygen is a cytotoxic agent which holds the ability to eradicate malignant cells by preventing both nucleic acid and protein synthesis. The treatment process also utilises HPD's capability of accumulating at higher levels in malignant tissues compared to most other tissues. In the case of deeply pigmented or larger tumours, a stronger course of this treatment process is required in order to be effective. Hyperthermia<unk>  can be treated through the use of hyperthermia by applying either surgical perfusion or interstitial techniques to the body. The use of this treatment type largely depends on the fact that malignant and normal cells have differing responses to the energy source used. This dependency is due to the intracellular changes which occur during hyperthermia; as the nucleic acids, cell membrane and cytoskeleton within each cell is affected indirectly and/or through multiple pathways. The combination of these intracellular changes means there is no specific target of cell death in the hyperthermic process. Chemotherapy Chemotherapy is commonly used as either the primary treatment or in conjunction with other treatment forms such as radiotherapy or surgery. It can be administered through “injection, intra-arterial (IA), intraperitoneal (IP), intrathecal (IT), intravenous (IV), topical or oral”. The purpose of chemotherapy is to use cytotoxic agents which kill rapidly dividing cells within the body. It targets the cellular mechanisms which allow the development of<unk>  throughout the body. There are no specific areas which are targeted and so, there is a lack of differentiation between normal and malignant cells, resulting in a range of side effects. This includes bone marrow suppression, gastrointestinal problems and alopecia. Some side effects are specific to the anticancer drug used, the most common being bone marrow suppression as bone marrow has the ability to divide rapidly due to high growth fraction. This is because anticancer drugs have the highest activity in high growth fraction tissues. Alkylating agents are used in chemotherapy as these are chemically reactive drugs which form covalent bonds when reacting with DNA. This results in breaks within DNA strands causing either inter-strand or intra-strand DNA cross-linking. The sub-classes of alkylating agents are “nitrogen mustards, oxazaphosphorines, alkyl alkane, sulphonates, nitrosoureas, tetrazines and aziridines.”
Malignancy
Degenerative disease
Mineral deficiency
Bone disease
Endocrine bone disease
Osteolysis
Neurodegenerative disease
Bone tumor