Supportive care for bone cancer

Supportive care helps people meet the physical, practical, emotional and spiritual challenges of bone cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from bone cancer and adjusting to life after treatment is different for each person, depending on where the cancer was in your body, the stage of the cancer, the organs and tissues removed during surgery and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for bone cancer may have the following concerns.

Rehabilitation is an important part of healing after bone cancer surgery. The type of rehabilitation you have will depend on whether you have limb-sparing surgery or an amputation.

Find out more about rehabilitation after bone cancer surgery.

How a person feels about themselves is called self-esteem. Body image is how a person sees their own body. Bone cancer and its treatments can affect a person’s self-esteem and body image. Often this is because bone cancer treatments can cause permanent body changes, such as:

• loss of a limb
• changes in your ability to move or lift things
• having to use an artificial limb (prosthesis)

For many people, body image and how they think other people see them is closely linked to self-esteem. It may be a real concern for them and can cause considerable distress. They may be afraid to go out, afraid others will reject them, or feel angry or upset, even if the effects of treatment may not show on the outside of the body.

Find out more about how to cope with problems of self-esteem and body image.

Bone cancer and its treatment can affect how you think about and have sex. It can also affect your sexual partners and relationships.

Changes to how a person’s body looks or works can make them feel less attractive to other people. Having a prosthesis may change the way that they are intimate with their partner.

There are many things that you can do to have a healthy sex life during and after bone cancer treatment. Most people can still enjoy sex and intimacy after cancer treatment, even if they need to make changes.

Find out more about sexuality and cancer.

Phantom limb pain can happen after a person has had an arm or leg amputated. Phantom limb pain is a feeling that the amputated limb is still there. It happens because the nerves are cut and damaged during surgery and they send abnormal feelings from the area where the limb was removed (called the stump). The symptoms of phantom limb pain may include:

• pain
• burning
• throbbing
• itching
• cramping

Phantom limb pain usually starts about 1 to 4 weeks after surgery. It usually gets better during the first year, but for some people phantom limb pain can become a long-term problem.

If you have phantom limb pain, your healthcare team will create a treatment plan just for you. It will be based on your health needs and other treatments you may have had. A pain specialist may be able to help treat problems caused by long-term phantom limb pain.

Treatment options for phantom limb pain may include the following:

• Medicines to relieve pain or to relax muscles.
• Non-drug treatments such as massage or using heat on the stump. Because phantom limb pain can get worse with stress, your healthcare team may recommend ways to relax to help you cope with your pain.
• Surgery to remove part of the limb above the stump. This may be done if phantom limb pain lasts for a long time and other treatments don’t work.

Lymphedema is swelling that happens when lymph fluid can’t flow normally and builds up in the soft tissues of a limb. It can happen after radiation therapy for bone cancer, if the radiation damages the lymph nodes in the area. Lymphedema after bone cancer treatment is more common in the leg or pelvis than the arm.

The symptoms of lymphedema include:

• swelling of the leg or stump
• a feeling of fullness, heaviness or aching in the limb
• skin that doesn’t get a dent when pushed on
• a prosthesis that will no longer fit over the stump

If lymphedema isn’t treated, it can cause damage to the tissues in the area and increase the risk of infection.

Once lymphedema is diagnosed, your healthcare team will suggest ways of treating it. This involves reducing swelling as much as possible to stop any more fluid from building up. It may include several treatments such as:

• raising (elevating) the arm or leg
• wearing a compression sock or sleeve or wrapping the stump
• massage or physiotherapy

Find out more about lymphedema.

To make the decisions that are right for you, ask your healthcare team questions about supportive care.