Oct 01, 2010 - 9:37 am
My 42-year-old daughter-in-law has been diagnosed with parosteal osteosarcoma, low grade. The location is on the femur near her hip joint. She lives in New York City. Her doctor is currently Dr. Timothy Rapp, chief of orthopedic oncology at NYU Medical Center. He ordered the MRI and biopsy. He has now ordered a PET scan to rule out spread of the cancer (which he says is extremely unlikely).
Dr. Rapp recommends he do a resection followed by an implant. There are two choices. A bone implant is not so invasive but is unlikely to be successful. He told my son that a third are unsuccessful and another third result in problems sometimes requiring a second operation. (I cannot understand how such unsatisfactory results qualify the bone implant as standard treatment.)
Choice two is a titanium implant. It is usually successful but is far more invasive. Based on the location of the cancer, he would have to remove the entire top of the femur including the knob or "ball" of the ball-and-socket of the hip joint. It seems to me that the socket in the pelvis would also have to replaced with an artificial socket or else precise mating would not be achieved. So in addition to removing and replacing part of the femur, this appears to require the equivalent of a hip joint replacement.
I am aware that hip joint replacement is a specialty in itself. Should I insist that such a specialist assist Dr. Rapp at the operation?
Do we have to choose between only two such unpleasant alternatives?
New topic, Dr. Rapp encourages us to seek a second opinion. The problem is that there seem to be only three top orthopedic surgeon oncologists in New York City. First, Dr. Rapp, who is the youngest (he has done only 20 such parosteal sarcoma removals in his career). Second, Dr. John Healey of Memorial Sloan-Kettering, with whom she has an appointment in about two weeks. Third, Dr. James Wittig, chief of orthopedic surgery at Mount Sinai Medical Center. Any comments? Any other top orthopedic oncologists?
Any other suggestions?
Thank you in advance.