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parosteal osteosarcoma, low grade

Albert1
Posts: 2
Joined: Sep 2010

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.

traveling_bones
Posts: 2
Joined: Nov 2010

I had low grade osteosarcoma and had my femur and knee replaced at Sloan Kettering by Carol Morris 10 months ago. When I fractured my femur recently I also met with Dr. John Healey. I recommend Sloan Kettering for the medical skills of their orthopedic oncologists, and for their nurses (my hospital stay was amazing). Sloan Kettering, however, is disorganized, their billing system is infuriating, and the doctors always treat me rudely and do not like to answer questions. REALLY frustrating. I've heard good things about Wittig so I would look into him.

If you're going with Sloan Kettering, I would be more than willing to answer any questions - esp. about navigating the system there. breakfast.cat@gmail.com

Good luck!

gmartin3
Posts: 1
Joined: Dec 2010

I am assuming by now you have been through the procedures. I had the tumor on the femur above the knee 7 years ago. Dr. Healey performed the surgery at MSK. I have no complaints other than a typical 2 hour wait in the office for folo up appointments. This never bothered me. You sometimes need to wait to see the best. I have 100% trust in him.

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