Kolkata doctors extract bone, burn cancer cells and graft it back

KOLKATA/MUMBAI: Remove the cancerous bone from the body, kill the affected cells with a super-high dose of radiation and then sew the bone back in its original place.
A private hospital in Howrah has become the first in eastern India to take this approach to treating bone cancer, which doctors say can help prevent limb amputations, and tasted success. The success of “extra-corporeal radiotherapy” (radiotherapy outside the body) at Narayana Superspecialty Hospital (NSH) comes two months after Fortis Hospital gave Kolkata — and eastern India — another first: a successful heart transplant.

Even holding a pen had become extremely painful for 13-year-old Iman Hossain from Agartala.It started with a swelling around his right wrist, prompting the class-VII student to check out the Howrah hospital in August 2017. “We detected that the boy was suffering from Ewing sarcoma (a type of bone cancer) and that the cancer had spread to the entire ulna bone (the forearm),” ortho-oncologist Koushik Nandy said.
But doctors were against amputation because of Hossain’s age. A medical board, comprising oncology director and radiotherapist Suman Mallik, Nandy, orthopaedic surgeon Kushal Nag, medical oncologist Vivek Agarwal and pain-management specialist Arghya Muherjee, was formed and, after a brainstorming session, the team decided on extra-corporeal radiation.
“Very few hospitals, one of them being Mumbai’s Tata Memorial Hospital (where many of us were trained), conduct this procedure. It is one of the most viable treatment options for those with bone cancer as it gives us a chance to salvage the affected limb,” Mallik said.
Hossain had to undergo several rounds of chemotherapy before he was put under the radiation procedure in November last year. Six rounds of chemotherapy after the surgery — and physiotherapy — later, Hossain is now back at school. “I loved cricket but the pain and stiffness put me off the game. Now I should be able to play with my friends again,” he told TOI.
The hospital wrote to the Tripura government about Hossain’s case. “The government has got back saying that it would tie up with the hospital for treatment of other chidren like Hossain,” hospital facility director Akshay Oleti said.
The team conducted the procedure on another patient, Palta resident Jiban Krishna Bhattacharya. The 53-year-old was detected with cancer in the right pelvic bone but the cancer had not spread. “Walking, even sitting, had become a struggle because of excruciating pain around the pelvic bone,” the central government employee said. He underwent the procedure this January and started walking with support in about four months. “But this procedure is not recommended for certain cases,” Nandy cautioned.
One of the seniormost doctors at Mumbai’s Tata Memorial Hospital, S D Banavali, said this process had not yet caught up in a big way across the country. “But it is an extremely viable option,” he said.
Veteran Kolkata oncologist Subir Ganguly added that the method could help curb recurrence of bone cancers though it was not yet widely used.
Siddharth Laskar from Tata Memorial Hospital’s radiotherapy department said the method was not exactly new. “We revived the method at our hospital seven years back. We use it on at least two patients every month,” he added.
A senior doctor from Mumbai said that extracorporeal irradiation of bone tumours had not caught on for a slew of reasons. “It cannot be used on every patient. Moreover, the procedure requires a trained ortho-onco surgeon as well as a good radiotherapy team,” he said. Such a combination may not be available at all oncology centres.