Bone Cancer Definition
Bone cancer can develop in any part of the body mostly on the pelvis, legs and arms. Unlike other cancers, bone cancer is not caused by genetic DNA mutations. They are caused by mutations that occur in the lifetime of an individual. The mutations occur as a result of the body being exposed to chemicals causing cancer and radiation. The typical symptoms are pain in the bones, tenderness and swelling around the affected area, fatigue, weak bones and weight loss (Bone cancer, 2018).
The most common treatment is bone scan which is a diagnostic imaging test that detects whether cancer is in the bones; radiopharmaceuticals are used to trace any skeletal abnormalities in the body (Segall, Delbeke, Stabin, Even-Sapir, Fair, Sajdak & Smith, 2010). The abnormalities detected could be either a fracture, tumour or an infection. The prognosis for the chances of survival for the patients ailing bone cancer are dependent on the specific cancer type. The expected five year survival rate of bone cancer in children and adults is around 70%.
PET/CT is a known nuclear medicine technology that coordinates anatomic imaging and cross sectional functions for diagnosing bone cancer. The CT is put on a specific region that is affected. The precautions taken before administering the treatment are; ensuring breastfeeding or pregnant mums are not examined. Additionally, the patients should be hydrated for improvement of image quality and enhance fast release of the radioactive materials. The patients are not expected to fast and they can take their treatment normally.
The radiopharmaceuticals that were used were F-18 Sodium Fluoride which was injected in the veins by an intravenous catheter (Van den Wyngaert, Strobel, Kampen, Kuwert, Van der Bruggen, Mohan & Langsteger, 2016). The dosage for adults is 185 to 370 MBq and a higher dosage for obese patients which is 370 MBq. Children should be given on basis of weight on intervals of 18.5 to 185 MBq. The patient should be positioned on basis of the scan being undertaken the arms may be by the side of the body or elevated. The emission of images can start after around 45 minutes of injecting the radiopharmaceutical (Donohoe, Brown & Collier, 2003). The images can be obtained in 2 or 3 dimensions. The standard acquisition time on basis of bed position is 2- 5 minutes depending on amount of radiopharmaceutical injected, body mass index, decay time and camera factors.
The patient had a history of osteosarcoma in her family. She admits to have not undertaken any laboratory tests recently. The patient is not pregnant or nursing presently which makes her fit for any radiopharmaceutical treatment that can be administered to her (Osteosarcoma Clinical Presentation, 2017). She says she has been experiencing pain on her arms where she has been affected. At times she experiences fever and sweats profusely during the night time (Osteosarcoma Clinical Presentation, 2017). Her arms swell from time to time bringing about severe pain to her body.
The fact that the patient admits of the presence of genetic osteosarcoma in her family prompts for tests even though bone cancer is in rare cases hereditary. The swelling around the arms is a typical symptom of the disease. The swelling is known to cause pain and irritation to the patient. The symptoms the patient is facing as stated above may lead to the study because the patient needs treatment. The symptoms are seen on the patient for weeks or months therefore, a long term solution should be found to help treat the patient.
Discussion of pertinent tests
The pertinent tests that should be ordered are the bone scans which will show clear information on the patient. If the information is known it makes it easier for the physicians to diagnose the disease that is affecting the patient. Thereafter, there will be results obtained for the diagnostic tests administered and the imaging results should be combined and summarized for use during treatment.
There should be a description of the procedure whereby the time of scanning and administration of the F-18 sodium. The arm where the treatment is administered should be described in detail. The patient’s position should be stated clearly whether the arm was by the side or elevated. The CT should be described in detail whether it was administered for attenuation changes or for diagnosis. Additionally, the name of radiopharmaceutical administered should be stated clearly, the dosage given, site of administration of the treatment, the route the medication was administered through and all the equipment used should be specified (Segall et al., 2010). All the patient information named above is beneficial to the physicians for the treatment process to be successful.
PET/CT scan showed the presence of abnormalities in the bones of her arm where
she experienced severe pain and swelling. The image obtained from the tests
contained darker spots where the radiopharmaceuticals accumulated. This was a
positive sign of an abnormality. The results of the image do not show the exact
problem the patient suffered from. As a result, there were more imaging and
laboratory tests that were used to make a precise decision on the condition of
the patient. Follow up tests were ordered for the patient, so she had to
undertake blood tests, detailed imaging tests such as the MRI and Single-photon
emission computerized tomography (SPECT) scans or even the bone biopsy.
Unfortunately, the patient was diagnosed with bone cancer. Luckily, it was no
severe so she was put in strict medication which proved to be successful after
a couple of months.
Bone cancer. (2018, April 25). Retrieved from https://www.mayoclinic.org/diseases-conditions/bone-cancer/symptoms-causes/syc-20350217
Donohoe, K. J., Brown, M. L., & Collier, B. D. (2003). Society of nuclear medicine procedure guideline for bone scintigraphy. Bone Scintigraphy, 205, 209.
Osteosarcoma Clinical Presentation. (2017, October 30). Retrieved from https://emedicine.medscape.com/article/1256857-clinical
Segall, G., Delbeke, D., Stabin, M. G., Even-Sapir, E., Fair, J., Sajdak, R., & Smith, G. T. (2010). SNM practice guideline for sodium 18F-fluoride PET/CT bone scans 1.0. J Nucl Med, 51(11), 1813-1820.
Van den Wyngaert, T., Strobel, K., Kampen, W. U., Kuwert, T., Van der Bruggen, W., Mohan, H. K., … & Langsteger, W. (2016). The EANM practice guidelines for bone scintigraphy. European journal of nuclear medicine and molecular imaging, 43(9), 1723-1738.