Q: What are the differences between sarcoma and carcinoma?
A: Carcinoma is the most common type of cancer that arises in organs such as the breast, prostate, lung, and kidney. If bone or muscle is involved, it is usually because the cancer spread (metastasized) to that area from the initial tumor. Sarcoma is a rare type of cancer that arises directly from bone or soft tissue. The treatments, both surgical and nonsurgical, for sarcomas and carcinomas are very different, so it is important to distinguish between the two types of cancer to determine the proper treatment.
Q: Is there a difference between bone cancer and a bone tumor?
A: A bone tumor is a general term that refers to any abnormal growth arising from the bone. A bone tumor can be non-cancerous (benign) or cancerous (malignant). Bone cancer is a malignant bone tumor. A malignant bone tumor can be a primary malignant tumor, meaning that it arose within the bone. Examples of a primary malignant bone tumors are osteosarcoma, Ewing's sarcoma, and chondrosarcoma. A malignant bone tumor can also be a metastatic carcinoma, which means that it spread to the bone from a cancer in another organ. While any cancer can spread to the bone, the most common ones are breast, lung, prostate, kidney, and thyroid cancers. It is important to speak with an orthopedic oncology to diagnose the specific type of tumor, as each has its own treatment and prognosis.
Q: Why do you need to perform a biopsy to make the diagnosis?
A: When we perform a biopsy, we obtain a piece of tissue from the tumor in question. A pathologist (a doctor who specializes in analyzing body tissue and liquids for diagnostic purposes) then studies the tissue under a microscope to identify the type of tumor and whether it is benign or malignant. Though imaging studies, such as X-rays, computerized tomography (CAT) scans, and magnetic resonance imaging (MRI) scans, can suggest the diagnosis, we often cannot make a definitive diagnosis without analyzing the actual tissue through a biopsy. We perform different types of biopsies, ranging from needle biopsies done in the office or radiology department under local anesthesia, to open biopsies done in the operating room under general anesthesia. If you need a biopsy, your orthopedic oncologist will discuss the various options with you and recommend the least invasive option that will provide the most accurate diagnosis.
Q: What does staging mean?
A: Staging is a way to indicate how much cancer there is, where it is, how much it has spread, and what the prognosis is. Staging involves imaging the tumor, usually with X-rays, MRIs, and/or a CAT scan to determine the tumor size and exact location. We may also take images of the rest of your body, usually with bone scans, or positron emission tomography and CT scans, to see if the tumor has spread. Staging a tumor helps determine prognosis and the optimal treatment plan.
Q: How do I schedule surgery?
A: Our administrative staff will schedule any surgeries, after discussing your scheduling preferences with you. Dr. Iofin operates at The Mount Sinai Hospital and Mount Sinai Saint Luke’s Hospital. He is also affiliated with Mount Sinai Beth Israel Hospital and Mount Sinai West. In certain cases, surgeries may be performed at the Hackensack University Medical Center in Hackensack, NJ. The administrative staff will do its best to accommodate your scheduling needs. Urgent surgery and operating room availability will determine whether we can accommodate your hospital preference. On rare occasions, we may need to reschedule a non-urgent (elective) surgery in order to accommodate an urgent or emergent surgery. Should such a situation arise, we will do whatever is necessary to reschedule your surgery as quickly as possible.