General measures
- Nicotine restriction (refraining from tobacco use).
- Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
- Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea).
- Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised program for the underweight.
- Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
Conventional non-surgical therapy methods
- Chemotherapy (cytostatic therapy):
- In Ewing sarcoma and osteosarcoma, neoadjuvant (preoperative/before surgery) chemotherapy may be considered to reduce tumor size.
- Likewise, plasmocytoma (synonym: multiple myeloma) responds well to chemotherapy (see below of the disease of the same name).
- Following surgical removal of the malignant (malignant) bone tumor, adjuvant chemotherapy may be required, depending on the situation.
- Osteoid osteoma, osteoblastoma: radiofrequency ablation (RFA) (synonyms: thermal ablation; sclerotherapy) – Since damage to muscles, tendons, soft tissues and also nerves located in the surgical access path to the nidus (focus) cannot always be excluded, CT-guided radiofrequency ablation of the nidus is now considered standard therapy. As part of this, a special probe is inserted into the nidus and heated via an alternating current field at the tip. This destroys the prostaglandin-producing cells (prostaglandin = “pain substance”) in the center and the pain conduction pathways. The procedure is minimally invasive.Another option for heat ablation is laser ablation (LA).
Vaccinations
The following vaccinations are advised:
- Flu vaccination
- Pneumococcal vaccination
Regular checkups
- Regular follow-up examinations for malignant (malignant) bone tumors for early detection of recurrence (recurrence of the disease) and for benign (benign) bone tumors with or without a risk of degeneration
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Nutritional recommendations according to a mixed diet, taking into account the general knowledge of nutrition in a tumor disease. This means:
- Consume only limited energy-rich foods.
- Moderate total fat intake
- Little red meat (pork, beef, lamb, veal) and sausages.
- Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
- Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
- Refrain from polluted foods such as offal and wild mushrooms.
- Do not eat moldy food
- Observe the following special dietary recommendations:
- Calcium-rich (1,000 mg calcium/day) diet: fish, fresh vegetables, dairy products, whole grains and nuts are beneficial for bone formation.
- Vitamin D-rich diet (supplementation with 800-1,000 IU of vitamin D3 required, since no sufficient absorption of vitamin D from food is possible!)
- Avoidance of phosphate-containing drinks and foods (eg cola drinks, various sausages and meat products).
- Note that for optimal bone metabolism must be fed less acid-forming foods and instead more base-donating foods.
- Diet rich in:
- Vitamins (A, C, D, E, folic acid)
- Minerals
- Trace elements (selenium, zinc)
- Omega-3 fatty acids
- Secondary plant compounds (e.g., carotenoids, polyphenols).
- Selection of appropriate food based on the nutritional analysis
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
Physical therapy (including physiotherapy)
- In cases of neurological deficits, physiotherapeutic procedures may be used, possibly in combination with surgery, depending on the exact tumor type.
Psychotherapy
- Stress management, if necessary
- Detailed information on psychosomatics (including stress management) can be obtained from us.