 Hello, I am Dr. Sreemant. I am the consultant orthopaedic oncosurgeon here at Manipal Cancer Centre at Manipala Hospital HL Airport Road, Bangalore. So today I would like to take you through another interesting treatment process where one master Sakil from West Bengal who is 12 years old actually presented to us around three months ago with severe pain and swelling of the left thigh and the knee part and also inability to move for more than a month duration. So basically it not put weight and that was alarming for the parents where they got him around for a check up. You know we did the routine check ups of X-ray and you know we found out that he apparently had some sort of a tumourish you know suspected growth in the lower part of the left femur. So what we did was we did all the additional scans such as MRIs and the biopsies and the PET scan and unfortunately we diagnosed bone cancer which is a very aggressive form of a cancer in children called as an osteosarcoma. But what was more interesting in the situation was that the cancer had grown to such an extent that it was threatening to break apart or basically lead to a fracture and as expected unfortunately even before you could just start treatment the boy's bone fractured and he was in severe agony. But the good point on the other side was that he did not have any spread of the same cancer anywhere in the body that means he was non-metastatic and as protocol we started him one new adjuvant chemotherapy. Master Sarkill actually went through the chemotherapy without any hiccups. He was encouraged by the signs that he had responded very well to the chemotherapy. Most often these fractures happening due to the bone cancer spreading we won't be able to do a limb salvage that is we won't be able to save the limb often. Since we saw a very good encouraging sign of response of chemotherapy in Master Sarkill we sat down with our team we discussed with all our radiologists and the surgery team and the pedologists and everything and we felt that we could give him a very good chance of salvaging his limb and we actually operated on him and it took around five hours for us to remove the tumor and we had to remove nearly 24 centimeters of his bone including the fractured part because the tumor had spread all along his bone up to the upper part of the thigh also. So we came up with a bit of an innovative solution which is more on Indianized and this tumor part which was broken and the extent of the tumor which was spread about was actually removed and reconstructed with the combination of nails, plates and cement which was also I would say a bit economical also. What was more encouraging was that Master Sarkill put his foot down from the next day and he walked and to see a child who's been better than for nearly four months of duration because of the bone cancer and the resulting fracture that actually motivated us to do more and again just to put it across this is one of the additional patients which we come across in such aggressive situations where even bone cancers with a fracture provided they respond very well can have a limb salvage and that would definitely go a long way in helping them get the best chance of cure. I'd like to close this opportunity by saying that we have the facilities to do such surgeries and you know provided the response to the treatment is available and secondly you know my advice is please not wait for so long if you have a bone cancer to come down to treatment because having a pathological fracture is not a good sign that means that the bone cancer is pretty aggressive and yes we can still save it in many situations but let us not allow it to go to that section so come early show you know meet the doctor early get evaluated early and have the best chance of cure because the earlier the stage earlier the disease the chance of you know cure is very high thank you