Obesity and Musculoskeletal Oncology

The relationship between certain cancers (hormonally influenced cancers such as breast, ovarian and endometrial) and obesity is becoming increasingly apparent. The main concerns with obesity in orthopaedic oncology are surgical exposure, delays in diagnoses and postoperative complications. Obesity can lead to an initial delay in diagnosis as obesity can hide smaller tumours which only become apparent as they increase in size. Exposure is paramount in oncological surgery to ensure the best possible outcome, with regards to margins and avoiding inadvertent damage to adjacent structures. In the obese patient, this can prove difficult and lead to an increase in postoperative complications such as infection, seroma formation or haematoma. These cases are time sensitive and therefore do not permit the use of many interventions preoperatively to address the issue. The risks associated with surgery for sarcomas in the obese patient should be noted and explained to the patient prior to surgery.