As a result of the blow, a lump may form in its place. a subcutaneous hematoma makes itself felt , which is formed as a result of a dense accumulation of blood under the skin. The lump appears instantly and even grows over time, looks soft and mobile, and feels like jelly to the touch. In the first days it is quite painful, any touch feels like a sharp pain. This lump usually resolves within a week or two , but in some cases the lump does not go away, and surgical treatment must be resorted to to remove it.
Photo 1. Most often, bumps “grow” on the skin of children. : Flickr (Sharon).
Description
A bump on the leg from an impact is formed due to swelling of the soft tissues. Blood accumulates in the damaged area due to ruptured capillaries. Although this neoplasm is unpleasant, if you approach treatment correctly, you can get rid of the seal quite easily and quickly.
Often the lump goes away either on its own or with the help of simple local medications and folk methods. However, it happens that the seal is quite serious and does not disappear for a long time. In this case, it makes sense to consider complicating factors and the likelihood of subcutaneous major hemorrhage.
Severity
- The first small bump appears in the first days after the injury. It doesn’t hurt too much, but the discomfort intensifies when the seal is touched.
- Second: A bruise appears and swelling is very noticeable. Also, patients with a second-degree lump often complain of painful lumps. Such a bump on the leg after an impact is significant in size and quite hard.
- Third Such a compaction forms only with serious injuries. The hematoma in this case is pronounced and extensive. In addition, the overall body temperature often increases.
- Fourth Difficult case: cones of the fourth degree of severity are usually formed in the area of the knees, joints and shins. To cure such a lump, mandatory medical care is necessary - and urgent.
What ointments are effective?
Troxevasin
The composition includes troxerutin, which gives a healing effect. For bruises, it is recommended to apply the ointment to the skin immediately after the blow.
Traumeel
Great for relieving pain and preventing inflammation. The injured area must be lubricated 4 times a day. Almost immediately there is improvement and the pain subsides.
Lyoton
The gel composition consists of capillary-stabilizing components. The product quickly and effectively eliminates swelling and pain. If you see that the bruise is swollen, then immediately use the gel. But in such a situation, it is recommended to consult a doctor, since swelling may indicate a serious injury. You cannot hesitate here, and it is recommended to immediately contact a traumatologist.
"Ambulance"
This is an effective and inexpensive assistant in the fight against bruises and contusions. This is an ointment that can quickly heal your wound. It is not a drug and allows you to heal shallow skin damage. Its use will protect you from wound suppuration and infections. Recovery will be quick and painless. Suitable only for minor injuries without swelling.
Dolobene
This remedy is recommended for use on its own without additional treatment. It is anti-inflammatory and allows wounds to heal quickly. It has proven itself on the positive side and is in demand.
Heparin ointment
An excellent remedy for relieving pain and healing wounds. Does not cause allergic reactions. For effective treatment, you should smear the wound 3 times a day for 1 week or until symptoms disappear.
Causes
There are several reasons why a lump has formed at the site of a bruise. With severe tissue damage, the vessels are deformed, which leads to an accumulation of blood - a hematoma. If there is little fatty tissue at the site of the bruise, then there is nowhere for the blood to be absorbed and a seal appears along with the bruise.
In another case, a lump appears a couple of days after the hematoma is detected. This may indicate infection in the tissues. Additionally, a person’s body temperature may rise, and at the site of injury he feels throbbing pain, which sharply intensifies when the lump is palpated.
Why it is not recommended to treat a hematoma on the leg at home
If there is large accumulation of blood under the skin, it must be removed. There are enough videos and articles on the Internet describing this procedure at home, but you absolutely cannot follow such advice. Firstly, a person risks damaging his leg even more and disrupting its normal functioning, even to the point of disability. Secondly, and more likely, you can introduce an infection into the body and provoke even greater inflammation. Thirdly, only an experienced doctor using special equipment will do this carefully, but independent attempts can permanently disfigure the skin and leave unaesthetic scars on it.
Doctor's help
Most cases of the formation of such seals due to bruises and injuries do not require mandatory medical intervention - they go away on their own and quite quickly.
However, some cases require qualified medical assistance:
- If the skin is red and noticeably swollen (often happens with severe injuries);
- With barely bearable pain in the damaged area;
- If the sensitivity of the skin has noticeably decreased;
- When the tumor increases in size;
- If the site of the bruise becomes very red and the body temperature rises, the symptoms indicate infection of the body;
- If the joint in the damaged area refuses to function.
In addition, medical help is also needed if the seal remains in place even after therapeutic measures. Doctors know of cases where a lump after a bruise on the leg did not subside for six months, or even a longer period.
Self-medication for serious injuries is unacceptable: only qualified and timely assistance from a doctor.
What happens after the impact?
During an impact, not only the skin is damaged, but also muscles and sometimes internal organs. It all depends on the force of the blow and the object. Also, often with a strong impact, cracks, dislocations and even fractures occur. Usually the bleeding stops within 10 minutes, but if the damage is serious, the bleeding may last for a long time. If a tumor forms, you must go to the hospital immediately. Time is important here and not a minute can be wasted. Take care of your health and take it seriously.
In what cases is it necessary to take a patient to the hospital?
Warning symptoms include the following:
- Pay attention to the color of the hematoma. With strong mechanical impact, the skin has pronounced redness.
- The patient feels a sharp pain, which intensifies when palpating the injured area.
- The temperature rises. This symptom indicates that an infection has entered the human body.
- The patient loses skin sensitivity due to damage to nerve endings.
- The lump at the site of the bruise does not resolve even after prolonged treatment.
- In some patients, the compaction does not go away for more than 6 months.
Important! The seal must not be opened independently. This may cause infection with harmful bacteria. The infection that has entered the blood begins to actively multiply. This significantly complicates the treatment process.
First aid
If a person falls, hits his leg, and a lump forms on the bone, he (or himself) needs to be able to provide first aid. Next, we will consider what steps should be taken in this direction.
Applying a cold compress to the injured area of the leg. As cold, you can consider a heating pad filled with ice, a towel soaked in cold water, or some cold metal object. If the injury occurs at home, you can use any product from the freezer.
Fixing the injured limb will also come in handy. For this purpose, you can use a bandage, any fabric, towel or even a rag - whatever you found at the site of the injury. It is necessary to give the affected limb a slightly elevated position - this measure will help relieve swelling of the soft tissues.
The victim should, if possible, be kept completely at rest. Any load on the injured limb should be avoided.
It is advisable to go to the emergency room as quickly as possible. This measure will help begin timely treatment and save the victim from possible problems in the future.
Degrees of bruises:
- 1st degree – minor damage. They do not require special treatment and heal on their own within a few days;
- 2nd degree – tissue damage. Special ointments will help as treatment;
- Grade 3 – characterized by damage not only to the skin, but also to muscles and tendons. In this case, a dislocation is possible upon impact, so it is recommended to consult a specialist;
- 4th degree - severe swelling appears at the site of the impact, disturbances in the functioning of internal organs are observed. Such injuries require hospital treatment of the victim.
Severity of lumps under the skin
First, you need to clearly understand the mechanism of development of such phenomena. There are three degrees of severity for the consequences of bruises:
- the seal forms during the day and is almost not painful (only when touched);
- the bruised area swells a little, constant pain appears, which disrupts general well-being;
- an extensive diffuse hematoma, compaction in the tissues after a bruise is sharply painful, especially when touched, the body temperature may rise.
In what cases is it necessary to go to the hospital?
At any of the above stages, you should consult a doctor. But if the first two can be treated on an outpatient basis, then the third is an absolute indication for a hospital.
There are also a number of alarming symptoms that require a more detailed examination in a hospital setting:
- if the compaction does not go away for a long time, it is necessary to examine it in detail, even in the absence of pain. It is advisable to do this as quickly as possible, but the optimal period is up to 6 months.
- sharp pain that increases with palpation;
- bright pronounced redness of the skin over the seal;
- increased body temperature;
- decreased or loss of sensation in the bruised area.
Treatment
Methods and methods of treatment for a bunion on the leg should be chosen by the doctor depending on the severity of the case, the age of the patient, the presence of complications, concomitant diseases, and other factors. Let's find out how to treat bumps on the legs due to bruises.
So, the following methods of therapy are usually used:
- Drug treatment;
- Physiotherapy;
- Traditional methods;
- Surgical treatment.
Next, we will consider all the methods in more detail.
Surgery
It is used in extreme, most severe cases. Usually, surgical intervention is resorted to if an abscess forms at the site of the bruise, and the bump on the leg does not go away from the blow. During the operation, the doctor opens the lump, removes pus from the wound, and then stitches it up.
Such an intervention usually takes place without complications, and the patient quickly recovers after the operation, immediately feeling significant relief.
Drug treatment
These methods are used in any case, regardless of the severity of the lump. Applying Vishnevsky ointment to the injured area of the leg has a good effect. The ointment has good absorbable, antimicrobial and warming properties, helping to quickly stop the problem.
An iodine mesh is also applied to the affected area. This measure reduces swelling and helps the hematoma resolve faster.
Dimexide solution is another way to relieve a bump from a blow to the leg. How to treat: compresses are made with this medicine, which have a pronounced warming, analgesic and anti-inflammatory effect.
If the pain is severe, you can use analgesics:
- Ibuprofen, Analgin, Nimesulide orally;
- Indomethacin ointment, Nise gel externally;
- Diclofenac, Ketorol, Movalis in the form of injections.
The following ointments will help relieve swelling, reduce the size of the hematoma and the lump itself:
- Heparin;
- Fastum-gel;
- Troxevasin;
- Bystrum-gel;
- Traumeel-gel;
- Lyoton-gel.
Troxevasin helps the seal dissolve faster, and Traumeel gel eliminates swelling by accelerating the removal of excess fluid. The latter remedy, in addition, also strengthens blood vessels. Lyoton gel promotes rapid resorption of compactions, and Heparin ointment is indispensable for creating a warming effect.
If a bruise with a bump has formed on your leg, you can use Badyagi powder: the product will help quickly eliminate the consequences of hemorrhage. However, to obtain a lasting result, it is necessary to carry out several procedures using a compress from Badyagi.
Rescue balm is also useful. This remedy is used to regenerate soft tissues that have been damaged. It contains components that accelerate the outflow of lymph, thanks to which the balm effectively relieves swelling and eliminates compactions.
Physiotherapy
Properly selected physiotherapeutic treatment methods help:
- Normalize blood circulation in the affected area;
- Reduce swelling;
- Eliminate painful sensations;
- Improve metabolic processes;
- Reduce the size of the cone;
- Restore damaged capillaries.
Physiotherapy can help cope with even large seals, including old, very dense ones.
The following procedures will be useful for bruises and the formation of a lump on the leg:
- UHF;
- Coagulation with infrared rays (excellent warming);
- Ultrasound;
- Electrophoresis;
- Magnetotherapy.
UHF will help get rid of serious and large seals. Electrophoresis helps medications reach deeper layers of affected tissue. And infrared irradiation can cope even with very large lumps, which drug treatment could not remove.
In addition, a foot massage can also help - but this procedure should only be performed by an experienced specialist who can do no harm. A competent massage helps eliminate swelling, activate blood supply to the affected limb, and get rid of the consequences of subcutaneous hemorrhage.
ethnoscience
Alternative medicine methods can only help as an additional method of treatment, but not as the main one. They are effective for first-degree bumps: they are not able to stop more complex cases. We will consider several options for traditional methods below.
- Banana compress If after a bruise there is a lump on your leg, you should apply a raw banana peel with the wrong side to the affected area. The compress should be secured with a bandage and left for 10-15 minutes.
- Cabbage compress A fresh leaf of white cabbage is steamed with boiling water, coated with honey, and applied to the sealed area of the leg. You need to secure the compress with a plastic bag and bandage and leave for an hour and a half.
- Compress with aloe Aloe leaves are crushed in a blender, applied to the affected area, and fixed with a bandage. The product will help relieve inflammation and reduce the size of the lump.
- Cranberry compress Take 100 grams of cranberries, mash them into a paste and then apply to the seal. Cranberries contain a lot of organic acids, which will help the bud soften faster.
So, a lump on the leg after a bruise is an unpleasant thing, often painful, sometimes requiring surgical intervention. It is important to see a doctor after receiving a leg injury - in this case, competent and timely measures will be taken.
There are several methods for treating such bumps; together they will give the most pronounced and fastest effect.
PHARMACEUTICALS FOR MINOR INJURIES
However, despite the fact that most people are familiar with complications after a blow in the form of hematomas, bruises, and swelling, few know about the rules of first aid and further treatment of bruises.
A LITTLE ANATOMY
Despite the fact that every person has had to deal with bumps and bruises to one degree or another, often not everyone knows what happens. Firstly, the skin, muscle tissue, and subcutaneous fatty tissue are damaged; bone tissue in most cases remains intact; vessels and capillaries are often injured; after local hemorrhage, the bruise site swells and pain appears. Depending on the force of the blow, the area of subcutaneous hemorrhage differs. Due to the fact that the blood cannot find a way out, it spreads into neighboring tissues and a hematoma is formed. The joints are affected, and the color of the bruise begins to change, taking on a variety of shades. Depending on the shade, a specialist can determine the age of the bruise. The appearance of unbearable pain often signals bone damage, so you should not delay your visit to a traumatologist and take analgesics yourself. Painkillers will interfere with diagnosing the overall picture and prescribing the correct treatment, which requires individual prescription in each specific case. Local remedies, of course, are good, but they will only relieve the pain a little without solving the essence of the problem. The inflammatory process in bone tissue can lead to serious consequences, so it is highly undesirable to bring your health to such a state.
GENERAL RULES
So that, when faced with bruises of various parts of the body, you do not have to suffer from unbearable pain, or “admire” the colored stains on the body for a long time, you just need to familiarize yourself with the rules of first aid for bruises.
Most often, athletes, tourists, and fans of an active lifestyle have to deal with them, so they are more prepared for damage to soft tissues. Despite the fact that injuries can be different: bruise of the tailbone, fingers, arms, legs, feet, knees, ribs, eyes and head, in all these cases it is necessary to ensure the bruised area at the first stage. Hands and feet must be kept in a natural position. If such a possibility exists, then it is better to lie down and try to move less. In this case, the bruise area should be above the heart area.
It is important to apply something cold to the bruised area as quickly as possible: ice, food from the freezer, etc. This must be done in order to reduce swelling and stop the spread of the hematoma. The best option for taming a hematoma is ice wrapped in a cloth, a cold compress made of wet gauze or a terry towel. If these products are not at hand, then you can use snow from the freezer (scrape off the walls), wrap it in a plastic bag/film and apply it to the bruised area. In addition, cold packages with kefir, milk or sour cream, a bottle of water, a cold egg, a can of canned food, in a word, anything that will have a low temperature are suitable. It is important to remember that the item that will be used as a cooler must be clean.
Instead of ice, you can turn on a tap with cold water and hold the bruised limb under a small stream for 5-7 minutes.
Keep the cold compress for no more than 15–20 minutes to reduce the rate of blood circulation and stop internal hemorrhage. After applying a cooling compress, the impact site is dried and medications are applied.
Rules about what not to do:
- Smoking and drinking alcohol are prohibited (dilates blood vessels);
- massage the bruised area;
- move actively;
- warm the hematoma.
Warming procedures are recommended after two days, but not earlier than after 24 hours.
In case of severe bruises to the eyes and brain, you should immediately consult a specialist (there are emergency rooms and ophthalmological hospitals that operate around the clock). If the bruise is serious, it is better to immediately seek medical help, since timely treatment will stop the process of hematoma formation and speed up recovery. Proper first aid is also of great importance, since a cold compress applied a day after the injury will be useless.
WHAT TO DO NEXT?
It should be noted that self-medication can only be done in case of a slight blow. So, after 48 hours. You will need a warm compress; it will relieve pain, irritation and restore blood circulation. An alternative to a warm compress is a bath filled with water at a comfortable temperature (but not hot). Warm water dissolves clots by restoring blood microcirculation. A light soothing massage of the sore spot is helpful. If pain occurs, it is better to postpone the procedure to a later time. During this period, it is good to perform simple exercises. For bruises on your arms and legs, you can tense and relax your muscles. In addition, you should continue to treat the affected areas with anti-bruise products.
NEW IS WELL FORGOTTEN OLD
√ Among the folk remedies that have survived to our times and are embodied in new pharmaceutical forms is badyaga . Today there are many local pharmaceutical preparations based on it: natural powder (crushed badyagi needles), multi-component gels, creams, etc. The popularity of badyagi today is not accidental: it has established itself as one of the best natural remedies for bruises and bruises. Sponge powder or other products from this freshwater are sold at any pharmacy. The greenish-gray powder is diluted with water in a ratio of 2:1. A bandage with badyagi mass is applied to the sore area twice a day.
√ There are situations in life when it is not possible to make a cooling compress, but there is a banana, or rather its peel , which is applied to the bruise with the inside.
lead coin and a tablespoon work in the same way (they are periodically moistened with cool water).
butter is suitable for resolving bruises and bumps (lubricate the sore spot every half hour). It resolves hematomas well and the pain quickly goes away when applying a compress of sea salt , which is sold in a pharmacy (half a teaspoon), diluted in 1/2 cup of vinegar. Action time: 30 minutes.
√ Long-time proven remedies - cabbage leaves, plantain, aloe . An ordinary leaf of cabbage, plantain or aloe resolves bruises, relieves swelling, and reduces pain. Before use, one of these products must be rinsed with water; it can be further cooled in the refrigerator and applied several times a day, replacing it with a new one. An analogue of plantain leaf is its juice, which is also sold in pharmacies, like aloe juice. It is also effective to lubricate the affected area with juice.
MEDICATIONS
It is good to have medications in your home medicine cabinet that are used for bruises, when there is a tube of gel or ointment for bruises in the refrigerator “just in case,” because the sooner you start treating the bump, the fewer harmful consequences for the body.
The effect of medications for external use is designed to heal hematomas, relieve swelling, and reduce pain.
√ Practice-tested gels, rubs and ointments based on badyagi:
- Badyaga forte gel, Badyaga 911 gel, Badyaga bio-balm from different manufacturers;
- Novikov's rubbing and many others. etc.
The composition of modern preparations with badyaga is additionally enhanced by such components as:
- plant extract (plantain, yarrow, horse chestnut, chamomile, ginger, St. John's wort, sea buckthorn, aloe vera);
- tea tree oils, mint, lavender, pine, eucalyptus, rosemary, juniper, lemongrass, arnica;
- medicinal leech extract;
- vitamin E, D-panthenol;
- shark oil.
Thanks to the improved formula of drugs with badyaga, the product has an active absorbable, decongestant, bactericidal, antiseptic effect, and reduces pain.
√ In addition, gels and ointments based on medicinal leech are in demand . Bruise-off gel and its analogue, which can be used as a foundation and treatment - Bruise-off cream.
√ Balm Rescuer and thermal balm Rescuer (for thermal procedures on the second day after injury).
√ Homeopathic drug Traumeel S , used in the form of tablets, injections, cream, ointment and gel based on herbal components (relieves swelling of soft tissues and inflammatory processes).
√ Other auxiliary local drugs for hematomas, having one active ingredient - troxerutin: Troxigel, Troxevasin, Troxerutin ;
√ Heparin ointment.
√ Pain-relieving anti-inflammatory patches (Salonpas, Salonsip, Nanoplast forte, Magikoplast for children). They have the following medicinal properties: resolve hematomas, reduce swelling, improve blood circulation, and relieve pain. When using the patch for 3-9 days, there is a noticeable improvement.
√ Another effective natural remedy is Medical bile . In addition to its other healing properties, it reduces swelling and resolves compactions after bruises. In the absence of contraindications, compresses with Medical bile are used. The dressing material is soaked in medical bile or a mixture based on it. Then the compress is applied to the affected area, cotton wool and compress paper are placed on top. All this is fixed with a light bandage and left for 12 hours. If severe discomfort occurs, the procedure is stopped. Depending on the extent of the injury, the course of treatment may last 6-30 days.
√ Other long-known remedies: lead lotion, calendula tincture, iodine mesh , etc.
TYPES OF BRUISES
Head contusion is one of the most common injuries to the soft tissues of the skull.
- Depending on the severity of the injury, various signs may occur:
- Headache.
- Formation of a lump or swelling.
- Increased body temperature.
- The appearance of nausea and vomiting, nosebleeds.
- Vision deteriorates.
- There is a feeling of weakness in the limbs.
- Problems with consciousness up to its loss.
All of the listed symptoms should not leave any doubt about visiting a doctor, since they clearly indicate a serious injury.
But if your health allows you to cope with the symptoms of a bruise on your own, then you should apply a cool compress (cooling procedures) and special ointments at the first stage, and after 48 hours. - heat treatment.
√ A black eye is another unpleasant injury that can result from any mechanical damage and occurs quite often in life.
Such an accident causes a lot of discomfort and also turns into a noticeable cosmetic defect, so when something like this happens in life, you want to get rid of the consequences of the injury as quickly as possible.
The healing process usually lasts for 7–10 days. without the use of drugs.
In addition to a bruise under the eye, symptoms such as severe pain, swelling and swelling, lacrimation, photophobia, blurred vision (after a strong blow), and involuntary closing of the eyelids may appear in the area of the injury.
Even if an eye injury does not cause serious concern, it is necessary to act quickly to avoid severe bruising and speed up recovery.
- As in all cases, the rule of first aid is to apply something cold to the injured area (in extreme cases, it can even be a piece of meat).
- Of the folk recipes used several hundred years ago, badyaga again takes pride of place, so all local remedies based on it are suitable for healing a bruise under the eye.
- self-prepared mixture of badyagi powder or a ready-made preparation in the form of a gel is applied directly to the bruise and left until completely dry.
Then you need to wash thoroughly with water. Since badyaga can cause irritation of the mucous membrane, it is important that the mixture does not get into the eye. During the day you can make 3-4 applications. Experience shows that these procedures are quite sufficient to disappear a small hematoma.
- Another well-known folk remedy for hematomas and bruises under the eyes is coltsfoot lotions . This plant has a wide range of uses in folk medicine, in particular for bruises.
To prepare the decoction, you need to purchase dry coltsfoot herb and wild rosemary herb from the pharmacy. A mixture of two herbs (1 tablespoon each) is poured with a glass of boiling water and placed on low heat (boil for 15 minutes). Then strain, cool and begin treatment by generously moistening a cotton or gauze swab, which is applied to the hematoma under the eye for ten minutes. Such lotions can be done every couple of hours on the first day and every three hours on the second. Practice in many cases has shown that three days are enough for the hematoma to completely disappear.
IMPORTANT! Despite the fact that ointment for bruises and contusions can be purchased at any pharmacy, you should pay close attention to the composition of the drug. Many medicines may contain antibiotics and other ingredients that cause an allergic reaction.
- Of the modern means for treating a black eye, it is better to use gels and creams containing essential oils and extracts of medicinal herbs. They apply well and are quickly absorbed, relieve pain and swelling, and accelerate the resorption of the hematoma. Ai-Bolit cream , which is based on an old recipe (badaga, extracts of arnica, horse chestnut and Japanese sophora, beeswax). Thanks to modern technologies, this product has a prolonged effect, has analgesic, anti-inflammatory, tonic properties, has an antiviral, antiseptic effect, heals wounds, and softens the skin.
RECOVERY THERAPY
Sometimes it happens that a long period of time passes, and the bruise does not heal. This happens if the impact affected the deep layers of the dermis or if first aid measures were not taken in a timely manner. In this situation, visiting a therapist is simply necessary. Perhaps a specialist will prescribe physiotherapeutic procedures (in the absence of contraindications). The following have proven effective: magnetotherapy using high-frequency magnetic fields, electrophoresis with solutions of medications, UHF (exposure to a high-frequency electric field).
How to get rid of a lump in the knee area
If, after an impact, a lump forms on the knee, usually at the bottom of the knee, you need to immediately begin treatment; the entire knee joint can be damaged. Serious damage is possible: soft tissue injuries, muscle spasms, ligament rupture or cartilage damage.
It is simply dangerous for a sick person to move during destruction, otherwise the integrity of the limb is compromised. The treatment is carried out by a doctor. The slightest mistake later leads to arthritis or deforming arthrosis, irreversible destruction of the knee. You should not remain frivolous; we advise you to call emergency help without delay.
How dangerous is an ordinary bruise to the body? Consequences of Injuries and Bruises. EXPERT Speaks: Video
Graduated from the St. Petersburg State Medical University named after Academician I.P. Pavlov. I have been working as a therapist for over 15 years. My motto in work and in life: “Never say never.”
Often after a person hurts his leg, he notices a lump or, as people say, a lump in the damaged area. A compaction is formed due to the fact that the injured tissues are swollen, filled with blood, and in the case of an abscess, pus. The lump can be of different sizes and often causes discomfort and pain.
And of course, the natural question is how to get rid of this compaction. We will consider this problem in the article: we will find out why a lump forms on the leg after a bruise, its symptoms, and we will get acquainted with the methods of treating the tumor.