Bone Cancer

This cancer may not cause any symptoms when it begins to develop. Over time, patients may experience:

• Pain in a bone or joint (the most common bone cancer symptom)
• Swelling or a lump
• Unexplained bone break (fracture)

Certain types, such as Ewing sarcomas, can also cause other symptoms, including:

• Fever
• Fatigue
• Unexplained weight loss

These symptoms may be caused by noncancerous conditions, like osteoporosis. If you notice any of these signs of bone cancer, see your primary care physician right away.

Bone cancer occurs in patients of all ages, races, and lifestyles.

Anyone can develop this cancer, and there's no clear cause. Scientists and doctors believe there are certain things that may increase the chances of bone cancer, such as:

• Previously undergoing cancer treatments like radiation therapy or chemotherapy
• Having a family history of osteosarcoma or other orthopedic cancers
• Having a related musculoskeletal condition or injury, such as Paget's disease, pre-existing noncancerous bone tumors, chronic osteomyelitis, and metallic implants
• Hereditary conditions, like Li-Fraumeni syndrome, Lynch syndrome, Rothmund-Thomson syndrome, Retinoblastoma, and others

However, most people with the disease don't have any risk factors, making it hard to spot in early stages.

• Reviewing your medical history and conducting a physical examination helps us understand your overall health, symptoms, and risk factors.

• Bloodwork measures specific enzymes and can indicate an abnormality in bone tissue.

• Advanced imaging tests pinpoint the tumor and any possible cancer growth using advanced technology. Our diagnostic radiologists are experts in knowing which tests to use for different patients to minimize unnecessary radiation exposure, especially for pediatric patients. These may include:

  • X-ray

  • CT (CAT) scan

  • MRI

  • PET scan

  • Bone scan

• Minimally invasive biopsies can help accurately identify cancer without going through surgery. Your doctor uses imaging-guidance to remove tissues or cells from the tumor to determine whether it is benign (noncancerous) or malignant (cancerous) and how aggressive it is. These are safer and just as accurate as open biopsies.

• Pathology and radiology review allows your doctors to learn about the tumor and cancer, including type and stage. This informs how much normal tissue your surgeon needs to remove around the tumor.

Treatments

We're dedicated to eliminating your cancer while preserving your quality of life.

Our MedStar Health cancer specialists have recognized expertise in treating cancers in the bone and soft tissues. With decades of experience focusing exclusively on sarcoma, our team is dedicated to eliminating your cancer while minimizing damage to the healthy structures of your body. We do this by involving several specialists with expertise in pathology, radiology, surgery, reconstruction, radiation, medicine, rehabilitation, and more. Together, we collaboratively plan personalized bone cancer treatment that considers all of your best options, including clinical trials that are hard to find elsewhere.

Surgery

Surgery is typically the primary treatment for bone cancer. Our goal is to remove every trace of cancer and minimize the risk your cancer will return. This means your surgeon will remove the tumor and the tissue directly surrounding it, allowing a specialized pathologist to determine whether any cancer cells may have been left behind.

Your musculoskeletal system is a complex system of diverse tissues, cartilage, and tendons. This means the surgical techniques we use will depend on the location of your tumor and the condition of surrounding organs, tissue, and bone. Because these tumors are rare, it's important to seek care from an experienced team like ours who has decades of experience in treating a wide variety of these types of cancers. Our surgeries are performed by orthopedic oncologists who:

• Are internationally recognized for their expertise with complex sarcoma surgery—treating patients referred from across the country and the world
• Help patients who received initial surgery elsewhere and now need additional care
• Use advanced techniques on arm and leg tumors to preserve as much function as possible, often sparing the whole limb
• Repair surgical areas (when needed) with sophisticated bone grafts or special implants, many of which can expand with younger patients as they grow

We offer top follow-up care, too, with a comprehensive rehabilitation program—often a crucial part of making treatment a success.

Chemotherapy

Chemotherapy drugs are swallowed or injected, and then travel through the bloodstream to kill cancer cells. They are used to shrink sarcomas before surgery or given afterward to make sure the cancer does not return or spread. In some cases, chemotherapy is given by itself to treat a tumor.

The type of chemotherapy depends on the type of tumor, its stage, and whether cancer is newly diagnosed or has returned. Drugs are typically given together, and we are studying new medications, new combinations, and more effective delivery methods.

While we always try to minimize the side effects of chemotherapy, we are especially committed to limiting toxic exposure as much as possible for children who are still growing.

Immunotherapy and targeted therapy

Targeted therapy represents a new front in attacking cancer—drugs and other substances aimed at specific molecules that help tumors grow, progress, and spread. The idea is to target a tumor’s unique characteristics, including genes, proteins, supporting blood vessels, or host tissue, while limiting damage to healthy cells.

Targeted therapies, including immunotherapy, may replace current sarcoma treatments, or complement them. We are studying several new targets and approaches, such as:

• Growth Factor Receptors: Block proteins on some cancer cells that cause them to grow
• Monoclonal Antibody: Replicates a natural antibody, then targets certain substances on cancer cells—either alone or with a drug, toxin, or radioactive material to kill the cells, block their growth, or keep them from spreading
• Kinase Inhibitor: Blocks a protein that cancer cells need for division
• Immune Modulators: Boost the body’s own immune system to fight cancer

Radiation therapy

Radiation therapy is commonly used to treat soft tissue sarcomas, but it is not frequently used to treat bone tumors in adults. Our radiation oncologists participate in the multidisciplinary team evaluating and planning your treatment, and there are certain situations where they may recommend this type of therapy as part of your care. For example, it may be used to alleviate pain or treat secondary bone cancers that develop when other cancers spread to the bone. If your care team thinks you would benefit from radiation, we have access to all of the most advanced radiation technologies to deliver it effectively while limiting exposure to healthy tissue.