Cancerous tumors on the bone or soft tissues are called sarcomas. Sarcomas that originate on bone are primary bone cancer, while cancer that has spread to the bone from another part of the body is metastatic bone cancer.
At University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC), Vincent Ng, MD, our orthopedic surgical oncologist, leads a multidisciplinary team of cancer specialists who care for adults and children with primary and metastatic bone cancer in most areas of the body. Our neurosurgery team provides care for spine tumors.
Our radiation oncology department works in partnership with the Maryland Proton Center, which offers a highly precise form of radiation therapy that increases the radiation dose to the tumor while decreasing dose to healthy tissue. Together they gives our bone cancer patients access to the most advanced radiation therapies.
Primary Bone Cancer
While metastatic bone cancer is more common, the most frequent types of primary bone cancer include:
The most common childhood bone cancer, osteosarcoma usually develops in large bones during periods of rapid growth between the ages of 10 and 19. Boys and girls are equally at risk until the late teens when boys are more affected. Osteosarcoma also affects people age 60 and older.
Although it can occur in any bone, osteosarcoma usually develops in the shin or thigh near the knee and the upper arm near the shoulder. The cause is not known, but it can run in families.
Mainly affecting adults 40 and older, chondrosarcoma begins in the cartilage that covers the ends of bones and lines the joints. It is most common in the pelvis, upper leg and shoulder. Chondrosarcoma is typically slow-growing.
This rare cancer usually affects children and young adults, typically developing in puberty during rapid bone growth. It can start anywhere in the body at any time. Ewing sarcoma most often appears in the long bones in the arms, legs, pelvis or chest. It can also appear in the skull and the trunk's flat bones and occasionally in soft tissues around the bones.
It often spreads to the lungs and other bones. Children of European descent are more at risk than African-American or Asian children.
Bone Marrow Cancer
Although bone marrow cancer forms inside the bones, it is considered a blood-based cancer. Learn more about UMGCCC's blood-based cancer treatment and multiple myeloma, a common form of bone marrow cancer.
Primary Bone Cancer Treatment
Treatment for bone cancer depends on the type and stage of cancer. Cancer specialists at University of Maryland Cancer Center offer the most advanced therapies available, including clinical trials. Your treatment may include one or a combination of therapies:
- Surgery to remove the entire sarcoma. Our bone cancer surgeon removes the least amount of healthy tissue possible. We perform limb-sparing surgery and reconstructive surgery where possible to preserve function.
- Chemotherapy uses specific anticancer medications to kill cancer cells. Patients who have Ewing sarcoma or newly diagnosed osteosarcoma may have a combination of anticancer drugs before surgery. We don't usually use chemotherapy for chondrosarcoma.
- Radiation therapy uses high-energy X-rays to kill cancer cells.
- Cryosurgery freezes and kills cancer cells using liquid nitrogen. We may use cryosurgery instead of conventional surgery to destroy bone cancer.
- Targeted therapy is advanced medication therapy that stops the growth of specific cancer cells.
Metastatic Bone Cancer
In metastatic bone cancer, the cancer cells originate elsewhere in the body but break away and settle in bone where it grows into a new tumor or tumors.
The treatment of metastatic bone cancer is typically palliative, meaning treatment is intended to maximize patients' quality of life by reducing pain and optimizing function. In rare and specific situations, patients with metastatic bone cancer can be cured of their disease.
A multi-disciplinary team is required for comprehensive metastatic bone cancer treatment. Potential treatments include:
- Medication to decrease the occurrence of disease
- Radiation therapy to prevent disease from spreading
- Surgical intervention to either reinforce a fragile bone or stabilize a fracture
Bone Tumor Symptoms
Pain is the most common bone cancer symptom. Depending on the type of cancer, other symptoms may include swelling and pain near the cancer, joint pain and reduced range of motion. Fractures or breaks at the site of the cancer can result from minor injuries.
Bone Cancer Diagnosis
You'll receive an accurate diagnosis from specialists using the latest diagnostic technologies, including:
- Imaging tests - like X-ray to show the size and location of bone cancer; CT, a technology that makes multiple, highly detailed cross-sectional images; and MRI, which uses a magnetic field and radio waves to create detailed pictures
- Bone scan - a type of nuclear medicine procedure that uses radioactive material injected into your bloodstream to detect cancer
- PET (positron emission tomography) scan - which uses a small amount of radioactive material to detect cancer, can be combined with CT in a PET/CT to provide detailed information about its location
- Biopsy - which examines a tissue sample under a microscope to confirm a cancer diagnosis.
Benign Tumors on Bone
Not every tumor that develops on the bone is cancerous. In fact, most are not. At UMGCCC, we do a thorough investigation to determine if a tumor is malignant. If it is not, treatment options range from observation to surgery to remove it.
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Clinical Trials and Orthopedic Oncology Education
As a leader in this field, our specialists engage in research and support other's research through education and fundraising efforts. Learn more about our orthopedic oncology program.