If You Have Bone Cancer
When you are referred to us for care – either for a sarcoma, which is a cancer that arises in the bone or the muscle and soft tissue surrounding the bone, or for cancer that has metastasized or attached itself to the bone after starting elsewhere in your body (such as the prostate or lung) – you will work with a team of orthopedic oncologists, medical oncologists, radiation oncologists and radiologists. Together, they will evaluate and diagnose your cancer, then discuss plans for treatment with you and your family.
What are Sarcomas?
Sarcomas are complex cancers involving bone (bone sarcoma) or the surrounding soft tissue (soft tissue sarcoma) such as muscles, tendons, fat, blood vessels, lymph vessels, nerves and tissue around the joints. In adults, soft tissue sarcomas can form anywhere in the body but are most common in the head, neck, arms, legs, torso and abdomen.
Because of their complexity, sarcomas often require coordinated treatment that combines surgery, radiation and chemotherapy. The goal is to improve your outcomes and reduce the chance that the cancer will come back. A specialized team of pathologists, radiologists and medical oncologists with advanced training in the latest reconstructive techniques and therapies for soft tissue sarcomas and bone malignancies work with you to devise and carry out the most effective care plan.
Bone Sarcoma: Tumors of the bone can be caused by infection, stress fracture or other conditions that cause cells to divide uncontrollably. Tumor cells can replace healthy tissue and even weaken the bone.
In many people, there are never any symptoms indicating they have a bone sarcoma, they simply notice a painless lump.
In others, bone sarcoma can cause these symptoms:
- Dull pain in the area of the tumor that may or may not worsen with activity. The pain may wake a patient up at night.
- Fever
- Night sweats
Diagnosis generally includes a physical exam, X-rays and lab tests. You may also be asked to have a biopsy o sarcomas:
- Osteosarcoma: A common form of bone sarcoma affecting as many as 3 million people each year. Most tumors are found around the knee and in teenagers. They can also be found in the hip and shoulder.
- Ewing’s sarcoma: Occurs mostly in children and teenagers. It includes several types of bone tumors typically found in the hip, upper arm, ribs or legs.
- Chondrosarcoma: Occurs in the hip, pelvis or shoulder, most commonly in people age 40 to 70.
Treating Bone Cancer
Treatment depends on the malignancy of the tumor. If it is benign, we generally monitor it or treat it with medication. If it is malignant, the orthopedic oncologist on your team will lead the treatment planning with a goal of curing the cancer while preserving function in your body.
Treatment options include:
- Limb preservation surgery: The cancerous part of the bone is removed but the muscles, tendons, nerves and blood vessels are kept in place. An implant/prosthesis or bone transplant is put in the bone’s place.
- Amputation: Removal of all or part of the limb affected by the cancer. This is usually done when the tumor is large or involves nearby blood vessels and nerves.
- Radiation therapy: Kills cancer cells and shrinks the tumor.
- Chemotherapy: Kills tumor cells spread to the bloodstream. It’s used if your medical team believes the tumors will spread.
What are Soft Tissue Sarcomas?
Although there is still much to be learned about these types of tumors, research has linked them to various conditions and activities, including:
- Exposure to phenoxyacetic acid in herbicides, chlorophenols in wood preservatives and vinyl chloride in the making of some types of plastic.
- AIDS
- Genetic alterations passed down in families
- Inherited diseases such as Li-Fraumeni syndrome and von Recklinghausen’s disease
When soft tissue sarcomas first form, they generally cause no pain, just emerge as a lump or swollen area. As they grow and press against nerves and muscles, however, pain or soreness might result.
Surgical biopsy is the only reliable way to determine if a soft tissue tumor is benign, meaning harmless, or malignant/cancerous. Biopsies involve using a special needle inserted through a surgical incision near the tumor to remove a tissue sample for examination.
The most common treatment for soft tissue sarcomas is surgery to remove it. We also use radiation therapy to shrink tumors before surgery or kill any cancer cells that remain after surgery. Sometimes, we combine it with chemotherapy to shrink the tumors and reduce pain.
What are Intra‑Abdominal Sarcomas
Intra-abdominal sarcomas are soft tissue cancers that originate within the abdominal cavity, often involving the:
- Retroperitoneum (the space behind the abdominal organs)
- Abdominal wall
- Mesentery (tissue supporting the intestines)
- Omentum
- Organs or connective tissues within the abdomen
Because the abdomen provides room for tumors to grow without causing early symptoms, these sarcomas are often diagnosed at a later stage.
Common Types of Intra-Abdominal Sarcoma
- Liposarcoma (including retroperitoneal liposarcoma)
- Leiomyosarcoma (often arising from smooth muscle in blood vessels or the GI tract)
- GIST – Gastrointestinal Stromal Tumor
- Malignant peripheral nerve sheath tumor (rare)
Symptoms
Symptoms depend on location and size and may include:
- Abdominal fullness or bloating
- Unexplained abdominal or back pain
- Early satiety (feeling full quickly)
- Changes in bowel habits
- Unintentional weight loss
- A palpable mass (in some cases)
Diagnosis
Evaluation may involve:
- CT or MRI of the abdomen and pelvis
- PET imaging
- Endoscopy (for suspected GIST)
- Image‑guided biopsy for confirmation
HHC Cancer Institute radiologists and pathologists have specialized expertise in differentiating these rare tumors.
Treatment
Treatment plans are individualized and may include:
- Complex abdominal or retroperitoneal surgery by surgical oncologists with sarcoma expertise
- Radiation therapy, sometimes before surgery
- Chemotherapy, depending on the tumor type
- Targeted therapies (especially for GIST, which may respond to medications such as tyrosine kinase inhibitors)
Tumors in the abdomen often require meticulous surgical planning to protect organs, vessels, and nerves while removing as much cancer as possible.