At Great Lakes Cancer Care Collaborative, we know that many patients don’t have much knowledge about sarcomas—a group of cancers that start in or spread to the bones—but we’re here to help if you or a loved one has received a sarcoma diagnosis.
When cancer starts in bone tissue, it is called primary bone cancer. When cancer cells travel to the bone from another site in the body, it is called secondary or metastatic bone cancer. Types of bone cancer include:
- Osteosarcoma — a cancerous tumor of the bone, usually of the arms, legs or pelvis
- Chondrosarcoma — cancer of the cartilage
- Ewing sarcoma — tumors that usually develop in the cavity of the leg and arm bones
- Fibrosarcoma and malignant fibrous histiocytoma — cancers that develop in soft tissues such as tendons, ligaments, fat and muscle, and move to the bones of the legs, arms and jaw
- Giant cell tumor — a primary bone tumor that is malignant; most common in the arm or leg bones
- Chordoma — primary bone tumor that usually occurs in the skull or spine
Symptoms
Symptoms of bone cancer vary depending on the location and size of the tumor. Talk to your doctor if you experience any of these symptoms to make sure you get the care you need:
- Swelling or a lump on the bone
- Deep bone pain severe enough to wake you up or keep you awake
- Unexplained weight loss
- Fatigue
- Trouble breathing
- Fever or night sweats
Risk Factors
There are specific risk factors that increase your chances of developing sarcoma or bone cancer and subtypes of bone cancer. Risk factors include:
- Paget’s disease (a noncancerous bone condition)
- Exposure to radiation
- Family history of bone cancer
- Bone marrow transplant (osteosarcoma-specific)
- Retinoblastoma (osteosarcoma-specific)
- Li-Fraumani and Rothmund-Thompson syndromes (osteosarcoma-specific)
- Multiple exostoses (chondrosarcoma-specific)
- Younger than 30 years old (Ewing sarcoma-specific)
Diagnosis
For symptoms that suggest sarcoma or cancer, your doctor will start by asking about your symptoms and medical history, and will also perform a physical exam. Additional testing and screening are needed to confirm a diagnosis and the stage of the cancer, and may include:
- Blood tests
- Biopsy
- X-ray
- CT scan
- MRI scan
- Bone scan
Treatment
If you need treatment for sarcoma or bone cancer, our collaborative team will work with you to develop an individualized treatment plan for your unique condition that will take into account the stage of your disease, your age, your general health and more.
Surgery
Surgery for bone cancer involves the removal of a cancerous tumor, nearby tissue and possible nearby lymph nodes. Surgery may require amputation of the limb that has the cancer. Whenever possible, doctors try to remove the cancerous part of the bone without amputating. In this case, metal plates or a bone graft replaces the cancerous tissue that has been removed.
Sometimes, adding radiation therapy or chemotherapy can help avoid the need for amputation. If the tumor is large or aggressive, or the risk of it spreading is high, chemotherapy and radiation therapy may be added to help prevent it from returning or spreading to other organs.
Chemotherapy
Chemotherapy uses drugs to kill sarcoma or bone cancer cells. If you receive chemotherapy, you will be seen by a medical oncologist, who will determine how many cycles of chemotherapy you need and what combination of drugs will work best.
Radiation Therapy Treatment
Radiation therapy uses high energy x-rays to destroy sarcoma or bone cancer cells and shrink tumors. Radiation treatment for bone cancer can be either external (directed at the tumor from outside the body) or internal (radioactive materials are placed inside the body near the cancer cells).
Myeloablative Therapy With Stem Cell Support
For cancer that has spread, intense chemotherapy is sometimes given to kill cancer cells. This therapy also destroys the bone marrow. Stem cells, which have the ability to develop into other types of cells, are then given to replace the lost bone marrow.
Cancer-Specific Treatments
For some types of sarcoma and bone cancer, there are specific treatments that are generally used, including:
- Osteosarcoma - Chemotherapy given before and after surgery is often successful in treating osteosarcoma and can allow for limb-sparing surgery in people who might have otherwise required amputation.
- Ewing sarcoma - Since Ewing sarcoma is responsive to chemotherapy, its treatment often involves several weeks of chemotherapy followed by surgical removal or radiation therapy, then several more months of chemotherapy.
- Fibrosarcoma and malignant fibrous histiocytoma - These conditions are usually treated with surgery to remove the cancerous tumor and a one-inch margin of healthy tissue surrounding it to ensure that all cancerous tissue has been removed.
Education
American Cancer Society
(800) ACS-2345 | 101 John James Audubon Pkwy, Amherst, NY 14228
The American Cancer Society's (ACS) mission is to save lives, celebrate lives, and lead the fight for a world without cancer. Attacking cancer from every angle, the ACS strives to achieve its mission through research, education, advocacy, and service. In conjunction with the local chapter, located in Amherst, the ACS offers numerous free programs and services appropriate for cancer patients, caregivers and their families.
National Comprehensive Care Network
The National Comprehensive Cancer Network (NCCN) is comprised of a group of leading cancer centers that works to improve quality of care and accessibility for cancer patients around the country.
National Cancer Institute
The National Cancer Institute engages in certain fundamental activities such as conducting and fostering cancer research; reviewing and approving grant-in-aid applications to support promising research projects on the causes, prevention, diagnosis, and treatment of cancer; and collecting, analyzing and disseminating the results of cancer research conducted in the United States and in other countries.