Cancer that arises in the bone (primary bone cancer) is not the same disease as cancer that spreads to the bone from another part of the body (secondary bone cancer). Primary bone cancer is rare, with approximately 2,500 new cases diagnosed each year in the United States. More commonly, bones are the sites of tumors that result from the spread (metastasis) of cancer from another organ, such as the breasts, lungs, and prostate.
Screening & Diagnosis
Several tools are utilized to make a diagnosis of bone cancer, including:
- Physical examination
- Blood tests, including checking the level of an enzyme called alkaline phosphatase. A large amount of alkaline phosphatase can be found in the blood when the cells that form bone tissue are very active.
- X-rays can show the location, size, and shape of a bone tumor
- Special imaging tests such as a bone scan, a CT (or CAT) scan, an MRI. Imaging studies help determine the size and location and extent of the tumor.
- Biopsy – There are two type of biopsies that can be performed, a needle biopsy and an incisional biopsy.
- Needle Biopsy - A small hole is made in the bone and a sample of tissue from the tumor is removed with a needle-like instrument.
- Incisional biopsy – The tumor is cut into and a sample of tissue is removed.
- Biopsies are best done by orthopedic oncologists—doctors experienced in the diagnosis of bone cancer.
- A pathologist—a doctor who identifies disease by studying cells and tissues under a microscope—examines the tissue to determine whether it is cancerous
Treatment
Treatment options depend on the type, size, and location of the cancer, as well as the person’s age and general health. The Alvin & Lois Lapidus Cancer Institute at Sinai Hospital of Baltimore, utilizes a team approach to develop and implement a treatment plan. A multidisciplinary team is utilized, including medical oncologists, radiation oncologist, and radiologists and orthopedic oncologists
Surgery is often the primary treatment for bone cancer but chemotherapy and radiation therapy can also be used alone or together. Our program is also involved in a clinical trial to study the effectiveness of radiofrequency ablation in treating bone tumors
Surgery
Although amputation of a limb is sometimes necessary, pre- or post-operative chemotherapy has made limb-sparing surgery possible in many cases. In these cases, only the cancerous section of the bone is removed and is replaced with an artificial device called a prosthesis. Limb-sparing surgery consists of three phases: tumor resection, skeletal reconstruction, and soft tissue and muscle transfers. The range of reconstruction techniques has been broadened by the developments in bioengineering. Among the more commonly used techniques are custom endoproseheses and allograft replacements.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. The Department of Radiation Oncology at Sinai Hospital of Baltimore provides the most advanced radiotherapy for many cancers.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. The way the chemotherapy is given depends on the type and stage of the cancer being treated. The Medical Oncology/Hematology Division at Sinai directs the chemotherapy program within LifeBridge Health.
Clinical Trials
Clinical trials are research studies conducted with patients who volunteer. The study examines basic questions and tries to find better ways to prevent, screen for, diagnose, or treat a disease. Patients who take part in cancer clinical trials receive up-to-date care from experts.
For trials that are currently available to bone cancer (sarcoma) patients click here
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