Bone Sarcoma Treatment

At Penn, our approach to bone sarcoma diagnosis and treatment provides better outcomes and gives you access to the most advanced treatment, surgical techniques and clinical trials.

The sarcoma program combines the expertise of physicians, nurses and experienced clinical and supportive professionals to provide a team approach to sarcoma treatment. This means that experts in treatment, nutrition, support and other areas will help to develop a personalized treatment plan. This ensures that you and your family will get the medical care and emotional support that you need.

Our program includes doctors from all the fields necessary to properly treat and diagnose bone sarcomas, including specialists in:

  • Orthopaedic oncology
  • Surgical oncology
  • Medical oncology
  • Radiation oncology
  • Diagnostic radiology
  • Pathology
  • Physical therapy

Experienced nurse practitioners, work exclusively with some sarcoma patients and are an important part of the team as are social workers and dietitians. Your team will take the time to explain your condition and treatment options in understandable terms and will follow you throughout.

Treatment for bone sarcomas include:

Chemotherapy and Targeted Therapies for Bone Sarcoma

Chemotherapy is a cancer treatment that uses drugs to kill cancer cells or stop their growth. Chemotherapy may be given through a pill, an IV, or an injection.

Chemotherapy for bone sarcoma may be used before surgery, after surgery or in conjunction with other therapies or other anti-cancer drugs in combination chemotherapy.

Targeted therapies are newer types of therapy designed to kill cancer cells without harming other, healthy cells and tissue. Penn Medicine physicians and researchers are pioneers in the development and use of targeted therapies and are backed by robust programs to further research in the area of bone sarcoma treatment.

Clinical Trials for Bone Sarcoma

Today, more and more people are surviving cancer. Clinical trials benefit patients with access to breakthrough therapies and treatments. These new advances in cancer treatment are occurring every day at Penn Medicine, giving patients hope that even greater discoveries lie ahead.

Through clinical trials:

  • Diagnosing cancer has become more precise.
  • Radiation and surgical techniques have advanced.
  • Medications are more successful.
  • Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes.
  • Strategies to address the late effects of cancer and its treatment are improving quality of life.

Drugs Approved for Bone Sarcoma

The following drugs are approved by the Food and Drug Administration (FDA) for bone cancer. The list includes generic names and brand names. There may be drugs used in bone cancer that are not listed here.

  • Abitrexate (Methotrexate)
  • Adriamycin PFS (Doxorubicin Hydrochloride)
  • Adriamycin RDF (Doxorubicin Hydrochloride)
  • Cisplatin
  • Doxorubicin Hydrochloride
  • Etoposide
  • Folex (Methotrexate)
  • Folex PFS (Methotrexate)
  • Ifosfamide
  • Methotrexate
  • Methotrexate LPF (Methotrexate)
  • Mexate (Methotrexate)
  • Mexate-AQ (Methotrexate

Radiation Therapy for Bone Sarcoma

Radiation therapy uses high-energy radiation to kill cancer cells. A radiation therapy schedule usually consists of a specific number of treatments given over an extended period of time. Depending on the type of bone cancer, radiation therapy may, or may not be necessary. It is not a commonly used treatment for most bone sarcomas.

Intensity-Modulated Radiation Therapy (IMRT)

Using 3-D computed tomography (CT) images of the patient along with computerized dose calculations, IMRT allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumor by controlling — or modulating — the intensity of the radiation beam. The therapy allows higher radiation doses to be delivered to regions within the tumor while minimizing the dose to the surrounding area.

Proton Therapy

At the Roberts Proton Therapy Center, we offer the largest and most advanced facility in the world for this precise form of cancer radiation. You will have access to one of the most sophisticated weapons against cancer, seamlessly integrated with the full range of oncology services available at the Abramson Cancer Center. Proton therapy is external beam radiotherapy in which protons are directed at a tumor.

Proton therapy, like all forms of radiation therapy, works by aiming the energized particles, in this case protons, onto the target tumor. The particles damage the DNA of cells, ultimately causing their death. Unlike X-rays, protons can be manipulated to release most of their energy only when they reach their target. With more energy reaching the cancerous cells, more damage is administered by each burst of radiation.

Surgery for Bone Sarcoma

Surgery for bone sarcoma is performed when possible. Sometimes we recommend neoadjuvant chemotherapy to help shrink the tumor before surgery.

At Penn Medicine, we perform the following types of surgery to treat bone sarcoma:

Wide Local Excision

We perform wide local excision for bone cancer to lower the risk of the tumor returning. If even a few cancer cells are left behind, it could result in new tumor growth. Wide local excision helps protect against recurrence by removing the bone tumor as well as some healthy tissue around it.

Recovery time will vary depending upon the size of the tumor and the area of the body where it was removed. Because wide local excision removes healthy tissue, it results in a larger wound. Our surgical oncologists work closely with plastic reconstructive surgeons to offer the best possible results both medically and cosmetically.

Limb-Sparing Surgery

We perform limb preservation techniques to spare patients' limbs whenever possible. Limb-sparing surgery for patients with bone sarcoma aims to remove all of the tumor and tissue while preserving appearance or function of the limb. After surgery, a cadaveric bone graft or metal prosthesis may be used to restore or maintain function.

Our surgical oncologists and orthopaedists are experts in limb-sparing techniques and offer the latest advancements and more options for those seeking second opinions.

We partner with the Children’s Hospital of Philadelphia (CHOP) to treat children as well as adults with bone sarcoma. When limb-sparing surgery is performed on children, the surgeon may insert a prosthesis that "grows" with the child. The prosthesis can be extended over time, lengthening the extremity to match the child's healthy arm or leg.

Amputation

At Penn, our specialists do everything possible to save limbs after a cancer diagnosis, but if this is not possible, removal of the limb may be necessary to save an individual's life. Amputation is surgery to remove part or all of a limb, if saving it from the spread of bone cancer isn't an option.

We offer custom prostheses for those who have had a limb amputated. Those who are fitted with a prosthetic limb work closely with our physical therapists to learn to use their prosthesis to perform daily tasks and functions.

Scientists and physicians at Penn's Gait and Biomechanics Laboratory conduct and implement the latest research for the treatment of amputees to ensure the best possible outcome and an improved quality of life.

Other Treatments for Bone Sarcoma

In addition to standard treatments and clinical trials, you may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy. These therapies do not have curative intent, and are designed to complement standard treatments, not take their place.

Integrative Oncology Services

At Penn, our integrative oncology services can supplement traditional cancer treatments such as chemotherapy, surgery and radiation therapy. While conventional medicine plays a critical role in eradicating cancer, integrative medicine and wellness programs offer you ways to enhance the quality of your life, minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.

Our cancer specialists are knowledgeable and supportive of complementary cancer treatments. Our cancer team works with you and your family to integrate these supportive programs into the overall care plan, while ensuring your health and safety.

The Abramson Cancer Center's range of integrative supportive services is designed to help you cope with the cancer experience and improve your overall sense of well-being.

Services include:

Joan Karnell Supportive Services at Pennsylvania Hospital offers an extensive variety of supportive care programs for patients and families, from diagnosis through survivorship. These programs are available at no cost to the patients treated at Pennsylvania Hospital, and some are open to patients treated elsewhere. These services include social work counseling, nutrition counseling, psychological counseling and spiritual counseling.

The Cancer Appetite and Rehabilitation Clinic focuses on patients with loss of appetite and weight.

The Supportive Oncology Clinic helps to manage cancer related symptoms. Integrative support programs include:

Palliative care provides medical and non-medical interventions to ease the symptoms of cancer and its treatment. Palliative care includes physical, emotional and spiritual care that can enhance the quality of life for cancer patients. Palliative care can be used to complement traditional cancer therapies, or can be used when curative therapies are no longer an option to treat symptoms and improve quality of life.

Palliative care is an approach to patient care that can be integrated with curative therapies at any point from diagnosis to survivorship or end of life care. Palliative care services include palliative chemotherapy, radiation therapy and surgery as well as psychological counseling, art therapy and support groups for patients and families.

Penn Home Care and Hospice Services

Penn Medicine offers a full range of “at home” health care services, including specialized therapies and medications, for patients with cancer and cancer-related conditions.