Physicians from the Division of Orthopedic Oncology work as part of an integrated team of specialists who provide efficient, coordinated care for people with tumors of the bone or soft tissues. The objective of all treatment is to completely remove the tumor and to kill any tumor cells that may have spread to other locations. This is achieved with a combination of surgery, chemotherapy, and radiation therapy. Some diseases treated within the division are listed below.
BENIGN BONE TUMORS
Benign bone tumors do not metastasize or spread to other areas. Many benign tumors are developmental abnormalities that do not require treatment. Others can be very aggressive and destroy bone quickly.
- Bone-forming tumors: osteoma, osteoid osteoma and osteoblastoma
- Cartilage tumors: chondroblastoma, periosteal chondroma, osteochondroma, enchondroma and chondromyxoid fibroma
- Diaphyseal sclerosis
- Fibrous tumors and conditions: metaphyseal fibrous cortical defect, non-ossifying fibroma, fibrous dysphasia and osteofibrous dysphasia
- Giant cell tumor of bone
- Hemangioma of bone
- Tumor-like conditions of bone: aneurysmal bone cysts, unicameral bone cysts and Langerhans cell granulomatosis
MALIGNANT BONE TUMORS
All malignant bone tumors require treatment. The likelihood of treatment success increases when these tumors are diagnosed and treated early.
- Angiosarcoma of bone
- Ewing's sarcoma
- Lymphoma of bone
- Malignant fibrohistiocytoma (MFH)
- Treatment-associated sarcomas
- All metastatic tumor to bone including but not limited to breast, lung, kidney prostate, thyroid, colon and melanoma
SOFT TISSUE SARCOMAS
Soft tissue sarcomas are very rare. As the name implies, soft tissue sarcomas develop in soft tissues, such as muscle or fat, rather than bone. Most occur in the extremities or pelvic area. There are many types of soft tissue sarcomas, but most are treated in the same way.
- Giant cell tumor of tendon sheath
- Hemangiomas; superficial, deep, intramuscular and intra-articular
- Lipomas; superficial, deep, intra-muscular and inter-muscular
- Pigmented villonodular synovitis (PVNS) of nodular and diffuse forms
- Synovial chondromatosis
- Schwannomas and neuromas of peripheral nerves
- Tumeral calcinosis
Chemotherapy (cancer-killing drugs) is used to treat bone and soft tissue cancer in two ways. Primary chemotherapy is given before surgery to reduce the size of the tumor so that it can be more easily removed. Adjuvant chemotherapy is used after surgery to destroy any cells that may remain or that may have spread to other parts of the body.
Radiotherapy relies on high-energy X-rays to shrink or destroy malignant tumor cells. Cancer affecting the bone usually requires surgery, but not necessarily amputation. The surgeon tries to remove the primary cancer completely. A second goal is to minimize the impact of the surgery on the function and appearance of the affected part of the body. Patients who undergo surgery receive a thorough evaluation by an anesthesiologist prior to surgery. If a patient will benefit from chemotherapy or radiation prior to surgery, medical and radiation oncologists work with the surgeon to coordinate the most appropriate preoperative and postoperative therapy.
Intraoperative radiation and brachytherapy are available if appropriate for the patient. Critical care services, medical subspecialists, and ancillary support for the very latest in postoperative care are available to patients undergoing complex surgical resection and reconstruction.