orthopaedic oncology

Orthopedic cancers are uncommon and start in the bone, muscle or soft connective tissue anywhere in the body. They are rare — 3,000 new bone cancer patients and 11,000 new soft tissue sarcoma patients each year — and can affect children, teens and adults, though some types are more common at certain ages.

These cancers are called sarcomas and they behave differently from the more common forms of cancer referred to as carcinoma. Common bone sarcomas include osteosarcoma, chondrosarcoma and Ewing’s sarcoma. Common soft tissue sarcomas include malignant fibrous histiocytoma, liposarcoma, leiomyosarcoma, and synovial sarcoma. Overall, there are close to 100 different forms or subtypes of bone and soft tissue sarcoma.

Sarcomas represent less than one percent of all cancers and require complex treatment to ensure the best possible outcome. That’s why the best care comes from teams of highly experienced doctors at major cancer centers like Washington Cancer Institute.

Our orthopedic oncology specialists are experts at limb-sparing procedures, saving an arm or leg while removing the cancer, reducing the need for amputation. Our physicians routinely treat multiple types of sarcomas, malignant tumors that begin in the bones or soft tissue, such as muscles, fat or nerves. Complex and revision bone cancer surgeries are often referred to us from other medical centers around the world.

The Sarcoma Program, located at the Washington Cancer Institute, along with colleagues at the Lombardi Comprehensive Cancer Center, offers care to a wide variety of patients. Combining the strengths of these two prestigious institutions, we provide the best possible care.

Our team provides musculoskeletal surgical consultations to the National Institutes of Health and the surgery and pediatric oncology branches of the National Cancer Institute, as well as Children’s National Medical Center.

Our doctors are conducting clinical research in many areas of sarcoma treatment, as well as in supportive care. That means access to promising clinical trials not always available elsewhere.

Our pathologists focus on musculoskeletal disease — an unusual specialty — and our radiologists focus on orthopedics. They are joined by other specialists at regular meetings called tumor boards to discuss new patients and create comprehensive, individualized treatment plans.

Our experts also provide care for many types of cancers that may have started elsewhere in the body too, but that have spread to the bone or soft tissues.

Bone Cancer Symptoms

Sarcomas may not cause any symptoms when they begin to develop, but over time patients may experience:

  • Pain in a bone or joint (the most common symptom)
  • Swelling or a lump
  • Unexplained bone break
  • Fever
  • Fatigue
  • Unexplained weight loss

Bone Cancer Risks

Among those who develop bone cancer, 95 percent do not have any obvious risk factors. Bone cancers occur more frequently in children and young adults, particularly those who have had radiation therapy or chemotherapy for other conditions. Bone cancers that appear in young people may also be associated with the rapid growth of bones that occurs during puberty.

A small number of bone cancers are due to heredity. For example, children with hereditary retinoblastoma (an uncommon cancer of the eye) are at a higher risk of developing osteosarcoma. Another hereditary condition that may increase bone cancer risk is Li-Fraumeni syndrome, a disorder caused by a mutation in the p53 tumor suppressor gene. This syndrome predisposes people to cancers of the breast and brain, osteosarcoma, and other types of sarcoma. Patients with neurofibromatosis are also at increased risk of sarcomas arising from the nervous system.

Adults with Paget’s disease, a noncancerous condition characterized by abnormal development of new bone cells, may be at increased risk for osteosarcoma. Bones affected by Paget’s disease are heavier and thicker, yet weaker than normal bones, and more likely to fracture.

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