Surgery

Surgical removal of the tumor and a margin of surrounding healthy tissue is the primary treatment for bone cancer (wide excision). Your doctor may give you chemotherapy to shrink the tumor before surgery and possibly to reduce the risk of the cancer coming back after surgery. Previously, the only treatment option for patients with bone tumors in an arm or leg was amputation (removal of the limb). With new advances in surgical techniques, doctors can usually perform limb-sparing surgery for patients with tumors in these areas. In this procedure, the doctor removes the tumor while saving nearby tendons, nerves, and blood vessels, to allow the patient to retain use of the arm or leg. In some advanced cases where the cancer has invaded these structures, amputation may be the best option. After removing the tumor, the doctor replaces the bone removed with a bone graft from another part of the body or an internal prosthesis.

Chemotherapy

Chemotherapy is the use of drugs to target rapidly growing cells in an effort to eliminate cancer cells. Most of these medications are given through the vein (intravenously). Chemotherapy may be given before and after surgery for bone cancer to decrease the chances of the cancer recurring. Chemotherapy may also be given to patients whose cancer has metastasized (spread) to other parts of the body.

Radiation Therapy

Radiation therapy uses waves of high-energy rays to target and kill cancer cells. Radiation therapy is not usually used as a main treatment for bone cancer, but may be used before or after surgery to kill any remaining cancer cells for certain types of bone cancer. Doctors may also use radiation therapy to treat some patients whose bone cancer cannot be removed with surgery, or to relieve symptoms of the disease in patients with advanced bone cancer.

Proton Therapy

Proton therapy is an advanced type of radiation therapy that uses “protons” rather than X-ray “photons” to deliver radiation to the tumor. In conventional radiotherapy, the photon beams can deposit radiation and damage healthy cells as they pass through the body. Proton therapy deposits most of the radiation directly at the tumor site, resulting in less damage to healthy tissue and maybe used in certain situations where this is beneficial.

• Please see Understanding Proton Therapy to learn more.

Targeted Therapy

Some types of bone cancer cells may have new proteins or changes in normal proteins that can fuel cancer cell growth. Targeted therapy inhibits proteins/markers and prevents them from stimulating the growth of malignant cells.

Clinical Trials

Clinical trials allow patients to try a new treatment before it is available to the general public or to compare different known treatments to determine if they are similar or which is better. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. Immunotherapy, which uses your body’s own defense mechanisms to attack the tumor, is still part of investigation in clinical trials for bone cancer. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.