Radiation Therapy (or Radiotherapy)

Radiation therapy for bone cancer uses radiation to kill cancer cells and shrink tumors. Radiation may be:

• External radiation therapy—radiation directed at the tumor from a source outside the body
• Internal radiation therapy—radioactive materials placed into the body near the cancer cells

Radiation of Tumor

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Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms, including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body, killing mostly cancer cells, but also some healthy cells. The most common chemotherapy drugs used to treat bone cancer include methotrexate with calcium, leucovorin, doxorubicin, and cisplatin. Ifosfamide and etoposide may also be used.

Surgery

Surgery for bone cancer involves the removal of a cancerous tumor and nearby tissues, and possible nearby lymph nodes. Surgery may require amputation of the limb with cancer. Whenever possible, doctors try to remove the cancerous part of the bone without amputating. In this case, metal plates or a bone graft replace the cancerous tissue that has been removed.

Sometimes, adding radiation therapy or chemotherapy can help avoid the need for amputation. If the tumor is large, aggressive, or the risk of spread is high, chemotherapy and radiation therapy may be added to help prevent a recurrence at the site of surgery, but also prevent spread to distant organs.

Myeloablative Therapy With Stem Cell Support

For cancer that has spread, intense chemotherapy is sometimes given to kill cancer cells. This therapy also destroys the bone marrow. Stem cells, which have the ability to develop into other types of cells, are then given to replace the lost bone marrow.

Special Treatment Considerations for Certain Cancer Types

• Osteosarcoma—Chemotherapy given before and after surgery will often cure osteosarcoma, and can allow for limb-sparing surgery in people who might have otherwise required amputation.
• Ewing’s sarcoma—Since Ewing’s sarcoma is very responsive to chemotherapy, its treatment often involves several weeks of chemotherapy followed by surgical removal or radiation therapy, then several more months of chemotherapy.
• Fibrosarcoma and malignant fibrous histiocytoma—These conditions are usually treated with surgery to remove the cancerous tumor and a one-inch margin of healthy tissue surrounding it.