Bone Sarcomas

Harold C. Simmons Comprehensive Cancer Center

At UT Southwestern Medical Center, our specialists provide expert care for bone sarcomas, rare cancers that start in the bones. We offer advanced diagnosis and the latest treatment options.

As the only National Cancer Institute (NCI)-designated Comprehensive Cancer Center in North Texas, we provide access to the latest diagnostic tools and treatments available. NCI designation means that we offer the broadest possible range of clinical trials, giving patients access to potential therapies not available at other facilities.

Harold C. Simmons Comprehensive Cancer Center

Cancer Care at the Highest Level. Anywhere.

Our team of hundreds of leading cancer physicians and oncology-trained support staff is a trusted partner in returning patients with cancer to good health.

Learn More

Bone cancer, knee joint, giant cell tumor of bone, osteosarcoma

What Are Bone Sarcomas?

Bone sarcomas are a group of uncommon cancers that begin in the bone. They develop when cells in the bone grow out of control and form a tumor. Some of these tumors become malignant (cancerous) and spread to other parts of the body (typically the lungs). In other cases, these bone tumors are benign (noncancerous) but still may require treatment.

Bone sarcomas are primary bone cancers, meaning they start growing in the bone rather than elsewhere in the body. Primary bone cancer is less common than metastatic bone cancer, or bone metastasis. This is cancer that spreads (metastasizes) to the bone from other areas, such as the breast, prostate, or lung.

Bone sarcomas can occur in people of all ages. Some types are more common in children, teenagers, and young adults, while others occur more often in older adults. They most frequently develop in the long bones of the arms and legs or in the pelvis, though they can grow in any bone.

Because bone sarcomas are rare, it’s important to seek care from a specialized team that has expertise in diagnosing and treating these cancers. Research shows that patients have better outcomes and live longer when they are treated at a multidisciplinary center that sees a high volume of bone sarcoma patients.

Why Choose UT Southwestern for Bone Sarcoma Care?

UT Southwestern is one of the nation’s leading centers for sarcoma care. At the Harold C. Simmons Comprehensive Cancer Center, patients with bone sarcomas benefit from:

Multidisciplinary expertise: Our bone sarcoma team includes cancer specialists with advanced training in orthopedic surgery, radiation therapy, medical oncology, and other specialties.
Collaborative care: Specialists from surgery, medical oncology, pathology, radiation oncology, and radiology meet regularly to review each case and design the most effective treatment plan.
The latest cancer treatments: We offer limb-sparing surgery, targeted therapies, advanced radiation therapy, and access to promising new treatments through clinical trials.
Comprehensive support: Patients and families have access to nurse navigators, physical therapists, genetic counseling, and supportive care services.
Research-driven innovation: As part of an academic medical center, we bring the latest research discoveries into patient care, advancing bone sarcoma treatment for future generations.

What Are the Symptoms of Bone Sarcomas?

Symptoms vary depending on the location and size of the tumor. They may include:

Persistent bone pain (often worse at night or with activity)
Swelling or a lump over the affected area of bone
Limited movement in a nearby joint
Bone fractures with minimal or no injury
Fatigue or weight loss (less common)

Because these symptoms can also happen with less serious conditions, it’s important to see a doctor if they worsen over time or don’t go away.

What Are the Types of Bone Sarcomas?

There are many types of bone sarcomas. The most common types are:

Osteosarcoma: The most common type of bone sarcoma, osteosarcoma usually starts in the long bones of the arms and legs. It most often occurs in young people between ages 10 and 30.
Chondrosarcoma: This bone sarcoma is more common in adults over age 40. It begins in cartilage, a tough, flexible tissue that lines joints and gives structure to the nose, ears, larynx, and other parts of the body. Most chondrosarcomas grow in the pelvis, legs, and arms.
Ewing sarcoma: This type usually grows in bones of the pelvis, chest wall (such as the ribs or shoulder blades), spine, and legs. It most often develops in children, teens, and young adults.
Giant cell tumor of bone: This type of bone sarcoma usually develops in the legs near the knee or hip and in the arms near the shoulder or wrist. It’s most common in people between ages 20 and 40.
Other rare types: These bone sarcomas include chordoma, malignant fibrous histiocytoma, and fibrosarcoma of bone.

How Is Bone Sarcoma Diagnosed?

Accurate diagnosis is crucial for planning the most effective treatment. At UT Southwestern, we use advanced imaging and lab tests to evaluate bones and diagnose sarcomas. Tests may include:

X-ray: Often the first test, an X-ray can show abnormal areas in bone that may be cancerous.
Magnetic resonance imaging (MRI): These scans use powerful magnets and radio waves to create detailed pictures of the bone and surrounding soft tissues, helping doctors see the extent of the tumor.
Computed tomography (CT) scans: CT scans combine X-rays taken from multiple angles to provide cross-sectional images. This imaging can show whether the cancer has spread to other areas, such as the lungs.
Positron-emission tomography (PET) scans: We inject a radioactive sugar into a vein, and cancer cells absorb large amounts of the sugar because they grow faster than other cells. A special camera takes images that highlight areas of rapid cell growth, which may be cancer.
Bone scan: We inject a dye into a vein, which travels to the bones. A special camera that picks up the dye creates images of the skeleton. Areas with active bone changes attract the dye, appearing as hot spots in the images.
Biopsy: We take a small sample of tumor tissue using a needle (in most cases) or a minor surgical procedure. Our experts examine the tissue sample under a microscope to confirm a diagnosis and identify the sarcoma type.
Blood tests: After a confirmed diagnosis, we may take a small blood sample to check the levels of specific substances. These tests can help determine the stage of a bone sarcoma, such as whether it has spread.

How Is Bone Sarcoma Treated?

At UT Southwestern, our experts personalize treatment for each patient with bone sarcoma. Our approach is based on the type of sarcoma, its size and location, whether it has spread, and the patient’s age and overall health. Most people benefit from a combination of therapies:

Surgery: This is the main treatment for most bone sarcomas. Whenever possible, our surgeons use limb-sparing techniques that remove the tumor while preserving the arm or leg. Rarely, patients may need amputation (removal of part or all of a limb) if the tumor is very large or involves critical structures. After surgery, we perform reconstructive surgery using bone grafts or prosthetic implants to restore function.
Radiation therapy: We use high-energy radiation beams to shrink tumors before surgery or to destroy remaining cancer cells after surgery. Advanced technologies enable doctors to deliver radiation precisely to the tumor while limiting damage to nearby healthy tissues. Radiation can be the main treatment for sarcomas that cannot be completely removed with surgery.
Chemotherapy: These medications destroy cancer cells throughout the body. Patients sometimes receive chemotherapy before surgery (neoadjuvant chemotherapy) to shrink tumors or after surgery (adjuvant chemotherapy) to destroy any remaining cancer cells. Chemotherapy is especially important in treating osteosarcoma and Ewing sarcoma.
Targeted therapy: These medicines attack specific genes, proteins, or pathways that help cancer grow. Targeted treatments may be an option for certain rare bone sarcomas.
Immunotherapy: This type of treatment helps the body’s immune system recognize and attack cancer cells. It may be an option for certain types of bone sarcomas.
Interventional radiology ablation: This minimally invasive procedure uses image-guided techniques to destroy cancer cells with extreme heat or cold. It can help control pain, reduce tumor size, or treat areas that cannot be removed surgically.

What Support Services for Bone Sarcoma Does UT Southwestern Offer?

Cancer care and life after treatment can be challenging, and support services can help. Our specially trained staff meets with patients and their loved ones during and after treatment. We provide support and information for patients at every stage of bone sarcoma.

Cancer supportive care at UT Southwestern includes:

Cancer psychology: Meet with a licensed clinical psychologist who is specially trained to help cancer patients.
EMBRACE Survivorship: EMBRACE is a half-day survivorship symposium designed to assist patients and their families with physical, emotional, and practical issues that can arise during the cancer journey.
Integrative therapies: Activities such as guided imagery, meditation, and expressive writing aim to improve patients’ well-being and quality of life during and after cancer treatment.
Oncology nutrition: Our dietitians help patients make informed food choices that are best for their health at various stages of cancer treatment and beyond.
Oncology rehabilitation: Cancer rehabilitation specialists help patients and survivors maintain or return to their optimal function and quality of life.
Oncology social work: Social workers trained to work with cancer patients are available to assist with any challenges faced during or after treatment.
Spiritual support: Our chaplains offer interfaith support for patients and their families and caregivers.
Support groups and classes: Meeting with others in similar situations can be helpful and cathartic.

What Clinical Trials Are Available for Bone Sarcomas?

As a leading academic medical center, UT Southwestern offers patients access to innovative new therapies that are not widely available elsewhere. Clinical trials give patients additional treatment options when standard therapies are not enough.

UT Southwestern and Children’s Health, an affiliated pediatric health system, offer several clinical trials for adults and children who have bone sarcomas. Current and upcoming clinical trials are studying targeted therapies, immunotherapy, surgery, and other treatments for patients at all stages of bone sarcoma, including metastatic disease.

Search for current clinical trials.