Bone Cancer Treatment
Bone cancer is primarily treated with surgery but may also include other treatment methods such as chemotherapy, radiation therapy, proton therapy and targeted therapy. A customized treatment plan is developed according to the needs of each patient.
Surgery
Surgery is the main treatment for most bone cancers. Both the biopsy and surgery should be done by a surgeon with extensive experience in these procedures. A biopsy in the wrong location can cause surgical problems and lower your chances of successful treatment.
If at all possible, the same surgeon should perform both the biopsy and surgery. The biopsy will help the surgeon locate the tumor more precisely. The goal of surgery is to remove as much of the cancer as possible. If any cancer cells remain, they may grow and spread. To get as much of the cancer as possible, the surgeon performs a wide-excision surgery. This involves removing the cancer, as well as a margin of healthy tissue around it.
If the tumor is in an arm or leg, the surgeon almost always is able to perform limb-sparing surgery, which removes the cancer cells but allows you to keep full use of your leg or arm. To replace bone that is removed during surgery, a bone graft may be done or an internal device called an endoprosthesis may be implanted.
If this is not possible, an amputation, or removal of the limb, may be performed. Reconstructive surgery and/or a prosthesis will be needed. Rehabilitation is necessary after either procedure.
Chemotherapy
Chemotherapy may be recommended to treat osteosarcoma or Ewing¡¯s sarcoma. In osteosarcoma, it is often given before surgery to shrink the tumor and make it easier to remove, and after surgery to destroy remaining cancer cells. Chemotherapy is also used for bone cancer that has metastasized (spread) to the lungs or other organs.
Radiation Therapy
Bone cancer is not highly sensitive to radiation, so radiation usually is not a treatment. It sometimes may be given if the tumor cannot be operated on or if cancer cells remain after surgery. Radiation may help relieve symptoms if bone cancer returns.
New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
Proton Therapy
Proton therapy delivers high radiation doses directly into the tumor, sparing nearby healthy tissue and vital organs. The Proton Therapy Center at MD Anderson is one of the world¡¯s largest and most advanced centers.
Targeted Therapy
These newer agents are used to help fight some types of bone cancer, including chordoma. Targeted therapies attack cancer cells by using small molecules to block pathways that cells use to survive and multiply.
Learn more about bone cancer:
Learn more about clinical trials for bone cancer.
Chordoma survivor: 'Put your faith in the doctors'
¡°I was very lucky to go to MD Anderson,¡± says Chuck Schlesinger.
In early 2015, Chuck was playing tennis when he felt a sharp pain in his neck. Thinking it was a sports-related injury, he went to a local specialist north of Houston to get it checked out. But X-rays revealed a tumor.
The tumor sat in Chuck¡¯s cervical spine, nestled among the bones of his neck. Given the tumor¡¯s location in the delicate cervical vertebrae, his doctor didn¡¯t believe a biopsy was possible. Instead, the doctor recommended doing a biopsy during a very invasive surgery.
¡°They said they¡¯d have to split my jaw and go through the back of my throat,¡± says Chuck, who was 62 at the time. Then, he would need chemotherapy and radiation therapy.
Chuck thought that procedure sounded extreme. He worried it would leave him disabled and change his life forever.
He called a friend, who told him, ¡°Chuck, you need to get a second opinion at MD Anderson.¡±
Second opinion leads to non-invasive procedure
Chuck soon met with neurosurgeon and spine specialist , who told him MD Anderson could do a biopsy as a quick outpatient procedure.
¡°That¡¯s when they found out it was chordoma,¡± says Chuck. This very rare tumor is diagnosed in only 300 to 600 people a year in the United States.
Instead of an invasive surgery, Tatsui recommended stereotactic radiation (SRS), an outpatient procedure offered at MD Anderson. Doctors use radiation to target the tumor with extreme accuracy, protecting the surrounding tissues. Patients are fitted with a mesh frame to wear during the procedure to help them stay still.
In May 2015, Tatsui and radiation oncologist , performed the SRS procedure at MD Anderson¡¯s Texas Medical Center Campus. ¡°It only took 30 minutes,¡± Chuck remembers.
And, how was his recovery? ¡°I had no aftereffects, no pain,¡± he says. What¡¯s more, Chuck needed only one SRS session. ¡°The radiation was a one-shot deal.¡±
Stabilization surgery improves patient quality of life
For several months, Chuck remained on surveillance. Tatsui sent him for regular MRIs at MD Anderson The Woodlands, close to his home. The MRIs showed the tumor was shrinking.
Six months after Chuck completed SRS, Tatsui suggested a surgical procedure to stabilize his cervical spine. ¡°He felt that the bone might have deteriorated, so he put some pins in it,¡± says Chuck.?
Chuck was a little concerned.
¡°I had never had surgery like that before,¡± he says. ¡°I was a little nervous because he had to go in my neck.¡±
But the procedure was a success. ¡°I didn¡¯t have any pain,¡± Chuck noted. And, with some physical therapy, he maintained normal function.
Immunotherapy at MD Anderson treats tumor
Chuck continued regular MRI surveillance and follow-up appointments with Tatsui every six months, then yearly. Seven years after his radiation treatment, MRIs revealed that the chordoma was growing again.
Tatsui consulted with MD Anderson sarcoma oncologist Conley recommended an immunotherapy drug called pembrolizumab, which trains the immune system to recognize and attack cancer.
¡°Most drugs for chordoma either don¡¯t work or have very limited benefit,¡± says Conley. But Chuck, who has been taking pembrolizumab since the summer of 2022, remains stable.?
He has had nearly two dozen infusions so far. Every six weeks, he receives an infusion at MD Anderson The Woodlands. ¡°It¡¯s very convenient,¡± he says of the location. ¡°They can do bloodwork, MRIs and CT scans.¡± Parking is easy, too, he says: ¡°You drive in, and there¡¯s a space. The parking lot is never full.¡±
The infusion takes 30 minutes. ¡°I¡¯m in and out in two hours,¡± Chuck says. He gets his infusions first thing in the morning and then goes about his day. ¡°I could play tennis the same day, but I don¡¯t!¡± he laughs.
A 10-year relationship with MD Anderson and its people
Every few infusions, Chuck travels to MD Anderson¡¯s Texas Medical Center Campus to meet with Conley. And every four months, he gets an MRI and reviews the results with Tatsui. The results are promising.
¡°We started seeing that the tumor was shrinking,¡± Chuck says. So far, there is no indication of tumor recurrence, and his doctors believe he is stable.
¡°I was very lucky to go to MD Anderson,¡± Chuck says. "If I had gone to another major hospital, my life would be totally changed.¡± He is grateful for MD Anderson¡¯s careful approach to his care. ¡°We¡¯re going on 10 years, and Dr. Tatsui thinks the tumor is inactive. My treatment was literally lifesaving.¡±
The people at MD Anderson make the difference for Chuck. ¡°Everybody is so helpful and friendly,¡± he says. ¡°When I go in for an MRI, they remember the type of music I like.¡±
So, what would he tell another patient? ¡°Put your faith in the doctors. They know what they¡¯re doing, and they care very much about the outcomes.¡±
or call 1-877-632-6789.
Chordoma survivor: How a spine tumor changed my perspective
My life changed forever on the morning of Nov. 6, 2016. I¡¯d felt some pain in my lower back, and decided to go to the emergency room at the hospital where I work as a nurse manager. I thought I would get some fluids for hydration and be sent back home to my husband and two babies. But God had different plans for me.?
Instead of fluids, I had CT and MRI scans of my spine. When the ER physician said, ¡°Ms. Mesa, you have a lesion at L2,¡± I knew immediately that tumor on my spine was cancer. I could see it all over his face.
Why I chose MD Anderson
In that moment, my husband, mom, dad and I shared a look. We knew we would go straight to MD Anderson. For us, there was no option other than the best cancer hospital.
MD Anderson has an exceptional reputation and outcomes, so I didn¡¯t mind making the five-hour drive from my home in Louisiana. I knew it was the right decision, because from the first time I walked through the doors, I was treated like the most important person in the world. In MD Anderson¡¯s Brain and Spine Center, I met my superheroes: neurosurgeon and Laurel Westcarth, his nurse practitioner. They treated me like my life mattered more than anything else.?
My chordoma
After additional testing at MD Anderson, I learned my spine tumor was a chordoma, a very rare type of bone cancer. Thankfully, Dr. Rhines and his team sat with me and answered every question I had. They didn¡¯t rush me, and they explained everything in exquisite detail. Shelly Kennedy, Dr. Rhines¡¯ research nurse, was also a great resource.?
Surgery is usually the first treatment recommended for chordoma, and that was true for me, too. Because my case was complex, I needed a 20-hour surgery that included multiple different procedures and a team of specialists. On Feb. 14, 2017, Dr. Rhines, along with plastic surgeon and thoracic surgeon , removed the entire tumor from my spine in one piece, without spilling any cancer cells. Then, they rebuilt my spine. I have rods, screws, a cage and a bone graft, plus three super-impressive, beautiful scars that I couldn¡¯t be more proud of.
My path to recovery
Dr. Rhines, Laurel and I had a plan for my successful recovery. I promised I would do everything they asked, if they promised me more time with my beautiful babies and husband. I went to physical therapy three days a week for six months, then got back in the gym. Now, a year and a half later, I¡¯m a regular in hot yoga classes and am getting certified to teach group weightlifting classes.?
Survivorship and emotional recovery
I don¡¯t think the magnitude of everything I¡¯d been through really hit me until I was almost fully recovered, about a year after my spine surgery. I was so focused on my physical recovery, I didn¡¯t spend time recovering emotionally. I felt absolutely alone, like no one could understand what I was going through. I¡¯m pain-free now, but I can still feel the effects of surgery, and it¡¯s a daily reminder that I had cancer.?
A different perspective
Everyone told me how proud they were of me and how awesome I¡¯d done in my recovery, but I felt so sad and alone. For them, it was over. But for me, it was just beginning: the constant fear that every twinge was the chordoma returning. That hasn¡¯t completely gone away, but through faith and family support, it¡¯s getting better. Cancer makes us feel like we¡¯re not in control, but we get to decide to make the most of every single day we have.
I still get scared and anxious sometimes, but I also view life differently. I soak up every single minute I have with my family. I relate to my patients completely differently, now that I¡¯ve been a patient, too. And I thank God for every minute I have, for giving me hope and a future, and for bringing me to my superheroes at MD Anderson.??
Request an appointment at?MD Anderson?online?or by calling 1-877-632-6789.
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