Tumors of bone fall into several categories:
Benign: The tumor cannot spread to other sites. It may or may not cause pain or other local problems. Examples include osteochondromas or enchondromas. These tumors can often be removed, or if they are not causing any problems may be observed over time with serial imaging such as an X-Ray every 6 months.
Benign, Locally Aggressive: These tumors cannot spread to other sites, but can cause bone destruction, pain, fracture, or other bony problems. These tumors also have a higher tendency to come back once removed. These tumors are usually treated with surgery to remove the tumor.
Malignant: This is primary cancer of bone. These tumors are called sarcomas, and can spread to other sites, and can be very aggressive and destructive. Examples of malignant bone sarcomas include osteosarcoma, chondrosarcoma, Ewing Sarcoma, and others. The management of these cancers is complex and requires a multidisciplinary team of medical oncologists, radiation oncologists, surgeons, pathologists, and radiologists, and sometimes others. These tumors are usually treated in centers with experience in treating sarcomas, such as the Kimmel Cancer Center at Jefferson. Individualized treatment plans are made for every patient after multidisciplinary review of each patient's case. Your orthopaedic oncologist will review the exact treatment plan with you, and help guide you through the necessary treatment.
Metastatic Disease: This is the name given for a tumor that came from another site. For instance, if a patient has breast cancer, and the cancer spreads from the breast to the bone, this is called “metastatic breast cancer to bone”. The concern is that when cancer spreads from another site to bone, it can cause pain, but also may increase the risk of a fracture in that area, known as a pathologic fracture. Cancers that commonly spread to bone are Breast, Lung, Prostate, Thyroid, and Kidney cancer, although many other cancers can and do spread to bone as well. Your orthopaedic oncologist works closely with your other physicians in a team approach, including your medical and radiation oncologist, to come up with the best treatment plan to avoid pain and fracture, maintain maximum mobility and function, and limit the amount of downtime between surgery and your medical treatments.
The Orthopaedic Oncology service at The Rothman Orthopaedic Institute and Kimmel Cancer Center are experienced in treating all forms of bone tumors and can recommend the best course of action for each specific case.