Treatment of Bone Cancer

The treatment of cancer of the bone, especially metastatic cancer, has two goals: management of the neoplasm and management of the symptoms produced by the local lesion. Prognosis is affected by a patient's age, the size of the primary tumor, grade and stage, degree of lymphatic and blood vessel invasion, the duration of symptoms and the location of the tumor on the arm, leg or trunk.
There are two ways bone metastasis is treated. Systemic therapy, aimed at cancer cells that have spread throughout the body, includes chemotherapy, hormone therapy, and immunotherapy. Local therapy, aimed at killing cancer cells in one specific part of the body, includes radiation therapy and surgery.


Surgery often has to be extensive, with a wide margin of tissue around the tumor being removed. Sarcomas involving muscles require removal of the entire affected muscle group.


Radiation therapy is used to prevent local recurrences of radiosensitive tumors and may be given either before or after surgery.


Chemotherapy - a number of drugs have proven to be effective in treating bone and soft tissue sarcomas. The dosages required to provide a good chance for cure often produce significant side effects. Effective single agents may include doxorubicin (Adriamycin), cyclophosphamide, high-dose methotrexate (with leucovorin rescue), ifosfamide, dacarbazine, vincristine, dactinomycin (Actinomycin D), etoposide and investigational agents. Combinations of these drugs are often used.


Hormone therapy is either the removal of the organs which produce hormones which can promote the growth of certain types of cancer (such as testosterone in males and estrogen in females), or drug therapy to keep the hormones from promoting cancer growth.

Biphosphonates are drugs that can be used to reduce bone pain and slow down bone damage in people who have cancer that has spread to their bones.



Even if a bone or soft tissue sarcoma is appears to be localized and could apparently be completely removed, there is still significant risk that tumor cells too small to detect have already spread to other places in the body. Additional treatment with chemotherapy (adjuvant chemotherapy) attempts to eliminate these tumor deposits.


There are also safe and effective ways to treat pain. Medications can allow people to be free of pain so that they can continue the activities that are important to them.