​ Musculoskeletal Oncology Services

Through cutting-edge technology and techniques, the UPMC Musculoskeletal Oncology program:

• Focuses on the treatment and research of both cancerous and noncancerous bone and soft tissue tumors.
• Diagnosis and treats bone and soft tissue cancers.
• Provides comprehensive care for hereditary (genetic) and acquired (nongenetic) bone cancers.

Why Choose UPMC for Bone Cancer Treatment?

Our expertise and access to leading-edge research  are just some of the reasons why hundreds of bone cancer patients come to us every year from across the region.

• Of the nearly 6,000 bone cancer operations performed nationwide each year, about 500 take place at UPMC in Pittsburgh, Pa.
• In the area of general orthopaedics, UPMC performs approximately 12,000 surgeries each year.
• And, at our dedicated ortho-oncology laboratory, we’re constantly developing new and better treatments through unprecedented clinical research in such areas as limb salvage procedures and ost eosarcoma.

A Team of Bone Cancer Experts With an Open-door Policy

Our Musculoskeletal Oncology program has dedicated experts in the field of orthopaedic oncology or bone cancer treatment, as well as supporting services that span the entire field of orthopaedics and cancer care.

One of our greatest resources — UPMC Cancer Centers — works closely with the Orthopaedic Surgery Department to offer integrated treatment that combines the expertise of both departments.

To promote the best outcomes possible we have three dedicated orthopaedic oncologists who work hand in hand with a variety of other surgeons and other specialists in a team setting. These can include:

• Microvascular surgeons
• Spine surgeons
• General and colorectal surgeons
• Vascular surgeons

For patients with malignancies, we have access to a complete oncologic team, including chemotherapy and radiation oncology experts. 

All musculoskeletal tumor cases are discussed at our multidisciplinary meeting.Those with sarcomas receive coordinated care through the Sarcoma Specialty Clinic in collaboration with medical and radiation oncology specialists with specific expertise in sarcoma and musculoskeletal neoplasms.

In fact, UPMC is one of only 12 hospitals in the United States that has this kind of dedicated team.

And, with our open-door policy, we see all patients regardless of whether they are referred by another physician.

The UPMC Musculoskeletal Oncology program uses the latest techniques to diagnose and treat cancerous and noncancerous bone and soft tissue tumors.

Pinpointing the Correct Diagnosis as Soon as Possible

The right treatment starts with the right diagnosis, which is why we use advanced imaging technology and techniques to detect and confirm a diagnosis of bone cancer.

Before testing begins, a doctor will ask about symptoms and medical history, and perform a physical exam.

After this exam, your doctor may order one or more of the following diagnostic tests:

• X-ray — this prime diagnostic test uses radiation to take a picture of the inside the body, especially the bones. Frequently, an x-ray is the only type of test needed.
• Bone scan — a radioactive substance is injected into the bloodstream and absorbed by bone tissue. This substance is tracked by the bone scan to look for evidence of bone tumors.
• CT scan — a CT Scan is type of x-ray that uses a computer to make images of organs, including bones, inside the body.
• MRI scan — this test uses magnetic waves to record images of structures inside the body. MRI scanning is the prime diagnostic tests for soft tissue tumors, and can sometimes yield an exact diagnosis.
• Biopsy — in a biopsy, a doctor removes a sample of tissue to test for cancer cells. Whenever possible, our doctors opt for minimally invasive biopsy techniques. These simple procedures are performed under local anesthesia, and most people go home the same day.

A Treatment Plan to Meet Your Specific Needs

Treatment for bone cancer doesn’t always mean surgery.

Once a diagnosis of bone cancer is made, staging tests are performed to find out if the cancer has spread and to what extent.

We then develop a customized treatment plan, depending on the type, stage, and location of the cancer, as well as your overall health.

Treatment options may include:

• Radiation therapy — kills cancer cells and shrinks tumors. Radiation may be external (directed at the tumor from a source outside the body) or internal (radioactive materials are placed inside the body, near the cancer cells).
• Chemotherapy— the use of drugs to kill cancer cells. It is 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.
• Surgery — to remove the cancerous tumor, nearby tissues, and possibly the nearby lymph nodes. Whenever possible, doctors will remove the cancerous part of the bone without amputation, and instead, replace the cancerous tissue using state of the art reconstruction techniques. Adding radiation therapy or chemotherapy can help avoid the need for amputation and may be added to prevent a recurrence or spread of the cancer.

On this page:

• What is bone cancer?
• What are the causes and risk factors of bone cancer?
• What are the general symptoms of bone cancer?
• What is a soft tissue tumor?
• What are the general symptoms of soft tissue tumors?
• What are the different types of bone/supporting tissue cancers?

What is bone cancer?

While many advanced cancers can spread to the bone, the American Cancer Society estimates that primary cancers of bones account for less than 0.2 percent of all cancers. Although relatively rare as compared to some other forms of cancer, bone cancer occurs when cancer cells—cells that divide without control or order—grow in the bone. When cancer cells divide in excess, the body accumulates more cells than are needed. These cells form a mass of tissue called a malignant or cancerous tumor.

There are several types of bone cancers, but all bone cancers fall into two categories:

• Primary: Cancer that starts in the bone.
• Secondary: Cancer that starts in another part of the body and spreads to the bone.

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What are the causes and risk factors of bone cancer?

No one knows the main causes of bone cancer, but we do know that genetics play a major role in most cases. There are also certain risk factors that may increase the likelihood of developing bone cancer, as well as risk factors for specific types of bone cancer. General bone cancer risk factors include:

• Prior history cancer of breast, lung, prostate, kidney, thyroid
• Paget's disease (a noncancerous bone condition)
• Exposure to radiation
• Injury to a bone causing chronic infection
• A family history of bone cancer

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What are the general symptoms of bone cancer?

There are no specific symptoms of bone cancer. Symptoms depend on the location and size of the tumor. However, some symptoms are more common than others. In general, the symptoms of bone cancer may include:

• Pain at the tumor location
• Swelling or a lump at the location of the tumor
• Deep bone pain severe enough to wake you up
• Bone fractures (rarely)

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What is a soft tissue tumor?

Soft tissue tumors occur in the parts of the body that hold us together:  muscles, fat, and connective tissues. Soft tissue tumors can range from harmless things, such as a lipoma or simple fatty tumor, to dangerous diseases such as soft tissue sarcomas (cancers).  These tumors can occur throughout the body, but are most common in the thigh, buttock, abdomen, or calf. 

Treatment of soft tissue tumors depends upon the exact type.

Benign, non-cancerous tumors such as lipomas often require no treatment, or may be simply removed surgically.  Soft tissue sarcomas can be much more aggressive, and generally require surgery.  Radiation therapy or even chemotherapy may be used for some of these tumors.

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What are the general symptoms of soft tissue tumors?

Soft tissue tumors usually present as a lump. This lump may or may not grow over time, but stability over months or years does not automatically guarantee that the tumor is not cancerous.

Counterintuitively, soft tissue tumors that hurt are more frequently not cancerous, and may represent a reaction to trauma or other inflammatory condition.  Soft tissue sarcomas (cancers) rarely cause substantial pain, and instead are simply a painless lump that may or may no t grow.

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What are the different types of bone cancers?

There are several different kinds of bone cancers and cancers of the supporting or soft tissues. Some cancers are more common in children and others may occur later in life.

The main types of bone and soft tissue cancers we treat at the UPMC Musculoskeletal Oncology program are:

• Osteosarcoma
• Ewing’s sarcoma
• Chondrosarcoma
• Soft tissue sarcomas
• Giant cell tumor of bone
• Metastatic bone disease
• Pigmented villonodular synovitis
• Chordoma

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