Advanced multidisciplinary care for patients with musculoskeletal tumors
Musculoskeletal tumors are tumors that form in bone and soft tissues such as fat, muscle, blood vessels and nerves. These tumors vary from benign lumps to life-threatening rare cancers called sarcomas, with treatment ranging from simple observation to combinations of surgery, chemotherapy, and radiation therapy.
Collaborative care approach
At the Musculoskeletal Tumor Center at Lankenau Medical Center outside of Philadelphia, specialists work together on behalf of each patient, bringing together specialists in orthopedic surgical oncology, pathology, radiology, medical and radiation oncology, and other disciplines relevant to the optimal management of challenging musculoskeletal tumors. Every step in the care process—from evaluation through ongoing follow-up—involves close collaboration among specialists to ensure the best-possible outcomes. All patient cases also are reviewed at regular multidisciplinary musculoskeletal tumor conferences.
Diagnosis of musculoskeletal tumors
The diagnosis of musculoskeletal tumors requires a comprehensive evaluation that begins with a detailed medical history and physical examination.
If a tumor is suspected, the first step is imaging studies. For a possible bone tumor, the first test often is an X-ray; if an abnormality is seen, a magnetic resonance imaging (MRI) scan is done to get a detailed picture of the abnormality and the area around it. When a soft tissue tumor is suspected, an MRI scan is the best choice for getting a good look at the area of the problem.
If MRI studies raise concern about a cancerous tumor, additional imaging studies are done to determine if and how far the tumor has spread locally or to distant sites in the body. This step provides important information needed to plan the best treatment for a cancerous tumor (staging).
If there is any question about the type of tumor, the final step is to obtain a piece of the tumor (biopsy) for examination under a microscope and other testing (pathology studies) needed to confirm a precise diagnosis. These steps are crucial if the tumor is a bone or soft tissue sarcoma.
Given the variable nature of musculoskeletal tumors, precise diagnosis and appropriately tailored treatment are crucial. Even sarcomas—the most challenging of these tumors—can be curable with proper treatment provided by a team of specialists experienced in managing rare and difficult bone and soft tissue tumors. This advanced level of care is available at the Musculoskeletal Tumor Center at Lankenau Medical Center.
The Musculoskeletal Tumor Center specializes in the evaluation, diagnosis, and treatment of musculoskeletal tumors of the limbs and pelvis, with a focus on aggressive or destructive benign tumors, sarcomas, and metastatic cancer of bone. Advanced treatments include:
- Limb-sparing and reconstructive surgery
- Tailored multimodality therapy for sarcomas
- Image-guided thermal ablation of tumors
- Surgical procedures to prevent fractures to bones weakened by cancer
Treatment of benign tumors: Some non-aggressive (“well behaved”) benign tumors can be watched. Aggressive benign tumors usually need to be treated. Most benign bone and soft tissue tumors can be cured by surgically removing the tumor.
Treatment of sarcomas: Sarcomas are challenging tumors that typically require surgery combined with chemotherapy and/or radiation therapy. It is particularly important to tailor treatment for sarcomas, as each of these tumor types responds differently to various methods of treatment.
For example, although osteosarcoma and chondrosarcoma are both bone sarcomas, chondrosarcoma generally does not respond to chemotherapy, whereas chemotherapy is a major component of curative treatment for osteosarcoma.
Research shows that soft tissue sarcomas also vary in their response to different treatments. This variability depends on the specific sub-type and growth pattern of the tumor. Although surgery remains the main form of treatment, specialized pathology tests now allow tumors to be classified as more or less sensitive to chemotherapy and radiation therapy. If a sarcoma has invaded neighboring tissue or has spread to distant sites, the treatment combination usually is different or more intense than if a sarcoma is small and confined to the bone or soft tissue in which it formed.