Tests, Treatments & Therapies for Bone Cancer at the University of Colorado Cancer Center

At the University of Colorado Cancer Center, we use the most minimally invasive approach possible for both diagnosis and treatment of bone cancer. We recognize that both work-up and management requires a multidisciplinary approach with numerous specialists working closely together.

We use both standard treatments and those being tested in clinical trials. You might consider participating in a trial, which are designed to improve current treatments or get information on new treatments. If a new treatment is proven better than the standard treatment, the new treatment may become the standard treatment.

Staging and Detection Tests

Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:

• Different types of scans
• Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)

Scans and other tests may also be used:

• In a “surveillance program” looking for any signs of relapse after treatment
• In a “screening program” to detect cancer early in individuals at high-risk
• To monitor responses to treatment

Tests that may be used include:

Blood test – An analysis of a sample of blood to help diagnose a disease. The doctor may suggest a blood test to determine the level of an enzyme called alkaline phosphatase. Sometimes it can indicate that disease or a tumor is present.

Biopsy – The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.

Types of scans and procedures include:

Angiogram – An X-ray of blood vessels. The patient is injected with dye to outline the vessels on an X-ray.

Bone scan – A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and collects in the bones, enabling them to be shown on the scanner.

CT scan (computed tomography) – An X-ray procedure that creates detailed, highly accurate cross-sectional body images.

PET scan (positron emission tomography) – An imaging test used to light up cancer in different parts of the body. You get an injection of a short-lived radioactive substance before having the scan. Cancerous tissue will build up more of the substance and appear brighter than normal tissue on the PET images. Other non-cancerous tissues, such as areas of inflammation, can also sometimes “light up.”

Magnetic Resonance Imaging (MRI) – An imaging technique that provides detailed images of body structures. It uses a radio waves and a powerful magnet linked to a computer. These pictures can show the differences between normal and diseased tissues. It is especially useful in showing the inside of bones.

X-ray – A type of high-energy radiation used to diagnose diseases by making pictures of the inside of the body. They can show the location, size and shape of a bone tumor. If X-rays suggest a tumor, the doctor may order other imaging studies like bone scans, CT scans, MRIs or an angiogram.

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Treatment & Therapy for Bone Cancers

The following treatments may be used alone or in combination to treat bone cancer.

Surgery

Surgery is usually the main treatment for primary bone cancer. The surgery can be:

Limb-sparing – in which the tumor is removed and the bone is reinforced with metal plates and screws, cement or allograft (donor bone).

Amputation – in which the entire involved part of the limb is removed and replaced with an artificial part called a prosthesis. Amputation is used in more advanced cases when no other options are available. In some cases, an allograft is used to replace the bone.

A musculoskeletal orthopedic oncologist – a doctor who specializes in diagnosing bone and soft tissue cancer and removing it through surgery-will perform an operation to remove the tumor and other areas that are affected by cancer.

Radiation Therapy (“Radiotherapy”):

Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:

• Kill cancer cells
• Prevent cancer cells from developing or recurring
• Improve many of the symptoms caused by cancer

Radiation therapy can be:

• Used before surgery to make the operation easier (this is called “neoadjuvant” treatment)
• Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”)
• Almost as effective as surgery in people who are not fit enough for an operation
• Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”)

Chemotherapy and other drug-based treatments:

Anti-cancer drug treatments: Chemotherapy-and new “targeted therapies”-involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed.

View current bone cancer clinical trials available at UCCC.

Anti-cancer drug treatments may involve:

• Single drugs or combinations of drugs
• Intravenous injections or tablets/capsules
• Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
• Taking some drugs every day or only on a few days within the cycles
• Taking other medicines to reduce or eliminate side effects associated with chemotherapy
• Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
• Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials

Chemotherapy and targeted therapies can:

• Be given before surgery to make the operation easier
• Be given in combination with radiotherapy to make both treatments more effective
• Be given after surgery to reduce the chances of cancer coming back
• Successfully control advanced cancer and many cancer-related symptoms

Embolization

All tumors need a rich supply of blood to grow. Embolization is a procedure that closes one or more blood vessels. After the procedure, the tumor may shrink or its growth may slow. Sometimes embolization is combined with chemotherapy.

Clinical Trials

The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:

• New drugs
• New combinations of therapies
• New treatment delivery methods

Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center-one of only 39 in the United States-your treatment will always include the latest and most comprehensive care options.

Learn more about clinical trials at UCCC.

Other types of treatments being tested in clinical trials include:

Biologic therapy (biotherapy or immunotherapy)  – A treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct or restore the body’s natural defenses against cancer.