Duke’s sarcoma specialists are nationally recognized for their diagnosis and treatment of sarcomas, rare cancers that occur in bones and soft tissues. Our experts offer the latest treatment options available today, preserve healthy tissue and bone, and perform comprehensive limb-sparing surgeries to avoid the need for amputation. We help you improve your chances for a positive outcome.
Expert care for bone cancer and all forms of sarcoma
There are two main types of sarcoma. Malignant tumors that occur in the bones are called osteosarcomas, bone sarcomas or bone cancers. Malignant tumors that occur in soft tissue — including fat, muscle, nerves, blood vessels, joints and other tissue — have many different names but are generally known as soft tissue sarcomas. Receiving your care at a medical center with the level of expertise we offer is crucial because sarcomas are rare cancers, representing only one percent of all adult cancer cases. And, because there are more than 50 types of sarcoma, it can be difficult to identify the type and appropriate treatment.
We have the expertise to identify the type of sarcoma you are experiencing. We offer you the latest treatments available today for these rare cancers, including high-dose radiation that specifically targets your soft tissue sarcoma or bone cancer, limb-sparing surgeries and advanced imaging technology that pinpoints the location of your tumor and helps us distinguish it from healthy tissue. We give you access to every possibility and minimize your chances of undergoing an amputation.
Chose Duke for your sarcoma treatment because we offer:
- National reputation. We are one of the top cancer programs in the nation, according to U.S. News & World Report, and one of the largest referral centers in the Southeast. We are a National Cancer Institute-designated Comprehensive Cancer Center, and are part of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers dedicated to improving care for our patients. We are also part of the Sarcoma Alliance for Research through Collaboration, a group of leading sarcoma centers in the U.S. dedicated to improving the care of sarcoma patients through research and clinical trials.
- Fast access to our treatment experts. You meet with a radiation oncologist, medical oncologist and orthopaedic surgeon, all in the same day. You leave your visit with a thorough understanding of your treatment options, and with a comprehensive treatment plan in place. In addition, our specialists in soft tissue and bone sarcoma meet regularly to discuss your care, and to make sure your treatment plan is the best it can be.
- Comprehensive sarcoma team. Your medical team specializes in diagnosing and treating soft tissue sarcoma and bone cancer. Patients who undergo rotationplasty, which removes diseased knee joints but preserves healthy ankle joints or, in rare instances, amputation also have access to our team of prosthetists and physical therapists.
- Limb-sparing approach. We are known for our expertise in treatments that preserve limbs threatened by cancer. Only a few decades ago, most patients with a soft tissue or bone sarcoma in their arms and legs had to face amputation. Today, our surgical team specializes in many alternatives to amputation.
- Computer-navigated cancer surgery. Our operating rooms are equipped with intraoperative CT and MRI imaging technology that helps us carefully plan for surgery and precisely remove your tumor. Deeply rooted soft tissue and bone sarcomas can be challenging to remove completely, especially while trying to separate these tumors from important nerves and blood vessels that must remain unharmed. This technology allows our surgeons to identify your cancer and operate under the guidance of high-resolution, 3-D images.
- Clinical trial access. You may be eligible to participate in clinical trials for sarcoma, which gives you access to new therapies before they are available elsewhere. One of our ongoing trials is testing a novel technique, developed in part by a Duke researcher. This approach uses fluorescent probes to light up a tumor so surgeons can find and remove your cancer, helping preserve more healthy muscle, bone, nerves and blood vessels than ever before.
- Comparative oncology program. Our doctors and researchers believe that we may never fully understand rare cancers like sarcoma if we only study humans. That’s why we have a team researching how sarcoma behaves in animals. Our research team includes Dr. William Eward, who is both an orthopaedic oncologist and a small animal veterinarian.
SARCOMA AND BONE CANCER
Medication that kills cancer cells or stops them from growing and is used to treat many types of sarcoma. We consider factors such as your specific diagnosis and anticipated risks versus benefits before recommending chemotherapy as part of your personalized treatment plan.
High energy radiation beams target tumors to kill or halt the growth of cancer cells. May be recommended before surgery or after to reduce the chances of cancer returning. Whether we use radiation depends on the type of sarcoma you have, its location and size. We use the following types of radiation to effectively target these rare cancers and spare as much healthy tissue as possible:
- Highly focused radiation therapy. Advanced imaging technology is used to focus radiation beams directly onto your tumor. May include 3-D conformal radiation therapy and intensity modulated radiation therapy (IMRT).
- Intraoperative radiotherapy. A computer-controlled robot delivers rice grain-sized bits of radioactive material to a tumor site during surgery to reduce damage to normal tissue and organs. Duke is one of only a handful of cancer centers nationwide with this technology.
- Brachytherapy. Delivers high doses of radiation to targeted areas from inside your body using a long, thin, flexible tube called a catheter. This form of radiation can prevent tumors from recurring after surgical removal.
Our goal is to preserve as much function possible. We excel at limb- and organ-sparing procedures, including:
- Wide local excision. Removes your tumor and a section of normal tissue around it to make sure we don’t leave any cancer cells behind.
- Advanced bone and joint reconstruction. We can replace bones damaged by cancer with a customized artificial joint for the hip, knee, shoulder or elbow.
- Vascularized bone grafting. Duke surgeons pioneered this procedure, which replaces a diseased bone with a healthy bone and blood vessels from your own body – typically your fibula. We perform more of these procedures than most hospitals around the world, giving us exceptional experience and precise results.
- Rotationplasty. This advanced limb-sparing surgery removes diseased knee joints but preserves healthy ankle joints. Our surgeons avoid amputation above the knee by re-attaching your ankle and foot to your thigh. That way, you can be fitted with a custom prosthesis that allows your ankle to function as if it were your new knee joint. You retain a wide range of movement and control. Many patients come to Duke specifically for this procedure.
- Amputation. Removing all or part of an arm or leg is a last resort for our surgical team. We explore all other treatment options before recommending amputation.
SARCOMA AND BONE CANCER
An MRI or CT scan — which produce high-resolution, detailed images — help us pinpoint the location of your tumor. A chest X-ray can help us determine if your cancer has spread to your lungs.
Takes a tissue sample to evaluate for cancer using a small incision. We use ultrasound- or CT scan-guided biopsy to guide us to the right location in your body.
A radioactive tracer injected into your bloodstream collects in your bones and helps a camera detect areas affected by cancer.