At City of Hope, our musculoskeletal tumor specialists routinely treat children and adults with rare tumors. Care is provided by surgical oncologists, medical oncologists and radiation oncologists, working together with pathologists, radiologists, rehabilitation experts and others to achieve the best possible outcomes.

Surgery
Surgery is typically required to remove the tumor and surrounding tissue, often including lymph nodes. Each case must be evaluated carefully to ensure that the most effective surgery is chosen for the individual.

Musculoskeletal tumors typically affect the limbs, and in the past, amputation was often required to prevent the disease from spreading to healthy tissue. Today, advanced surgical techniques combined with radiation therapy make it increasingly possible to preserve the limb (“limb-sparing surgery”). Limb-stabilizing devices may also be used to reduce the number of surgical procedures needed and accelerate recovery.

Radiation Therapy
Radiation therapy uses energy beams to destroy cancer cells. Often, radiation is used as an added measure after surgery to destroy any remaining cancer cells. However, radiation can be used before surgery, or it may be the main treatment in some cases. Radiation therapy can also be used to relieve symptoms when a cancer has spread. Types of radiation therapy used to treat musculoskeletal tumors include:

• Helical TomoTherapy TomoTherapy is an advanced radiation therapy system that merges intensity modulated radiation therapy with precision spiral computed tomography scanning.  This allows doctors to deliver the highest dose of radiation in a way that matches the exact shape of the tumor, providing effective treatment while reducing exposure of healthy tissues.
• Brachytherapy In this procedure, tiny pellets of radioactive material smaller than a grain of rice are inserted directly into the cancerous tissue. The radiation attacks the tumor from the inside out.  By directly targeting cancer, brachytherapy minimizes radiation to healthy tissue.

Developmental Cancer Therapeutics
The Developmental Cancer Therapeutics Program focuses on the molecular basis of cancer to develop novel agents that fight cancer more effectively and with fewer side effects. Over the long term, scientists in the program aim to match individual patients with the highly customized therapies for the best clinical outcomes.

Chemotherapy
Chemotherapy, anticancer medicines given by mouth or intravenously, includes a wide range of drugs and treatment strategies to treat musculoskeletal tumors. Depending on the type and stage of disease, chemotherapy may be given as the main treatment or in addition to surgery.

Patients recovering from musculoskeletal tumors benefit from coordinated services offered by different departments at City of Hope, including:

• Rehabilitation services Our team includes professionals in occupational therapy, physical therapy, recreation therapy and speech and language pathology. Orthotics and prosthetic services also are coordinated here.
• Occupational therapy Occupational therapy focuses on restoring skills, teaching adaptive techniques and recommending adaptive equipment necessary in self-care, daily living, homemaking and work-related activities.
• Physical therapy Physical therapy facilitates patient recovery with a focus on mobility, exercise training, reconditioning and other specific therapies. Patients who experience the loss or function of a limb may require braces and prostheses. The City of Hope team includes orthotists and prosthetists who can design appliances that offer maximum function and comfort, and provide training to achieve the best possible outcome.
• Recreation therapy Recreation therapy promotes wellness and improves the quality of life through leisure. Our recreation therapists work to minimize the impact of disease and treatment in the lives of their patients.