Understanding Orthopaedic Oncology
Learn about orthopaedic oncology, bone and soft tissue tumours, their symptoms, diagnosis, and advanced treatments that bring hope to patients.
Written by Dr. Md Yusuf Shareef
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 16th Sep, 2025
Introduction
Finding a lump or experiencing persistent bone pain can be an incredibly worrying experience. Your mind might jump to the possibility of cancer. The medical field dedicated to addressing these precise fears is orthopaedic oncology. This specialised branch of medicine focuses on the diagnosis and treatment of tumours that develop in the musculoskeletal system—your bones, muscles, cartilage, ligaments, and connective tissues. The important thing to know is that not all tumours are cancerous. Many are benign and highly treatable. This article will guide you through the world of orthopaedic oncology, explaining the different types of tumours, the key symptoms you shouldn't ignore, and the advanced, life-preserving treatments available today. Our goal is to replace anxiety with understanding and hope.
What is Orthopaedic Oncology?
Orthopaedic oncology is a highly specialised field that deals with both benign (non-cancerous) and malignant (cancerous) tumours of the musculoskeletal system. These specialists are trained to handle the unique challenges these tumours present, which often involve complex surgery to remove the tumour while preserving as much function and limb integrity as possible.
The Role of an Orthopaedic Oncologist
An orthopaedic oncologist is a surgeon with extensive training in cancer care. They don't work in isolation; they are the captains of a multidisciplinary team that includes medical oncologists, radiation oncologists, radiologists, pathologists, and physical therapists. Their role is to accurately diagnose the tumour, determine the best course of treatment, perform intricate surgical procedures, and manage long-term follow-up care to ensure the best possible outcome for the patient.
Benign vs. Malignant Bone Tumours: Knowing the Difference
This is a crucial distinction. Benign tumours are not cancerous. They do not spread to other parts of the body and are rarely life-threatening. They can, however, weaken bone and cause pain or fractures, requiring treatment. Malignant tumours are cancerous. They can grow aggressively, destroy healthy tissue, and metastasise (spread) to other organs. The treatment approach for each is fundamentally different, making an accurate diagnosis from an expert essential.
Common Types of Bone and Soft Tissue Tumours
Tumours are classified based on the type of tissue they originate from.
Primary Malignant Bone Tumours
These cancers start in the bone itself.
- Osteosarcoma: The most common type of primary bone cancer, often occurring in the long bones of the arms and legs of children and young adults.
- Chondrosarcoma: A cancer of cartilage cells, typically found in the pelvis, thigh, and shoulder of older adults.
- Ewing's Sarcoma: A highly aggressive tumour that usually arises in the bones of children and young adults, but can also start in soft tissues.
Benign Bone Tumours
These are far more common than malignant ones.
- Osteochondroma: The most common benign bone tumour, often appearing as a bony protrusion near the growth plate of long bones.
- Giant Cell Tumour of Bone: While benign, it can be locally aggressive, causing significant bone damage and pain, typically around the knees.
- Enchondroma: A cartilage cyst found inside the bone, commonly in the hands and feet.
Soft Tissue Sarcomas
This is a broad category of cancers that develop in soft tissues like muscles, fat, blood vessels, nerves, and tendons. Examples include liposarcoma (fat) and rhabdomyosarcoma (muscle).
Recognising the Symptoms: When to See a Doctor
Early detection is key to successful treatment. While many symptoms can be caused by less serious conditions, it's vital to get them checked out.
The Most Common Red Flags
- Persistent Pain: Pain in a specific bone that gradually becomes constant, is worse at night, and isn't relieved by over-the-counter pain medication.
- Swelling or a Lump: A noticeable mass or area of swelling, which may or may not be painful to the touch.
- Unexplained Fracture: A bone that breaks from a minor injury or fall (called a pathological fracture), indicating the bone was already weakened.
Less Common Symptoms to Be Aware Of
- Limited Range of Motion: If a tumour is near a joint, it can impede movement.
- Unexplained Weight Loss or Fever: These systemic symptoms are more associated with advanced disease.
- Fatigue: General, persistent tiredness.
If you experience persistent bone pain or discover a lump, especially one that is growing, it is crucial to consult a doctor. If symptoms persist beyond two weeks, consult a doctor online with Apollo24|7 for further evaluation and to discuss if you need a specialist referral.
Consult an Oncologist for Personalised Advice
How is a Bone Tumour Diagnosed?
Diagnosis is a multi-step process designed to be as accurate as possible.
The Diagnostic Journey: From Imaging to Biopsy
The process almost always begins with a physical examination and a discussion of medical history, followed by imaging tests.
Imaging Techniques: X-Rays, MRI, and CT Scans
- X-Ray: The first and most common test. It can often reveal the location, size, and some characteristics of the bone abnormality.
- MRI (Magnetic Resonance Imaging): Provides exquisite detail of soft tissues, muscles, and the bone marrow itself. It's excellent for determining the exact extent of the tumour.
- CT (Computed Tomography) Scan: Useful for providing detailed images of the bone structure and for checking if the cancer has spread to the lungs or other organs.
- PET Scan: Sometimes used to stage cancer and see if it has metastasised.
The Gold Standard: The Biopsy
This is the definitive diagnostic test. A small sample of tissue is taken from the tumour and examined under a
microscope by a pathologist. This confirms whether the tumour is benign or malignant, identifies the specific type of cancer, and helps determine its grade (how aggressive it is). It is critical that the biopsy is performed by an orthopaedic oncologist or a surgeon experienced in the staging of musculoskeletal tumours, as an incorrectly done biopsy can complicate future treatment.
Modern Treatment Options in Orthopaedic Oncology
Treatment is highly personalised, depending on the tumour type, size, location, and stage, as well as the patient's age and overall health.
The Multidisciplinary Team Approach
Care is delivered by a team of experts who collaborate to create a comprehensive plan. This often combines surgery with other therapies for the best result.
Limb-Salvage (Limb-Sparing) Surgery
This is a complex procedure where the surgeon removes the cancerous tumour and a margin of healthy tissue around it, while preserving the limb and its functionality. The resulting bone defect is then reconstructed using:
- Metal Prostheses: Custom-made artificial joints and bones.
- Bone Grafts: Bone taken from another part of the patient's body (autograft) or from a donor (allograft).
Over 90% of patients with limb tumours are candidates for this type of surgery today.
Chemotherapy and Radiation Therapy
Chemotherapy: Uses powerful drugs to kill cancer cells. It is often used before surgery (neoadjuvant) to shrink a tumour, making it easier to remove, and after surgery (adjuvant) to destroy any remaining microscopic cells.
Radiation Therapy: Uses high-energy beams to target and kill cancer cells. It is particularly useful for treating soft tissue sarcomas or tumours in locations where surgery is difficult.
When Amputation is Necessary
In some cases, if the tumour is very large, involves major nerves and blood vessels, or recurs after previous treatment, amputation may be the safest option to ensure all cancer is removed. Modern prosthetic technology allows for a very high level of function and mobility post-recovery.
Innovations in Treatment: Targeted Therapy and Immunotherapy
These are newer, more precise treatments. Targeted therapy uses drugs that specifically attack cancer cells based on their genetic mutations, often with fewer side effects than traditional chemo. Immunotherapy helps the patient's own immune system recognise and attack cancer cells. These are areas of active and promising research.
Recovery and Rehabilitation After Treatment
Recovery is a process. After surgery, patients often need physical therapy to regain strength, mobility, and function in the affected limb. The duration and intensity of rehab depend on the procedure performed. The goal is to help the patient return to their daily activities and enjoy a good quality of life. The support of the entire care team, including physical and occupational therapists, is invaluable during this phase.
Living Well: Prognosis and Follow-Up Care
The prognosis for bone and soft tissue cancers has improved dramatically over the past few decades. Survival rates vary widely depending on the specific type and stage of cancer at diagnosis. For example, the 5-year survival rate for localised osteosarcoma is between 60-80%. Long-term, regular follow-up care is essential to monitor for recurrence, manage any long-term side effects of treatment, and support overall health.
Conclusion
A diagnosis of a bone or soft tissue tumour is undoubtedly life-altering, but it is far from hopeless. The field of orthopaedic oncology has made staggering advances, moving from primarily amputative procedures to sophisticated limb-preserving techniques that save lives and limbs. The key is early detection and seeking care from a specialised multidisciplinary team. Understanding your condition, the available sarcoma treatment options, and the recovery process empowers you to be an active participant in your care journey. Remember, behind every diagnosis is a team of dedicated professionals using the latest technology and research to provide the best possible care. If you have concerns, take that first step and talk to a doctor. If your condition does not improve after trying conservative methods, book a physical visit to a doctor with Apollo24|7 to get a proper evaluation and peace of mind.
Consult an Oncologist for Personalised Advice
Consult an Oncologist for Personalised Advice
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Sanchayan Mandal
Oncologist
17 Years • MBBS, DNB Raditherapy, DrNB Medical Oncology
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr.sanchayan Mandal
Oncologist
17 Years • MBBS, DrNB( MEDICAL ONCOLOGY), DNB (RADIOTHERAPY),ECMO. PDCR. ASCO
Kolkata
Dr. Sanchayan Mandal Oncology Clinic, Kolkata
Dr. Gopal Kumar
Head, Neck and Thyroid Cancer Surgeon
15 Years • MBBS, MS , FARHNS ( Seoul, South Korea ), FGOLF ( MSKCC, New York )
Delhi
Apollo Hospitals Indraprastha, Delhi
(25+ Patients)
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Consult an Oncologist for Personalised Advice
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Sanchayan Mandal
Oncologist
17 Years • MBBS, DNB Raditherapy, DrNB Medical Oncology
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr.sanchayan Mandal
Oncologist
17 Years • MBBS, DrNB( MEDICAL ONCOLOGY), DNB (RADIOTHERAPY),ECMO. PDCR. ASCO
Kolkata
Dr. Sanchayan Mandal Oncology Clinic, Kolkata
Dr. Gopal Kumar
Head, Neck and Thyroid Cancer Surgeon
15 Years • MBBS, MS , FARHNS ( Seoul, South Korea ), FGOLF ( MSKCC, New York )
Delhi
Apollo Hospitals Indraprastha, Delhi
(25+ Patients)
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
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Frequently Asked Questions
What is the most common first sign of bone cancer?
The most common first sign is persistent, deep, aching pain in the affected bone. The pain may initially come and go but typically progresses to become constant and is often worse at night.
Can a benign bone tumour turn into cancer?
The vast majority of benign bone tumours do not become cancerous. However, in very rare instances, certain types like osteochondromas have a small potential to transform into a malignant chondrosarcoma, which is why monitoring is sometimes recommended.
How successful is limb salvage surgery?
Limb salvage surgery is highly successful. Studies show that it is as effective as amputation in removing cancer and preventing recurrence. Furthermore, patient satisfaction and functional outcomes are generally very good, allowing individuals to return to an active lifestyle.
Are there any new treatments for osteosarcoma?
Yes, research is ongoing. While chemotherapy and surgery remain the backbone of treatment, new approaches include:
- Mifamurtide: An immunotherapy drug used alongside chemo for some osteosarcoma patients.
- Targeted Therapies: Drugs that target specific genetic abnormalities in cancer cells.
- Clinical Trials: Many patients explore innovative new treatments available through clinical trials.
Is bone cancer curable?
Many bone cancers are curable, especially when they are detected early and haven't spread. The term 'cure' is often replaced with 'long-term remission,' meaning there is no evidence of cancer after treatment. The specific prognosis depends greatly on the type, stage, and location of the cancer.