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Bone cancer treatments

Cancer Education

The Bone and Soft Tissue Tumour Service offers a range of Bone cancer treatments including surgery, radiotherapy, and chemotherapy. 

Surgery 

The Bone and Soft Tissue Tumour Service supplies a comprehensive range of surgeries. We perform surgeries that aim to cure disease or relieve symptoms. Sometimes we decide not to perform surgery if it's not the best option.  

Usually, we ‘resect’ new tumours after neoadjuvant therapy. For soft tissue sarcomas, we give radiation therapy before surgery. For certain types of bone tumours, we give chemotherapy before surgery. 

The principles of surgery include: 

  1. Ensuring adequate and proper investigation including biopsy before surgery

  2. Ensuring that we give multidisciplinary expert consideration before surgery

  3. Ensuring adequate oncologic surgical margins

  4. Including the biopsy track en bloc with tumour specimen where possible

  5. Limb sparing surgery where possible

  6. Early involvement of plastic surgical team for soft tissue reconstructions

  7. Experts in sarcoma surgery should always do surgery

We classify sarcomas by location. Each of these need different surgical considerations. We have specific surgical teams within the sarcoma service. These teams may undertake resections related to these sites: 

  1. Trunk wall, pelvis and limbs 

  2. Retroperitoneum and abdomen 

  3. Head and neck

The timing of surgery follows specific guidelines: 

  1. We perform surgery for soft tissue sarcomas four to six weeks after radiotherapy. Under special circumstances, you may need radiotherapy after surgery. We may start this after your surgical wound has healed. We try to make this between four weeks after surgery and six weeks before (about one and a half months)

  2. Some bone sarcomas need chemotherapy.  We usually perform surgery for these two weeks after a predetermined chemotherapy cycle. We also wait until blood indices allow such surgery. We do so only after consultation with the medical oncology team

St. Vincent’s Hospital and our sarcoma service deliver supervision of surgical care. Find out more about surgery.

We offer Isolated Limb Perfusion surgery for advanced limb sarcomas. We are Australia's only institution to do so. Find out more about Isolated Limb Perfusion.

Radiation oncology 

Our qualified sarcoma radiation oncologists supply radiotherapy. 

Our team delivers radiotherapy services by ultramodern resources. Our treatment protocols are evidence-based and comply by international guidelines. We publish them in the Quality Management System (QMS) and review them yearly. We deliver all treatments according to the documented QMS guidelines. 

The weekly radiotherapy QA meeting reviews all new radiotherapy treatment plans. This takes place before we start treatment. The following will attend this meeting: 

  • The treating clinician 

  • At least two other radiation oncologists 

  • A radiation therapist

The radiotherapy QA meetings also reviews radiotherapy charts of all patients on treatment. The radiation oncology nurse reviews all patients. They perform this review in the first week of treatment. 

We document treatment related toxicity weekly. These are on standardised toxicity templates. 

Find out more about radiation therapy.

We encourage patients to take part in clinical trials. Visit our sarcoma clinical trials page for more information.

Medical oncology 

We can consider chemotherapy either as:  

  • Systemic adjuvant treatment. The goal of this is to treat microscopic disease at the time of first presentation 

  • A complement to local treatment by surgery or radiation. In this setting, the goal of chemotherapy is to ‘downstage’ the tumour. This improves the chances of surgery or radiation controlling the disease. Tumours may shrink after pre-operative chemotherapy (chemotherapy treatment before surgery). Such shrinkage may also supply important prognostic information. This information enables informed treatment decisions after the completion of local treatment

Our qualified sarcoma medical oncologists will recommend and supervise chemotherapy. We base treatment protocols on evidence and abide by international guidelines. We deliver all treatments according to the documented QMS guidelines. 

We review new chemotherapy treatment plans at the weekly chemotherapy Quality Assurance meeting. This review takes place before we start treatment. The following will attend this meeting: 

  • The treating clinician  

  • At least two other medical oncologists

A paediatric medical oncologist is sometimes also involved. They supervise chemotherapy treatment plan development for adolescents and young adults.  

Find out more about chemotherapy. 

Related pages

Cancer Council

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