Sarcoma

Osteosarcoma, Chondrosarcoma and Ewing Sarcoma

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Duke’s sarcoma specialists are nationally recognized for their diagnosis and treatment of sarcomas. The team of medical, radiation, surgical oncologists, and others is experienced in treating all types of rare sarcomas and offers the latest treatment options to preserve healthy tissue and bone, including comprehensive limb-sparing surgeries to avoid the need for amputation. We help you improve your chances for a positive outcome.

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About Sarcoma

Sarcomas are rare benign or malignant tumors that affect bone, muscle, fat, and other connective tissues in the body.

The most common sarcomas of bone include osteosarcoma, chondrosarcoma, and Ewing sarcoma.
The most common sarcomas of soft tissue include undifferentiated pleomorphic sarcoma, leiomyosarcoma, and liposarcoma.

While there are many different types of sarcomas, the disease typically appears in two ways: a growing mass or bone pain. See your doctor if you find a lump anywhere on your body that grows and causes pain.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Diagnosing Sarcoma

Multiple tests may be performed to determine the type of sarcoma, its location, and stage.

Imaging Tests

An MRI or CT scan produces high-resolution, detailed images that help us pinpoint the location of your tumor. A chest X-ray or CT scan can help determine if cancer has spread to your lungs.

Needle Biopsy

A tissue sample is removed through a small incision, then evaluated for cancer. Biopsies may be performed in the clinic. We use ultrasound- or CT-scan-guided biopsy to guide us to the right location in your body for masses that cannot be biopsied in the clinic.

Bone Scan

A radioactive tracer injected into your bloodstream collects in your bones and helps a camera detect areas affected by cancer.

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Sarcoma Treatments

After sarcoma is diagnosed, it is graded on a scale of one (lowest) to three (highest) based on how fast it could spread. Our doctors will determine your treatment based on the grade. Many sarcoma treatments include a combination of systemic therapy, radiation therapy, and surgery.

Systemic Therapy

Systemic therapy includes traditional chemotherapy, immunotherapy, and targeted therapies. Chemotherapy kills cancer cells or stops them from growing and is used to treat some types of sarcomas, including most sarcomas of bone. Most soft tissue sarcomas that have not spread to other parts of your body can be treated without chemotherapy. Our oncologists consider your specific diagnosis, anticipated risks and benefits, and other factors before recommending systemic therapy as part of your personalized treatment plan.

Radiation Therapy

Radiation therapy kills or slows the growth of cancer cells by targeting tumors with high-energy radiation beams. It may be recommended before or after surgery to reduce the chances of cancer returning. Your type of sarcoma, its location, and its size indicates whether and what type of radiation therapy may be recommended as part of your treatment plan. Radiation therapy may be performed before or after surgery.

Intraoperative Radiotherapy
A machine delivers targeted radiation to a surgical site after a tumor is removed. This kind of precision reduces potential damage to surrounding tissue and organs at the former site of the tumor.
Brachytherapy
Using a long, thin, flexible catheter, a "seed" is implanted inside your body to deliver doses of radiation therapy to a targeted area. This form of radiation can prevent tumors from recurring after surgical removal.

Your radiation oncologist will discuss a radiation plan with you if that's best for your condition.

Related Treatments and Services

Wide Local Resection

Surgeons remove cancerous cells and a small section of healthy tissue around the tumor to make sure no sarcoma is left behind. In some cases, additional steps may be needed to reconstruct bone that’s removed to make sure you experience optimal recovery.

Advanced Bone and Joint Reconstruction

Replaces bones damaged by cancer with a customized artificial joint for the hip, knee, shoulder, or elbow. Titanium 3-D printed reconstruction may be recommended as part of your personalized treatment plan.

Vascularized Bone Grafting

Replaces a diseased bone with healthy bone and blood vessels from your own body. A new, healthy bone is typically grafted from a piece taken from your fibula, the smaller of two bones in your calf.

Rotationplasty

Our surgeons can amputate above the knee and re-attach your ankle and foot to your thigh to replace your removed, diseased knee joint. You may work with our physical therapists and prosthetists to learn to use a custom prosthetic leg to restore your ability to walk with the function of a below-knee amputation instead of an above-knee amputation.

Amputation

We will explore all treatment options before recommending amputation, which removes all or part of an arm or leg to make sure your cancer is gone.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Why Choose Duke

The Duke Cancer Institute
The Duke Cancer Institute brings together the extensive resources of Duke University, Duke Health, and the Duke Comprehensive Cancer Center. We are committed to making innovative discoveries, developing new ways to prevent, diagnose, and treat cancer, and delivering those therapies in a patient- and family-centric way.

Experienced Sarcoma Center
As a National Cancer Institute-designated Comprehensive Cancer Center, we offer a level of expertise found only in the top cancer centers across the country. We are also part of the Sarcoma Alliance for Research through Collaboration, a group of leading U.S. sarcoma centers dedicated to improving the care of sarcoma patients through research and clinical trials.

Convenient Care
You meet with a radiation oncologist, medical oncologist, and orthopaedic surgeon, all on the same day. You leave your visit with a thorough understanding of your treatment options, and with a comprehensive treatment plan in place.

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, 3D images.

Support for You and Your Family
Our comprehensive support services range from helping to minimize the side effects of cancer treatment to coping with the emotional and psychological effects of diagnosis and treatment. View all of our cancer support groups in our event calendar.

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.

This page was medically reviewed on 01/19/2023 by

Brian E. Brigman, MD, PhD | Orthopaedic Surgical Oncologist