Childhood Osteosarcoma Treatment
Our osteosarcoma treatments
If your child is diagnosed with osteosarcoma, the doctor will discuss the best treatment options. This depends on several factors, including the size and location of the cancer, if it has spread, and your child’s age and general health.
Osteosarcoma usually is treated with a combination of therapies that may include surgery, chemotherapy and radiation. Surgery is almost always part of treatment.
The experts at Children’s Cancer hospital will customize a course of treatment especially for your child’s needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.
Surgery
At Children’s Cancer Hospital, our specialized orthopedic surgeons are often able to avoid amputation when osteosarcoma is in an arm or leg. Complex limb-sparing surgery removes the tumor, but saves the tendons, nerves and blood vessels. Bone is replaced with a bone graft or an internal prosthesis, similar to an artificial joint.
Like all surgeries, osteosarcoma surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. MD Anderson surgeons are among the most skilled and recognized in the world. They among the few surgeons in the world who specialize in pediatric sarcoma treatment, and they use the least-invasive and most advanced methods.
Whenever possible, the biopsy and surgical treatment should be planned together.
Chemotherapy
Osteosarcoma chemotherapy treatment is usually given before (neoadjuvant chemotherapy) and after surgery (adjuvant chemotherapy).
Children’s Cancer Hospital offers the most up-to-date and advanced chemotherapy options.
Radiation therapy
Radiation therapy (also called radiotherapy) uses high-energy beams to destroy cancer cells. Osteosarcoma cells do not respond well to radiation, so it is not a main part of treatment for most cases. It may be used if the tumor cannot be completely removed by surgery or to help control symptoms.
If radiation is needed, new radiation therapy techniques allow Children’s Cancer Hospital doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
Children’s Cancer Hospital provides leading-edge radiation treatments, including 3D-conformal radiation therapy and intensity-modulated radiotherapy (IMRT), which are tailored to the specific shape of the tumor.
Proton therapy
The Proton Therapy Center at MD Anderson is one of the world’s largest and most advanced centers. It’s the only proton therapy facility in the country located within a comprehensive cancer center. This means this cutting-edge therapy is backed by all the expertise and compassionate care for which MD Anderson is famous.
Proton therapy delivers high radiation doses directly into the tumor, sparing nearby healthy tissue and vital organs. For many patients, this results in better cancer control with less impact on the body.
Radioactive drugs (radiopharmaceuticals)
Targeted therapies
Children’s Cancer Hospital is leading into the future of cancer treatment by developing innovative targeted therapies. These agents are specially designed to treat each cancer’s specific genetic/molecular profile to help the body fight the disease. Many of the doctors who treat osteosarcoma, or bone cancer, at Children’s Cancer Hospital are dedicated researchers who have pioneered and actively lead national and international clinical trials with novel targeted agents.
Our treatment approach
Osteosarcoma, or bone cancer, is rare, and most oncologists have little experience treating it. Children’s Cancer Hospital physicians treat a high number of patients with osteosarcoma, which translates to a remarkable level of skill and expertise. This has earned us the reputation of being one of the best osteosarcoma treatment centers in the country.
Since osteosarcoma usually requires multiple treatments, a comprehensive, personalized team approach is crucial. At the Children’s Cancer Hospital, your child is the focus of a multidisciplinary group of specialized physicians, including surgeons, oncologists, radiation oncologists and pathologists, who are with your child throughout treatment. They are supported by highly trained rehabilitation specialists, therapists, nurses and other health care professionals who work together to ensure your child receives the best care.
Advanced expertise
In most osteosarcoma cases, very small areas of cancer have spread to other parts of the body. They are called micrometastases. These areas usually do not show up in imaging tests. For that reason, chemotherapy, which travels to all parts of the body, is almost always the first treatment for osteosarcoma. Chemotherapy is almost always given after surgery as well.
Osteosarcoma treatment almost always includes surgery. Children’s Cancer Hospital surgeons are among the most skilled in the nation. They use the most up-to-date techniques and technologies, including limb-sparing surgeries, so most patients can avoid the loss of an arm or leg. If limb-sparing surgery is not an option, Children’s Cancer Hospital offers the most advanced prostheses, with specialized pediatric rehabilitation services.
Groundbreaking research
Many children with osteosarcoma are treated with innovative agents through clinical trials. The Children’s Cancer Hospital participates in Children’s Oncology Group protocols, as well as other clinical trials available at only a few hospitals in the nation.
Learn more about childhood osteosarcoma:
Orthopedic oncologist passionate about helping patients regain mobility
Valerae Lewis, M.D., always knew she wanted to be a doctor. Math and science fascinated her. She liked working with her hands. As a child, she already had her career planned out.
“I was going to be a doctor Monday through Friday, a carpenter at my workshop on Saturday and, on Sunday, I would own a gas station, so that I could wipe down all the drivers’ car windows,” Lewis recalls with a laugh.
Today, she may not be a carpenter or own a gas station, but Lewis is living out her doctor dreams as chair of MD Anderson’s Department of Orthopaedic Oncology.
Road to becoming an orthopedic oncologist
With a father who was an internal medicine doctor and a mother with a master’s degree in education, Lewis and her two older sisters learned the value of education early.
“As a child, I remember working in my dad’s doctor’s office, though I probably hindered more than I actually helped!” she says. “My dad always emphasized the importance of education, and he ended every conversation with ‘study hard and get good grades.’”
That she did. When it was time to select a college, Lewis weighed acceptances to both Harvard and Yale. She ultimately decided to attend Yale.
“My mom’s wish was to have one of her daughters go to Harvard, so I promised her I would attend Harvard after I graduated from Yale,” says Lewis.
A few years later, Lewis made good on her promise when she enrolled in Harvard Medical School.
“I wanted to be a surgeon because I really liked working with my hands,” she says. “To me, surgery was like fixing something, and that gave me immediate gratification.”
She fell in love with orthopedics at Harvard.
“I had two mentors in medical school, and they were both orthopedic oncologists,” she says. “They made orthopedic oncology exciting. As an orthopedic oncologist, you operate anywhere in the body, and no operation is ever the same. You are always challenged because a tumor changes the anatomy of the body.”
Lewis also liked the camaraderie she experienced with the orthopedic surgeons.
“Doctors often go into their specialty because they like the people in that specialty,” she says. “I felt like the orthopedic surgeons were very team-oriented. We always supported each other.”
A leader in orthopedic surgery
At MD Anderson, Lewis is an orthopedic oncology surgeon with specific expertise in limb salvage and pelvic sarcoma surgery in adult and pediatric cancer patients. Lewis is part of a small number of Black female orthopedic surgeons in the United States. She is also the first Black woman to chair an orthopedic surgery department in the United States.
“I encourage anyone who’s interested to consider pursuing orthopedic surgery as a profession," Lewis says.” It is truly rewarding.”
Making sure patients have a voice
In the operating room, Lewis leads a team of surgeons performing complex surgeries.
“I really love and respect the anatomy of the human body,” she says. “The resilience of the human body is unbelievable. I like being challenged in the operating room. That really drives me.”
Challenging operations could include anything from a rotationplasty on a 10-year-old osteosarcoma patient to a hemipelvectomy on a 17-year-old Ewing’s sarcoma patient.
“One of the mottos in our department is ‘We keep kids running,’” says Lewis. “Getting rid of the cancer is always the first goal. But the reconstruction and getting patients – child or adult – back to participating in the activities they enjoy is incredibly important. It helps with prognosis and longevity of life. If we can get you back up and moving, you’re definitely going to do better.”
And Lewis makes sure every patient has a say in what their surgical treatment looks like.
“Before surgery, we talk to the patient about their life and expectations,” says Lewis. “With younger kids, I encourage them to tell me how they feel because they have to be comfortable with their decision, whether that’s amputation, a rotationplasty, limb salvage, prosthesis or something else. I present the options and explain the pros and cons of each. Then we work together to decide the best option.”
A fulfilling purpose
For more than 20 years, Lewis has been helping MD Anderson patients with cancers of the bone and soft tissue get back to walking, running, jumping and being active.
“I love my patients and the relationships we develop,” she says. “There are patients I worked with decades ago who I’ve watched grow up. I’m always happy to hear about their families, watch them graduate high school and college, get married and have children of their own.”
Lewis is excited about sarcoma research and other advances that will help MD Anderson better treat patients with cancer of the bone and soft tissue.
“3D modeling and 3D printing are examples of exciting new tools,” says Lewis. “They not only guide us in the operating room, but they help patients better understand their tumor.”
Lewis started MD Anderson’s Multidisciplinary Pelvic Sarcoma Program in 2011. Through this program, she has been critically evaluating the oncologic and functional outcomes of pelvic sarcoma surgery.
“I like that we’ve been performing these procedures long enough that we can evaluate what we do and how we do it,” she says. “For example, with hemipelvectomies where we remove part of a patient’s pelvis, one option is to reconstruct with custom 3D prosthesis. Another approach is to reconstruct without a metal prosthesis, using only soft tissue. By critically evaluating our approach and outcomes, we have shown that both approaches can provide a patient with the ability to ambulate and perform their daily activities – even some sports. In some cases, we're going back to what we used to do years ago, but with better technique.”
While the most enjoyable part of Lewis’ job is being in the operating room, the most fulfilling part of her job is seeing patients get better.
“Seeing patients at two years out, five years out and then discharging them from clinic at 10 years – that’s the best,” she says. “I love seeing them reach those milestones. I always tell patients that my goal is to get them old.”
Request an appointment at MD Anderson online or call 1-877-632-6789.
Childhood cancer caregiver is passionate about serving our children
When it comes to MD Anderson’s pediatric cancer patients, Tomika Gamble is the agent of fun.
As program director for pediatric support programs, Gamble handles camps, prom and other special events for some of the hospital’s youngest patients and their families.
“I like to say I’m responsible for putting smiles on the faces of many,” says Gamble.
Part of that is because of the unique aspect of the programming, which serves the entire family. For example, Gamble’s team hosts a three-party prom where patients, their caregivers and siblings can all take part in exciting activities.
“I’ve had dads run up to me after events and say, ‘Y’all are amazing,’” she says. “Sometimes the kids are in tears when they get back into their parents’ cars after camp because they enjoyed themselves so much and don’t want to leave.”
A son's childhood cancer diagnosis
The old adage, ‘If you do what you love, it doesn’t feel like work,’ rings true for Gamble.
“I probably have the most enjoyable job at MD Anderson,” she says. “My goal is to give our pediatric patients a sense of normalcy.”
Gamble knows firsthand how much that’s needed.
When her oldest son, Isaiah, was diagnosed with a rare form of lung cancer at age 3, she was pregnant with her second son.
“It was a very difficult time for our family,” recalls Gamble, who had previously lost her grandmother to salivary gland cancer and her aunt to pancreatic cancer.
At the time, Gamble was doing public relations for a local school district, and her husband was a coach in another local school district.
“We received so much support from our community,” she says. “Our community taught us the importance of giving, so once my son’s treatments were done, it then became: ‘How can we give back?’”
Passion and purpose come together
Gamble started a nonprofit to support children facing life-threatening medical conditions, which gave her the opportunity to work on events with MD Anderson. When she applied for and ultimately accepted a role at MD Anderson managing pediatric support programs in 2018, it was a dream come true.
“I had wanted to work at MD Anderson for a long time, but I didn’t know where I fit in,” says Gamble. “It was a blessing to watch it come full circle – my son’s cancer diagnosis and my experience in PR and special events helped me take on the responsibilities of my role and really connect with the families we serve.”
Gamble’s family also volunteers with MD Anderson’s programs. Isaiah, now 17, is a summer camp counselor at Camp Star Trails where children ages 6 to 14 can attend. They have the opportunity to begin training to be counselors starting at age 16. Isaiah has also participated in MD Anderson’s Boot Walk to End Cancer®.
“At MD Anderson, I know I’m doing the work that God placed me on this earth to do,” says Gamble. “When you find that passion and that purpose, it’s the most amazing feeling ever.”
Request an appointment at MD Anderson online or call 1-877-632-6789.