Bone and Soft Tissue Cancer (Sarcoma) in Children

At Rush Children’s Hospital, we believe in caring for the whole child — and their families — while treating bone and soft tissue cancer (sarcoma).

Pediatric oncologists, orthopedic and spine surgeons, radiation oncologists and other clinicians at Rush use the latest diagnostic, surgical and medical therapies to treat bone cancer in children. Your child’s entire care team — which also includes nurses, child life specialists, social workers, child psychologists and other staff — will help you and your child stay strong and resilient throughout treatment and recovery.

What is Bone Cancer in Children?

Sarcoma in children is rare cancer that begins in children’s bones. Some genetic disorders or past radiation exposure increase a child’s risk of developing bone cancer. Currently, however, physicians and researchers do not know what causes the majority of bone cancers in children.

Types of Bone Cancer in Children

Osteosarcoma

• Forms in the bone and usually begins in areas of bone that are rapidly developing
• Primarily affects children ages 10 to 19 years old
• Occurs most frequently in the knees, but is often found in the upper arm bone, the pelvis, shoulder and jaw

Ewing’s sarcoma

• Usually occurs in children ages 10 to 19 years old 
• Can affect any bone but occurs most frequently in the pelvis, thighs, lower legs, upper arms or ribs

Symptoms of Bone Cancer in Children

The most common symptom of bone cancer in children is pain in the bone. Other symptoms include the following:

• Swelling or tenderness of a joint or bone
• Lump on a joint or bone
• Difficulty moving normally
• Weak bones, resulting in fractures
• Fever, weight loss or fatigue

Make an appointment with your child’s pediatrician if your child complains of pain in their bones, or is having any other symptoms of bone cancer.

Care for Bone Cancer in Children at Rush

Diagnosis

Diagnostic tests: Imaging tests, such as an MRI or CT scan, may be used to identify or confirm bone cancer. Your child needs to be still during these tests, which can be challenging depending on their age and personality. Your child’s clinician may recommend sedating them for the test.

Diagnostic surgery and biopsy: Depending on your child’s condition, their care team at Rush may recommend surgery to remove all or part of the tumor to help determine your child’s diagnosis. 

Treatments

Your child’s care team will work closely with you, your child and each other to tailor a treatment plan for your child.

Treatment plans are based on these three factors:

• Your child’s age
• The type and location of the cancer
• How advanced the cancer is

Your child’s doctors may recommend one or more of the following treatments:

Surgery: Your child will likely need surgery to remove the cancer from the bone. Pediatric orthopedic surgeons at Rush perform surgery to preserve the affected limb whenever possible. They often use implants in children that lengthen as young people grow. That means your child likely will not need additional surgeries as they grow.

Chemotherapy and other drug therapies: Your child will need chemotherapy before or after surgery to kill any remaining cancer cells and prevent them from spreading. In addition, Your child’s care team may also recommend these drug therapies:

• Targeted therapy: When molecular mutations are identified in bone cancer, your child’s pediatric oncologist may recommend drugs that specifically attack those mutations. These therapies tend to cause few side effects because the drugs do not affect noncancerous cells.
• Immunotherapy: These drugs help your child’s immune system attack bone cancer cells.

Radiation therapy: Your child may need radiation as a part of their treatment plan. To limit the side effects of radiation in children, radiation oncologists at Rush determine how to use the lowest possible amount of radiation to target cancer cells, while leaving healthy tissue unharmed.

Rehabilitation: Sarcomas can sometimes cause physical disabilities and challenges, including the need for prosthetic limbs. Our onsite prosthetic clinic and pediatric rehabilitative medicine specialists at Rush will work with your child to help them learn to function and thrive despite physical limitations.

Alternative and complementary therapies: Your child can receive counseling, massage therapy, acupuncture, nutritional counseling and other supportive therapies from Rush’s Cancer Integrative Medicine Program.

Palliative care: Pediatric palliative care specialists offer an additional layer of care and support to your child as they undergo treatment for bone cancer. Palliative care focuses on improving your child’s quality of life, managing pain and providing emotional support for your child and your family.

Pediatric psychosocial services: Licensed pediatric clinical psychologists and social workers are an integral part of your child’s care team at Rush. They will work with your family to address the social and emotional challenges you are facing as your child goes through cancer treatment.

Long-term Monitoring and Support

Your child’s care team will follow your child through adulthood to quickly identify and address any cancer recurrence.

With coordinated medical, rehabilitation and psychosocial care, Rush provides a comprehensive continuum of care for other health, physical and developmental problems that are sometimes associated with bone cancer. 

Rush also provides comprehensive, multidisciplinary care for adults with bone cancer.

Rush Excellence in Sarcoma Care for Kids

• Multidisciplinary care: Your child’s care team will include a team of experts who specialize in treating bone cancer in children. The team may include pediatric oncologists, orthopedic surgeons, radiation oncologists, physical medicine and rehabilitation doctors, palliative care specialists, pediatric psychologists and others. They will work with you, your child and each other to create a personalized care plan for your child.
• Dedication to limb preservation: Pediatric sarcoma specialists at Rush University Children’s Hospital work with specialists in the Rush Center for Limb Preservation to save children’s limbs that are affected by sarcoma. They use advanced techniques and latest technologies — including bone implants that can lengthen as your child grows — to avoid the need for amputation whenever possible.
• Access to clinical trials: As a member of the Children’s Oncology Group (COG), Rush offers our patients opportunities to enroll in National Cancer Institute-backed clinical trials of new treatments for bone cancers in children.
• Kid-friendly care: We know that kids don’t stop being kids when they develop bone cancer. Child and teen life specialists at Rush will make sure that your child gets time to play, hang out, study and socialize — whether in their cheerfully designed patient room or in our activity center and lounges filled with toys, books and games. Additionally, our social workers, cases managers and finance specialists are dedicated to supporting patients and families at every point of treatment.