Musculoskeletal Tumor Program
Contact Musculoskeletal Tumor Program
A Multidisciplinary Approach to Diagnosis, Treatment and Research
The Musculoskeletal Tumor Program at Children’s Health℠ offers comprehensive, multidisciplinary treatment of patients with benign and malignant bone and soft tissue tumors. The program, part of the nationally recognized Pauline Allen Gill Center for Cancer and Blood Disorders, provides children, adolescents, and young adults with musculoskeletal tumors, expert care based on vast experience and ongoing depth of research.
Our team of specialists and subspecialists, led by Patrick Leavey, M.D., Director of the Musculoskeletal Tumor Program at Children’s Health and Professor of Pediatrics at UT Southwestern, develops treatment plans for newly diagnosed patients and patients in relapse. Our team also provides expert second opinions to physicians and families for patients whose complex care merits consultation and review.
Based on referral characteristics, patients will be evaluated initially by an orthopedic oncology surgeon or a pediatric oncologist. Patients with benign lesions will primarily be treated in the orthopedic oncology clinic at Children’s Health, while patients with malignant disease will be primarily treated in the Gill Center at Children’s Health.
Why Children's Health℠?
The Musculoskeletal Tumor Program at Children’s Health is unrivaled in North Texas. We provide expert comprehensive care to patients with the most challenging conditions. We offer the latest treatments and access to groundbreaking clinical trials assessing novel targeted therapies for musculoskeletal tumors. Our affiliation with the UT Southwestern Harold C. Simmons Comprehensive Cancer Center, allows us to be part of the only NCI-designated Cancer Center in North Texas.
Evidence-based diagnosis and treatment are provided by an integrated team focused on your child’s condition and needs. Our clinicians design treatment plans that are tailored to your child specifically, by sequencing the genetic composition of tumors and collaborating in the clinical, tumor board and laboratory settings.
Conditions We Treat
We deliver best-in-class, evidence-based care to children with benign and malignant musculoskeletal tumors. A musculoskeletal tumor is classified as an uncontrolled growth of tissue, or abnormal solid mass, arising in the bones or soft tissues. These growths, which predominantly occur in younger children, are considered benign or malignant. A benign tumor does not spread to distant sites in the body, but remains in its primary growth site. While not necessarily harmful to health, a benign tumor can have adverse effects if it presses on surrounding nerves or blood vessels. A malignant tumor is considered cancerous because it can metastasize, or spread, to another location in the body, either by entering the blood stream or through the lymphatic system of the body. We specialize in, and are referred to, for musculoskeletal tumors including, but not limited to:
- Aneurysmal and unicameral bone cysts
- Non-ossifying fibroma
Malignant musculoskeletal tumors
General Treatment Plans
All patients receive individualized treatment for their specific cancer, but there are standard techniques that can be implemented depending on the patient’s age, tumor size or previous treatment.
Chemotherapy drugs and clinical trials: Chemotherapy and other medicines play a key role in the treatment of patients with musculoskeletal tumors. Chemotherapy drugs, often used in combinations, systemically destroy cancer cells in the body. These medications are administered in regular rounds, or cycles, with intervals of rest for normal cells to recover from the drugs’ effects. Depending on the treatment plan, chemotherapy drugs can be used either to shrink a tumor mass before radiation and surgery or to destroy any remaining cancerous cells after radiation and surgery. Our treatment methods balance the use of established medications with emerging approaches, either in early-stage or late-stage clinical trials. Learn more about our current clinical trials and about our Experimental Therapeutics Program.
Radiation therapy: While radiation use depends on the type of cancer, our radiation oncologists offer next-generation techniques and delivery systems to safely and effectively treat bone cancer and soft tissue sarcoma. We have access to the latest treatment modalities, including but not limited to: intensive-modulated radiation therapy (IMRT) and proton beam therapy. Radiation therapy involves the use of high-energy radiation to damage the DNA of cancerous cell. Radiation is typically administered after surgery to kill any remaining cancer cells or as an alternative when surgery is not possible.
Surgery: Almost all osteosarcomas and most Ewing tumors can be surgically removed. Chemotherapy, radiation therapy, and surgery combined have the ability to effectively control, destroy, and remove the tumor mass for good. Physical removal of the tumor by surgery is a critical component of bone and soft-tissue cancer treatment when possible. In order to fully remove the cancer, the surgeons take out the tumor mass as well as some surrounding healthy tissue that may contain cancerous cells. There are three broad types of surgical procedures performed for cancerous bone tumors:
- Limb-sparing surgery: If our doctors recommend the removal of a cancerous tumor in the arm or leg, our surgeons are able to spare the affected limb for the vast majority of patients. The surgically removed area is replaced with bone from a bone bank or a special metal insert called an endoprosthesis.
- Amputation: In the rare case that limb-sparing surgery is not an option, our team will recommend a partial or complete removal of the limb, so that patients may have better motor function and fewer complications.
- Minimally invasive procedures for benign tumors: Depending on the type of tumor, our surgeons can either scrape the mass out of the bone in a procedure called curettage, or destroy the mass with a needle and electricity in a procedure called radio frequency ablation.
Rehabilitation: Treating a cancerous bone or soft tissue tumor with these therapies can affect limb function. In the case that amputation is necessary, we work with Texas Scottish Rite Hospital for Children and the UT Southwestern Prosthetics Orthotics Department for advanced prosthetic care. In all cases, the experienced physical and occupational therapists at Children’s Health make sure your child’s recovery is as successful as possible.
Patrick Leavey, M.D., Director of the MSKT Program is leading a multi-site study to develop a brand new way to measure response to chemotherapy for patients with osteosarcoma. To do this he is leading a team made-up of computer scientists from the University of Texas at Dallas, and investigators in pathology, radiology and the Analytical Imaging and Modeling Center at Children’s Health and UT Southwestern. Together, the team is creating an image pattern recognition software and patient-specific tumor models to more efficiently determine treatment response and to refine a patient’s treatment plan.
Dr. Leavey is also the study chair and lead investigator for the recently completed international study within the Children’s Oncology Group for patients with newly diagnosed non-metastatic Ewing's sarcoma.
Stephen Skapek, M.D., is leading a multi-investigator sarcoma research project to sequence the genetic composition of sarcoma in order to personalize a patient’s treatment options.
Ted Laetsch, M.D., is working with Rajiv Chopra, M.D. in the Advanced Imaging Research Center, to develop a novel technology called MR-HIFU for the treatment of sarcomas and other relapsed pediatric solid tumors. Built into an MRI scanner, this high intensity, highly focused technology heats tumors without damaging the surrounding tissue. This can be targeted at cells carrying chemotherapy to tumors, speeding up the delivery and, researchers hope, the treatment. Researchers hope this technique will treat tumors more effectively and in a non-invasive way.
James Amatruda, M.D. is leading a multidisciplinary group of investigators whose goal is to build innovative collaborations for more effective treatment of Ewing's sarcoma. Dr. Amatruda, a pioneer in the development of zebrafish genetic models of Ewing's sarcoma, is using these models to study how a normal cell becomes a Ewing's sarcoma cell and to identify new drugs for treatment of the disease.