Overview

The Division of Orthopedic Oncology at Mayo Clinic offers highly specialized care for people of all ages (infants to adults) with benign (noncancerous) and malignant (cancerous) bone and soft tissue tumors at Mayo Clinic.

Why contact Orthopedic Oncology?

Orthopedic oncologists at Mayo Clinic in Arizona, Florida and Minnesota offer specialized expertise that uniquely combines large surgical volumes for even some of the rarest tumors with cutting-edge technology.

  • Experience and surgical volume. Mayo Clinic evaluates one of the largest numbers of patients with bone and soft tissue tumors nationally or internationally, including some of the rarest tumors. This results in an immense level of experience in these issues.
  • Evidence based. Mayo Clinic orthopedic oncologists are intimately involved in research that translates directly into current patient care.
  • Individualized. Each patient coming to Mayo Clinic is unique. Our resources allow us to provide individualized care tailored to each person's need.
  • Cutting-edge technology. From mixed reality and robotics to point-of-care 3D printing of tumors, orthopedic oncologists are at the forefront of technology and innovation.
  • Multidisciplinary advantages. When you come to Mayo Clinic for your bone or soft tissue tumor evaluation, many other specialties collaborate as needed to assess your overall health, review imaging studies, and provide the best possible pain control and anesthesia techniques when surgery is needed.
  • Implant design. Our experts are intimately involved in the design of implants and instruments used for various orthopedic tumor procedures.
  • Expertise in rare cancers. Sarcoma is a very rare type of cancer that makes up less than 1% of all cancers diagnosed in the U.S. every year. The orthopedic oncologists at Mayo Clinic diagnose and treat hundreds of patients each year with this type of rare cancer, giving them unique expertise in the condition.

A team approach to care for the whole person

Mayo Clinic orthopedic oncologists use an integrated practice model that coordinates care across multiple specialties and subspecialties. This team approach provides a thorough evaluation with well-rounded treatment recommendations for each person.

You'll receive a comprehensive consultation that includes evaluation by multiple specialists to assess any related or peripheral concerns before we determine the best treatment approach for your specific condition. Your team will recommend a treatment plan that's specific to your individual tumor and other medical needs.

During your consultation you'll meet with an orthopedic oncologist and others based on your specific tumor. You also may complete diagnostic or imaging studies such as X-ray, CT scan, MRI and PET-CT. Other teams commonly involved in your care include medical oncology and radiation oncology.

Mayo Clinic's advanced approach to sarcoma care

If you have been diagnosed with a sarcoma or have a concerning lump, bump or mass, Mayo Clinic is ideal for you:

  • Multidisciplinary tumor treatment. The objective of all treatment is to completely remove the tumor and to kill any tumor cells that may have spread to other locations. This typically involves radiation (high-energy beams to destroy cancer cells) and surgery (to remove the cancer), and it sometimes involves chemotherapy (cancer-killing drugs). Our surgeons work with radiation oncologists and medical oncologists to make personalized treatment plans for each person.
  • Prompt evaluation and communication. For patients with cancer, waiting to hear about results and next steps can be very difficult. Our surgeons prioritize getting testing (images, biopsies, labs) done as quickly as possible — often the same day or week — and communicating results and next steps promptly.
  • Advanced imaging. Cutting-edge imaging is crucial to diagnose and treat sarcoma. Our surgeons have quick access to any type of imaging that might be needed, including MRI and PET-CT imaging. Our radiologists have specialized expertise in reviewing images for tumors and can also review images done outside of Mayo Clinic.
  • Tumor board. Multiple experts in sarcoma treatment (surgeons, medical oncologists, radiation oncologists, radiologists, pathologists and others) meet regularly to discuss challenging cases and come up with appropriate treatment plans.
  • Proton beam. When radiation is recommended to treat a sarcoma, Mayo Clinic radiation oncologists will consider treatment with the most advanced radiation technologies, including proton beam therapy.
  • Limb-sparing surgery. Most sarcomas in the arms, legs, and pelvis or hip can be removed without an amputation.
  • Onco-regeneration. Our surgeons prioritize not just preserving limbs but keeping the limb looking and functioning as normally as possible after the cancer is removed. Onco-regeneration often includes working with plastic surgeons who are experts in:
    • Wound closure.
    • Free functional muscle transfers to restore the function of a muscle that had to be removed with the cancer.
    • Targeted muscle reinnervation to reduce neuropathic pain.
    • Lymphovenous bypass to decrease limb swelling and lymphedema.
  • Complex reconstruction. When a joint needs to be removed along with the cancer, orthopedic oncologists work directly with their colleagues who specialize in hip or knee surgery, shoulder or elbow surgery, hand surgery, and foot or ankle surgery to restore or replace the joint.
  • Modern amputation techniques. When and if amputation becomes necessary, orthopedic oncologists work with plastic surgeons to employ the most recent techniques:
    • Targeted muscle reinnervation and creation of regenerative peripheral nerve interfaces can decrease nerve pain and phantom limb sensation after amputation.
    • Osseointegrated implants are available when appropriate for your needs.
    • A multi-disciplinary amputee team, led by a physiatrist meets with people scheduled for amputation before surgery to discuss your ongoing needs following amputation, and is closely involved in care after surgery to guide your rehabilitation.
  • Anesthesia. Through an intimate collaboration with Anesthesiology and Perioperative Medicine, even the most complex operations can be carried out safely at Mayo Clinic with various techniques available to help control pain after surgery.
  • Technology in the operating room. Execution of the surgical plan is aided by computer-based planning, patient-specific guides, point-of-care 3D printing, mixed reality guidance, computer navigation and robotic surgery.
  • Rehabilitation. Physical medicine and rehabilitation doctors, physical therapists and occupational therapists provide critical expertise in all aspects of rehabilitation after surgery, in the hospital as well as following discharge. Some people may benefit from intensive inpatient rehabilitation care at Mayo Clinic after surgery to maximize independence and assist with the transition home.

Pelvic and sacral tumors

Malignant tumors in the pelvis and sacrum are particularly complex to treat surgically and require specialized planning and surgical techniques. Our surgeons are leaders in treating these conditions. Mayo Clinic surgeons have led the way in making these surgeries safe and feasible. They continue to treat many patients each year who require these rare and complex surgeries.

  • Hemipelvectomy. This surgery involves removing a portion of the pelvis that has cancer. Sometimes this also involves removing the hip socket or even the entire leg along with the pelvis.
  • Hip joint reconstruction. Mayo Clinic orthopedic oncologists and hip replacement surgeons can discuss the possibility of a complex hip reconstruction after hemipelvectomy in which the hip has to be removed.
  • 3D printing. The complex bony anatomy of the pelvis and sacrum makes 3D printing a valuable technique to better understand each person's specific tumor and more accurately plan how to remove it. Orthopedic Oncology teams can print patient-specific cutting guides for use during surgery to accurately remove the cancer. Orthopedic Oncology can also manufacture corresponding patient-specific 3D printed hip replacement implants.
  • Sacrectomy. This surgery involves removing a portion of or the entire sacrum, and Mayo Clinic orthopedic oncologists safely perform these complex operations with multidisciplinary surgical teams (vascular surgery, plastic surgery, colorectal surgery and urology).
  • Spinopelvic reconstruction. When a large part of the sacrum has to be removed or when the tumor extends to involve the spine itself, Mayo teams can reconnect the spine to the pelvis with spinal instrumentation and free vascularized fibular bone autografts.

Spinal sarcomas

Bone and soft tissue sarcomas involving the neck (cervical spine), middle back (thoracic spine) or lower back (lumbar spine) are very rare and pose unique treatment challenges.

  • Sarcomas in the spine require specialized planning and surgical techniques. Our surgeons are leaders in treating these rare and complex conditions.
  • Orthopedic oncologists lead multidisciplinary teams to remove these tumors in an en bloc curative fashion (completely removing all of a tumor without rupturing its capsule) when feasible.
  • Radiotherapy is often necessary, and advanced radiation techniques are available at Mayo Clinic, including proton radiotherapy and intraoperative radiotherapy.
  • Reconstruction of the spine after surgery involves modern spinal hardware, including carbon fiber instrumentation and vascularized bone autografting techniques.

Shoulder girdle sarcomas

The complex anatomy of the shoulder and shoulder blade (scapula) so close to nerves (brachial plexus) and arm blood vessels pose unique challenges when sarcomas occur around the shoulder.

  • Orthopedic oncologists evaluate each patient to see if limb salvage is feasible.
  • If so, your care team can turn to a range of techniques pioneered at Mayo Clinic by our Orthopedic Oncology and Shoulder Surgery teams to reconstruct the shoulder.
  • We review the best options for your care with you, to provide the most functional shoulder and arm possible.

Oncoregeneration: Restoring limb function and appearance after cancer surgery

A unique and special collaboration between orthopedic oncologists and plastic surgeons at Mayo Clinic has let these teams push the envelope on not only saving limbs affected by cancer but maximizing the function and appearance of these limbs.

  • Removing cancer from a limb can sometimes leave the limb painful, weak, swollen and disfigured.
  • A variety of surgical techniques (flap coverage, free functional muscle transfer, lymphovenous bypass, targeted muscle reinnervation and others) performed in collaboration with plastic surgeon colleagues brings the salvaged limb both the best function and best cosmetic appearance.

Pediatric tumor care: Specialized expertise for children

Infants, toddlers, children, and teenagers can develop unique types of bone and soft tissue tumors (both benign and malignant). Mayo Clinic's Orthopedic Oncology team has deep experience treating these conditions.

  • Multidisciplinary pediatric sarcoma care. Children with sarcomas are seen and evaluated together with pediatric oncologists to determine the best treatment plan that may involve chemotherapy and surgery. Additional teams with expertise in pediatric sarcoma care are involved as needed, and complex cases are discussed at dedicated pediatric sarcoma tumor boards weekly.
  • Rotationplasty. Mayo Clinic has decades of experience with this unique surgical procedure that can be used to successfully remove cancer around the knee and convert the child's ankle and foot into a functional knee joint.
  • Physeal (growth plate) sparing surgery. When safe from a cancer perspective, orthopedic oncologists can remove cancer around a child's knee or shoulder while maintaining the growth plate. This allows for a curative surgery while allowing the limb to continue growing.
  • Vascularized bone grafting/Capanna technique. Mayo Clinic surgeons pioneered moving bone along with its blood supply from one part of the body to another. This can be a very useful technique for reconstructing bone defects after tumors are removed from a child's bone.
  • Benign bone tumors. Benign bone tumors in children can be painful and destructive. Often surgery is not necessary, but when it is, orthopedic oncologists work closely with pediatric orthopedic surgeons in treating these tumors while preserving normal bone growth. Minimally invasive treatments, including needle ablation for osteoid osteoma, is used whenever possible.
  • Spinal tumors. Benign and malignant bone tumors in the spine in children are rare and require specialized surgical techniques that orthopedic oncologists at Mayo Clinic have experience with. When appropriate, nonsurgical treatment can be employed including needle ablation or specialized radiotherapy techniques.

Metastatic bone disease: Key strengths at Mayo Clinic

Among patients with metastatic cancer, bones may become affected by the cancer. Key features of our approach to metastatic bone disease include:

  • Prompt evaluation for tumors of unknown origin. Bone pain may be the first symptom of cancer even for people with no known cancer history. Our orthopedic oncology team sees people with new bone lesions quickly to start their evaluation, performs testing to figure out where the cancer is coming from and directs them to the appropriate cancer treatment team.
  • Surgery only when needed. Many times, the metastatic bone disease can be treated with radiation, chemotherapy or needle ablation. Surgery is most often recommended when a bone has become weakened by cancer and is at risk for breaking.
  • Pathologic fractures. If bones do become weakened by cancer and break — called a pathologic fracture — it must be treated using highly specialized surgical techniques.
  • Multidisciplinary care. People with metastatic cancer have complex care needs. If we recommend surgery, your orthopedic oncologists collaborate closely with other members of your cancer care team (whether at Mayo Clinic or elsewhere) to make an appropriate surgical plan and decide on the best time for surgery.

Spinal metastases

Cancer that has spread to the bones of the spine can be particularly complex to treat surgically and can require urgent surgery or radiotherapy when cancer is pushing on the spinal cord.

  • Orthopedic oncologists are available for urgent referrals and expedited surgical treatment of those with metastatic spine disease, particularly when there is spinal cord compression or spinal instability with intractable pain.
  • Our surgeons work closely with radiation oncologists, medical oncologists and neuroradiologists to personalize treatment for each patient. Treatment may include modern radiation techniques (stereotactic radiotherapy, intensity modulated radiotherapy, proton beam), minimally invasive or percutaneous surgery, carbon fiber spine hardware, sophisticated needle ablation techniques, and vertebroplasty.

Peri-acetabular metastases

Cancer that has spread to the hip socket (acetabulum) can require complex surgery to reconstruct the bone that has been dissolved by cancer.

  • Most patients can be treated with radiation and chemotherapy, but when surgery is necessary, our orthopedic oncology and hip reconstruction teams have expertise in reconstructing these complex defects.
  • Innovative minimally invasive techniques including needle ablation, cement and minimally invasive screw placement also are options as medically appropriate when a large surgical reconstruction is not the best option.