Cancers and Tumors

Bone Tumors and Sarcoma Treatment

Your child can get the very latest bone tumor treatment and sarcoma treatment at Seattle Children's.

More than two-thirds of young patients with sarcoma survive without a return of their cancer (recurrence) for more than five years after their diagnosis. Most live much longer.

The cure rate ranges from 20% to 90%. It depends on the type of sarcoma, the extent of disease at the time of diagnosis and how quickly the sarcoma responds to the first treatment.

Your child's doctor and healthcare team will suggest a treatment plan for your child based on many factors, such as:

  • The type of sarcoma your child has
  • The location, size and stage of the bone tumor or sarcoma
  • Your child's age and overall health

After the first round of treatment, your doctor will check to see how the cancer is responding and may change the treatment plan.

Treatment Basics by Disease

Many children receive more than one type of treatment.

Ewing sarcoma treatment

For this disease, doctors use chemotherapy. Many children also have surgery to remove tumors. Doctors may also suggest radiation because it tends to work well against this form of cancer.

Osteosarcoma treatment

Children with this disease almost always have chemotherapy, then surgery to remove as much of the cancer as possible.

Soft tissue sarcoma treatment

Treatment for this disease may depend on the location of the cancer. Most children have surgery to remove tumors. Doctors most often use chemotherapy and radiation as well to control the cancer or kill cancer that remains after surgery.

Many of our patients with sarcoma or other types of cancer take part in clinical trials.

These research studies give children the chance to get the very latest treatment options being studied - options that are not offered at all treatment centers. Learn more about clinical trials.

Treatment Options for Bone Tumors and Sarcoma


Surgery is common for some types of sarcoma. But it may not be the right choice in all cases. The first step may be a biopsy, a procedure used to check for cancer.

In some cases of soft tissue sarcoma, doctors use surgery to remove as much of the tumor as they can, along with some of the healthy tissue around it, before giving chemotherapy.

More often, doctors give chemotherapy first, before surgery. This is most common with osteosarcoma and Ewing sarcoma.

When doctors must remove bone, they may replace it with bone from somewhere else in the body or with a device, such as a metal implant. This helps support the bone that remains. Doctors add the device at the same time the tumor is taken out.

In rare cases of osteosarcoma or Ewing sarcoma in a child's arm or leg, doctors need to remove the whole limb. Our surgeons are leaders in operations called "limb sparing," which means removing areas of cancer in bone without having to amputate.

Fewer and fewer children need amputation as doctors learn more about how to use other treatments well along with less extensive surgery.


Chemotherapy means giving medicines that go throughout your child's body to kill cancer cells. These medicines spread around the body through the bloodstream.

Doctors can give these medicines through a vein, as a shot in the skin or muscle or by mouth. The method depends on the medicine, and the type and location of the cancer.

The exact mix of medicines and how long they are given depend on the type of cancer or sarcoma your child has. Researchers are studying new mixes of medicines to find the most effective combination for each type of the disease.

This may be your child's main treatment. Doctors may also use chemotherapy before surgery to shrink a tumor and/or after surgery to kill any cancer cells that may still be in your child's body.

Our patients receive chemotherapy at our main campus in Seattle - most often in the hospital but sometimes in a clinic as outpatients.


Radiation uses high-energy beams to kill cancer cells and reduce the size of tumors.

Some types of sarcoma (bone cancers), such as Ewing sarcoma, tend to respond very well to this treatment. Others do not respond as well.

Most often doctors give radiation using a machine outside the body to send rays to the right spot. In some cases, doctors give radiation by putting a small device inside the child's body.

Doctors sometimes use radiation before or after surgery. Before surgery, radiation is used to shrink a tumor so that it's easier to remove.

Even when doctors are able to remove the entire tumor, they may suspect or know that cancer cells are still in the child's body. They may use radiation after surgery to kill any remaining cancer cells.

Our patients receive radiation therapy at our partner institution, UW Medicine.

Learn more about Children's Radiation Therapy Service.

New Treatments for Bone Tumors and Sarcoma

Researchers are doing studies to find more effective treatments for children with sarcoma.

They are looking for the best mixes of chemotherapy medicines and ways to use radiation with better results. They are also looking for new types of cancer treatments. Their main goals are to improve cure rates and reduce the risk of long-term effects from the disease and treatment.

Seattle Children's takes part in childhood sarcoma research, as a member of the Children's Oncology Group (COG), and in other ways.

COG conducts studies on many forms of childhood cancer. Many of our pediatric oncologists serve on COG committees. They aim to better understand how the disease works, develop new treatment programs and reduce future effects of the disease and treatments.

Dr. Douglas S. Hawkins is a member of the Children's Oncology Group (COG) Bone Sarcoma Disease Committee and chair of the COG Soft Tissue Disease Committee. He is the study chair for two international clinical trials, one for Ewing sarcoma and the other for rhabdomyosarcoma.

COG is an international organization of childhood cancer specialists who conduct studies on many forms of childhood cancer. With these committees, Dr. Hawkins is responsible for directing studies for childhood soft tissue sarcomas across North America.

Dr. Hawkins is the principal investigator for all of the COG studies at Seattle Children's.

One current line of research for Ewing sarcoma is in the area of stem cell transplant.

In this treatment, the child receives high-dose chemotherapy designed to kill cancer cells. Such high doses damage the child's bone marrow, which makes stem cells - cells that grow to become red blood cells, white blood cells, and platelets.

After the high-dose chemotherapy, doctors give the child an infusion of bone marrow or stem cells to create new bone marrow.

Also, Seattle Children's is a member of a consortium within COG that works to create new medicines. As part of a research study called a clinical trial, we may be able to give new medicines to children whose cancer does not respond to treatment or comes back after treatment.

Your child's doctor will talk with you in detail about any new treatment that might be a match for your child. Then you can decide whether you want to try this option.