Orthopaedic Oncology Division

Treating bone and soft tissue tumors

Our multidisciplinary approach means you have different specialists working together for your treatment plan.

Sarcoma care

If you have a sarcoma, it is cancer that arises from tissue in the musculoskeletal system. This includes bone or soft tissue, from the fat, muscles, nerve, blood vessels, connective tissue around the bone.

We work closely with medical oncology and radiation oncology throughout care to understand your overall health. Radiologists may help gather the biopsy to send for testing. A pathologist tests a sample to help us make an official diagnosis. An open biopsy for diagnosis allows us to make a multidisciplinary plan specific to your needs.

Many sarcomas require surgery by wide incision. This varies for each individual case based on the specifics of the tumor, such as the size, location, and what tissue it is located in and next to. Our first goal is to remove the cancer with negative margins. The close second goal is to optimize function after removing cancer or reconstruct areas to negate defects after surgery.

Surgical approaches include:

• Intraoperative navigation
• Custom cutting guides
• Custom reconstructions
• Multidisciplinary surgical coordination with vascular surgery
• Plastic surgery or thoracic surgery to take out these cancers and reconstruct the area

For benign tumors, we often employ standard of care resections (marginal resections) that do not have to take out extra tissue. We may use other treatment options to minimize surgical impacts such as cryoablation and radio frequency ablation.

Learn more about our Sarcoma Center of Excellence.

Soft tissue and bone sarcomas

Soft tissue sarcomas originate in muscles, tendons, fat, nerves, blood vessels, and deep skin tissues. They can develop anywhere in the body, but are most common in the arms, legs, chest, and abdomen. Bone sarcomas develop in the bones. They are most often found in the long bones of the arms and legs, but they can occur in any bone.

Treatment may include: 

• Radiation (multiple types, MR Linac)
• Chemotherapy/systemic/immunotherapies/targeted therapies
• Surgery and interventional abilities
  • Bone resections reconstruct areas with mega prosthetics like joint replacements, but with replacement of much more of the skeleton (complex arthroplasty).
  • For big soft tissue resections, we count on plastic surgeons to perform all types of soft tissue reconstruction, including skin grafts, rotational flaps, free flaps, and more.

Benign bone and soft tissue tumors may not be cancer, but can be life-changing and disruptive to function. We have broad abilities to monitor and treat these in ways that are best for each individual patient.

Learn more about soft tissue sarcomas.

Metastatic disease

Metastatic diseases of the soft tissues and bone occur when cancer cells from a primary tumor in another part of the body spread to these areas.

Our goals are to prevent impending fracture and to treat pain. We fix completed fractures with a focus on quality of life in function, pain control, and, if needed, your ability to undergo cancer treatments.

Metabolic disorders of the skeleton

Metabolic bone diseases are a group of conditions that affect bone strength or integrity due to problems with the body's processes of bone building and breakdown. These processes are ongoing and vital for maintaining healthy bones.

We treat metabolic disorders of the skeleton including:

• Osteoporosis: The most common metabolic bone disorder, characterized by low bone mass and deterioration of bone tissue, leading to increased fracture risk.
• Osteomalacia/rickets: Inadequate bone mineralization usually due to vitamin D deficiency. In children, it's called rickets and leads to soft, weak bones. In adults, it's called osteomalacia and causes bone pain and weakness.
• Hypophosphatasia: A rare genetic disorder affecting bone mineralization due to low levels of an enzyme called alkaline phosphatase.
• Paget's disease of bone: Disruption in the normal bone remodeling cycle, leading to enlarged and misshapen bones that are weaker than normal.
• Hyperparathyroidism: Overactive parathyroid glands produce too much parathyroid hormone, which pulls calcium from the bones, weakening them.
• Osteogenesis imperfecta: A group of genetic disorders causing fragile bones that break easily.
• Bone cancer: Cancerous cells in the bone can weaken bone structure.
• Drug-induced bone loss: Certain medications, like corticosteroids, can lead to bone loss as a side effect.
• Musculoskeletal infections: This can often look like or have symptoms similar to tumors. We are one of two facilities in the area that treat these issues.

Metastatic care

Orthopaedic oncology metastatic care focuses on managing cancer that has spread to the bones from a primary tumor elsewhere in the body (bone metastases). It requires a multidisciplinary approach to alleviate symptoms, improve quality of life, and potentially extend survival.

At AHN, we take into account the type of cancer, where it is, and how active you are to determine the best metastatic care plan for you. We coordinate your surgical care with other treatments to optimize care and minimize complications to help treat your quality of life, not just the cancer.

Learn more about our Metastatic Disease to the Skeleton Program.

Specialists working with orthopaedic oncology

AHN orthopaedic oncologists are focused on providing individualized, comprehensive care to their patients. We offer multidisciplinary care in a variety of locations so you can see the specialist you need closer to home.

Surgery

Medical Oncology

Radiation Oncology Leads

Pathology

Radiology

How to get care

To make an appointment you can:

• Call our scheduler: (412) 359-8614
• Schedule online
• Use MyChart and schedule with Dr. Lisa Ercolano to make an appointment

Please bring all relevant imaging on a CD or through PowerShare with correlating reports for review by our team to your initial appointment.

You can expect to meet the orthopaedic oncology team and get a brief overview of the treatment timeline. Your appointments may feel overwhelming at times, so write down your questions and bring them with you to the office. It can be helpful to bring someone who can act as your support. These people can help you remember details discussed in the office and be there or you, if needed, throughout the appointment.

Clinical trials and research

AHN participates in clinical trials of new therapies that are open for patients who qualify and wish to participate. Patients are screened for consideration with ongoing clinical trials at every stage of their treatment.

What is a clinical trial

Clinical trials are studies that try to answer questions about new ways to treat cancer with medications, radiation, or surgical techniques. Previous trials have shown how new methods of treatment improve survival and quality of life and reduce the risk of cancer returning.

You participate in a clinical trial only if you volunteer to do so and meet criteria for inclusion in the study, and you can stop participating in a trial at any time.

Who can join a clinical trial?

The plan for the trial, called a protocol, explains what the trial will do and how the study will be done. Based on the questions the research is trying to answer, each clinical trial protocol outlines specific criteria necessary to be eligible to join the trial.

Common criteria for entering a trial are:

• Having a certain type or stage of cancer.
• Having received a certain kind of therapy in the past.
• Being in a certain age group.
• Federal rules help ensure that clinical trials are run in an ethical manner, with your rights and safety protected. It’s to ensure that you’re not put at increased risk by participating in the trial, and that the results of the study are accurate and meaningful.

Conducting clinical trials helps us contribute to Cancer Moonshot — an initiative created by former President Joe Biden and the White House. The goal is to prevent more than 4 million cancer deaths by 2047 and improve the experience for people affected by cancer. We’re doing our part to join this fight by collaborating with more than 60 private companies, patient groups, academic institutions, and nonprofits.

Currently active cancer clinical trials

If you would like to participate in a clinical trial and help our innovative team discover groundbreaking cancer solutions, ask your doctor if you’re eligible to participate in one. Find currently active clinical trials that are open for participation.

Refer your patient to an AHN specialist

Referrals are sent to Allegheny Orthopaedic Associates (AOA) - Lisa Ercolano

• All outside referrals can be faxed to (412) 359-4988. Referrals should include relevant office notes and imaging of concern.
  • When the referral is received, we will call the patient directly to schedule an appointment.
• Providers can call our office to discuss a particular case or patient with a provider directly. 
• We are able to fax or share information via EPIC EMR to share any information necessary to the patient's primary doctor or an outside facility.

For more information about referring your patient to an AHN specialist, read the Independent Physician Referral FAQs.