Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose bone and spine sarcomas early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.

Once sarcoma has been diagnosed, each patient meets with dedicated medical, surgical and radiation oncology experts– sometimes, all in one day – who subspecialize in treating sarcoma patients, so that a precise treatment plan can be designed and begun right away.

Additionally, the OSUCCC – James partners with Nationwide Children’s Hospital and the OSU Wexner Medical Center to offer world-renowned sarcoma expertise in one of the top integrated pediatric and adult sarcoma care programs anywhere in the country.

Diagnosing Bone and Spine Sarcomas

If a bone and spine sarcoma is suspected, your OSUCCC – James sarcoma specialists will conduct a physical examination and record your medical history. In addition, these experts may conduct one or more imaging examinations to detect signs of sarcoma in the bones and spine, including:

Imaging Exams


This exam uses X-rays to produce images of the organs and bones and can image the spinal column.

Computed Tomography (CT) Scan

A CT scan is an X-ray that produces detailed, cross-sectional images of the body.

Magnetic Resonance Imaging (MRI)

MRI uses a high-powered magnet and radio waves to capture high-resolution, detailed images of the body.

Nuclear Medicine Bone Scan

A bone scan can look for signs of cancer throughout the skeletal system by using a small amount of injected radiation that highlights potentially cancerous activity on images taken by a scanner.

Positron Emission Tomography (PET)

A PET scan is an imaging examination used to find malignant tumor cells in the body. The specialists inject a small amount of radioactive glucose (sugar) into a vein, then use a specialized scanner that rotates around your body to take detailed pictures of where the glucose gathers in high amounts. Cancer cells absorb more glucose than normal cells.


For a biopsy, a sarcoma specialist removes a small sample of tissue to be analyzed under a microscope for signs of cancer. There are several ways to obtain a biopsy sample for diagnosing bone or spine sarcoma:

Incisional Biopsy

The surgeon removes a tissue sample or part of a lump in the tissue during a surgical procedure.

Fine-Needle Aspiration Biopsy

Fluid or tissue is removed using a thin needle.

Core Biopsy

The physician uses a wide needle to remove a small sample of tissue.

Biopsy Analysis

Removed tissue may undergo other tests following biopsy to help the OSUCCC – James experts classify the type and subtype of sarcoma. These tests include:


This test uses a radioactive dye on proteins called antibodies to identify certain antigens in the tissue sample. Antigens are any substance that causes a response in the body’s immune system against that substance. Antigens include toxins, bacteria, chemicals, viruses or other substances that come from outside the body.

Light and Electron Microscopy

Changes in cells that indicate cancer types are evaluated under high-powered microscopes.

Cytogenetic Analysis

This test analyzes the cells to identify changes in the genetic material of the cell.

Flow Cytometry

Flow cytometry measures numbers and proportions of cells in a tissue sample and can determine characteristics of cells, such as their shape, size and presence of tumor markers. Tumor markers are substances that indicate certain cancers.

Bone Marrow Aspiration and Biopsy

Patients with Ewing’s sarcoma also will see an OSUCCC – James physician who will remove a small sample of bone marrow, blood and bone through a hollow needle, usually from both hip bones. Then an expert pathologist who specializes in bone and spine sarcomas reviews the sample under a microscope for signs that sarcoma has spread.

(Source: National Cancer Institute)

Staging Bone and Spine Sarcoma

Identifying sarcoma stages helps determine how much cancer is present your body, the size and grade of the tumor, whether or not the cancer has spread, and if so, where it has spread. Staging is just one of many ways that the OSUCCC – James bone sarcoma experts plan the most targeted, accurate way to treat your specific cancer.

The staging classification remains the same throughout treatment.

Osteosarcoma and Ewing's Sarcoma Staging

Osteosarcoma and Ewing's Sarcoma are either localized or metastatic.

  • Localized osteosarcoma or Ewing's sarcoma has not spread outside of the bone where the cancer started. 
  • Metastatic osteosarcoma or Ewing's sarcoma has spread from the bone in which the cancer started to other parts of the body, which may include other bones or organs. Osteosarcoma and Ewing's sarcoma may spread to the lungs.

(Source: National Cancer Institute)

If you’ve been diagnosed with a bone and spine sarcoma, would like a second opinion or would like to speak with a sarcoma specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

460 West 10th Avenue

Columbus, Ohio 43210

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