Orthopedic Oncologist Brings a Highly Specialized Skillset to South Dakota

Joshua Johnson, MD, is an orthopedic oncologist at Sanford Health and one of the only specialists in this field across the state. Orthopedic oncology is highly specialized with only a few hundred practitioners in the country.

The specialty focuses on the diagnosis, treatment and management of tumors or cancers that start in, spread to or otherwise affect bones and soft tissues, including cartilage, fibrous tissues, muscles, nerves and vessels.

Bone cancer can involve any bone. Cancer that originates in the bone – as opposed to elsewhere and spreading to the bone – is very rare. It makes up less than 1% of all cancer cases and noncancerous bone tumors are more common than cancerous bone tumors.  Metastatic disease followed by myeloma and lymphoma are the most common cancers to affect bone in adults.

If patients report bone pain, especially if it occurs primarily at night or have constitutional symptoms such as fatigue, weight loss, fever, chills, etc.,  they should see their provider for imaging. Scans may reveal a tumor or other lesion, which should be further examined by a specialist like Dr. Johnson.

“Anytime a provider discovers a concerning  bone or soft tissue lesion, I’m happy to see their patient,” said Dr. Johnson.  Any soft tissue mass larger than a golf ball should be evaluated with advanced imaging prior to resection.

Dr. Johnson treats all types of soft tissue tumors, as well as benign and malignant bone tumors. 

“My role as an orthopedic oncologist is to manage cancer involving or arising in soft tissues or bones. I offer surgical treatments to remove cancer with the goal of cure in the case of localized sarcoma. If the patient needs adjuvant chemotherapy or radiation therapy, I offer referrals to those specialists. I also treat metastases to bone or other lesions that weaken the bone by stabilizing the bone prior to fracture or repairing bone if fracture has occurred,” he said.

Specific surgical approach depends on the stage of disease, the tumor’s location, size, as well as the condition of the surrounding tissues. Treatment is tailored to each specific case and to provide the best possible outcomes.

“My goal is to provide reduction of pain, thereby improving function and quality of life for patients. In the case of primary bone or soft tissue cancer, my goal is to cure, if possible,” he said.

Dr. Johnson can operate on all ages, from pediatric to senior patients, and on all parts of the body.

“I chose orthopedic oncology since it’s one of the few orthopedic specialties where you can save lives. I also get the opportunity to interact with patients and help them through what is likely one of the most challenging situations they will face,” he said.

Although his specialty is orthopedic oncology, Dr. Johnson’s training enables him to offer a variety of orthopedic procedures. He also treats patients with hip and knee arthritis, failed hip and knee arthroplasty and trauma.

“I did five years of a general orthopedic residency at the Mayo Clinic, as well as a year of an orthopedic oncology fellowship at the University of Texas MD Anderson Cancer Center in Houston,” Dr. Johnson said.

Dr. Johnson went to medical school at the University of North Dakota. He completed several rotations at Sanford Health hospitals during that time. He is excited to return to his roots.

“I like the mission of the hospital, and my wife and I are both from North Dakota and wanted to come back to the region,” he said. “I’d say Sanford is the leader of healthcare in the Dakotas.”

Since orthopedic oncologists are so rare, most patients with bone or soft tissue cancers need to travel to get the care they need.  “I’m eager to build something that hasn’t previously been here. Historically, a lot of patients were referred to the Mayo Clinic or Minneapolis,” Dr. Johnson said. “To be able to provide this treatment locally is something I’m very excited about.”