There are more than 30 different types of primary bone cancer. Also called bone sarcoma, the most common types include: Osteosarcoma, which affects cells that grow bone tissue; Chondrosarcoma, which grows in the cartilage; and Ewing's sarcoma, which affects cells in the bone or soft tissue that multiply rapidly.
Bone cancer is rare. More commonly diagnosed is secondary bone cancer, where a cancer that has started in another part of the body and has spread to the bones.
If you have secondary cancer in the bone, it may be useful to read information about the primary cancer in conjunction with this information, as secondary bone cancer is treated differently to primary bone cancer. A secondary cancer is named after the primary site where it began, for example lung cancer with bone secondaries.
The most common symptom of bone cancer is pain in the bones and joints, which may be worse at night or during activity. Other symptoms may include:
- swelling over the affected part of the bone
- stiffness or tenderness in the bone
- problems with movement
- unexplained weight loss
- loss of feeling in the affected limb
There are no known causes of primary bone cancer, however there some factors that increase the risk, including:
- previous radiotherapy, particularly for people who received high doses at a young age
- other bone conditions, such as Paget’s disease of the bone
- genetic factors, such as inherited conditions like Li-Fraumeni syndrome, and a strong family history of certain cancers.
There is currently no screening for bone cancer available.
If you are experiencing symptoms, the following tests may be used to identify a bone cancer diagnosis:
X-rays are used to scan the bones.
CT or MRI scans
Scans, including three-dimensional imagery, create pictures of your body that help highlight any bone.
A biopsy is when a small tissue sample is removed from the bone and examined under a microscope. It can be done under local or general aneasthesia.
Primary bone cancer is usually treated with surgery, chemotherapy, radiotherapy or a combination of these treatments.
Surgery for bone cancer will depend on the location of the cancer:
Surgery to remove the cancer but spare the limb is the most common type of surgery for bone cancer. Under general anaesthetic, the surgeon removes the affected part of the bone where the cancer is growing. The bone that is removed is replaced with either an implant (prosthesis) or a bone graft, using a healthy part of bone from another part of the body or from a ‘bone bank’.
When it is not possible to remove all of the cancer without affecting the arm or leg too much, the limb will be removed. This is becoming increasingly less common. After the area has healed, a replacement limb (prosthesis) will be prepared.
Others areas of the body
Surgery here usually involves removing the cancer, the affected bone along with some healthy tissue around it. Bones from other parts of the body may be used to replace the bone that was removed.
Chemotherapy drugs are used to destroy or damage cancer cells. For certain types of bone cancer, chemotherapy can be used in combination with surgery to either shrink the tumour before surgery, or after surgery to kill any cancer cells left behind.
Chemotherapy can also be used as a form of palliative treatment, to arrest the growth, or control the symptoms of advanced cancer.
Radiotherapy uses high energy rays to destroy or damage cancer cells. It may be given before surgery, to help make surgery easier and safer, or after surgery, to reduce the chance of the cancer cells regrowing.
It is not possible for a doctor to predict the exact course of a disease, as it will depend on each person’s individual circumstances. However, your doctor may give you a prognosis, the likely outcome of the disease, based on the type of bone cancer you have, the test results, the rate of tumour growth, as well as your age, fitness and medical history.
As there is no known cause for primary bone cancer, it is not possible to prevent most cases of this disease.