Bone cancer can begin in any bone in the body, but it most commonly affects the pelvis or the long bones in the arms and legs. Bone cancer is rare, making up less than 1 percent of all cancers. In fact, noncancerous bone tumors are much more common than cancerous ones.
The term “bone cancer” doesn’t include cancers that begin elsewhere in the body and spread (metastasize) to the bone. Instead, those cancers are named for where they began, such as breast cancer that has metastasized to the bone.
Some types of bone cancer occur primarily in children, while others affect mostly adults. Surgical removal is the most common treatment, but chemotherapy and radiation therapy also may be utilized. The decision to use surgery, chemotherapy or radiation therapy is based on the type of bone cancer being treated.
There are many types of bone cancer but a couple of the main types are listed below.
The cause of most bone cancers is unknown. A small number of bone cancers have been linked to hereditary factors, while others are related to previous radiation exposure.
Types of bone cancer
- Osteosarcoma. Osteosarcoma is the most common form of bone cancer. In this tumor, the cancerous cells produce bone. This variety of bone cancer occurs most often in children and young adults, in the bones of the leg or arm. In rare circumstances, osteosarcomas can arise outside of bones (extraskeletal osteosarcomas).
- Chondrosarcoma. Chondrosarcoma is the second most common form of bone cancer. In this tumor, the cancerous cells produce cartilage. Chondrosarcoma usually occurs in the pelvis, legs or arms in middle-aged and older adults.
- Ewing sarcoma. Ewing sarcoma tumors most commonly arise in the pelvis, legs or arms of children and young adults.
Signs and symptoms of bone cancer include:
- Bone pain
- Swelling and tenderness near the affected area
- Weakened bone, leading to fracture
- Unintended weight loss
Imaging tests can help determine the location and size of bone tumors, and whether the tumors have spread to other parts of the body. The types of imaging tests recommended depend on your individual signs and symptoms. Tests may include:
- Bone scan
- Computerized tomography (CT)
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
Needle or surgical biopsies
Your doctor may recommend a procedure to remove a sample of tissue (biopsy) from the tumor for laboratory testing. Testing can tell your doctor whether the tissue is cancerous and, if so, what type of cancer you have. It can also reveal whether the tumor cells are growing quickly or slowly.
Types of biopsy procedures used to diagnose bone cancer include:
- Inserting a needle through your skin and into a tumor. During a needle biopsy, your doctor inserts a thin needle through your skin and guides it into the tumor. Your doctor uses the needle to remove small pieces of tissue from the tumor.
- Surgery to remove a tissue sample for testing. During a surgical biopsy, your doctor makes an incision through your skin and removes either the entire tumor or a portion of it.
Determining the type of biopsy you need and the particulars of how it should be performed requires careful planning by your medical team. Doctors need to perform the biopsy in a way that won’t interfere with future surgery to remove bone cancer. For this reason, ask your doctor for a referral to a team of doctors with extensive experience in treating bone tumors before your biopsy.
Stages of bone cancer
If your doctor confirms a diagnosis of bone cancer, he or she tries to determine the extent (stage) of the cancer because that will guide your treatment options. Factors to be considered include:
- The size of the tumor
- How fast the cancer is growing
- The number of bones affected, such as adjacent vertebrae in the spine
- Whether the cancer has spread to other parts of the body
The stages of bone cancer are indicated by roman numerals, ranging from 0 to IV. The lowest stages indicate that the tumor is smaller and less aggressive. By stage IV, the cancer has spread to other parts of the body.