Table Of Content


Bone cancer is a rare cancer that occurs when a tumor, or abnormal mass of tissue, grows in a bone. These are referred to as bone sarcomas. It can begin in any bone in your body, but it usually begins in pelvic bones or the long bones in legs or arms, such as the femur, shinbone, or upper arm.

There are two prevalent types of bone cancer, primary and secondary. Primary bone cancer originates in the bone itself. Secondary bone cancer is otherwise known as metastatic bone cancer, where cancer spreads to the bones from other areas of the body.

Types of Bone Cancer

In general, bone cancer is classified broadly into two types.
1. Primary bone cancer
2. Secondary bone cancer

Primary Bone Cancer

This type of cancer begins in your bone or surrounding tissue, like cartilage. It is otherwise known as bone sarcoma. The most prevalent types of primary bone cancer include:

(i) Osteosarcoma is the most prevalent type of bone cancer that begins in bone cells in the arms, legs, or pelvis. It mostly affects persons between the ages of 10 and 30, and it affects men more than women. It is otherwise known as osteogenic sarcoma.

Based on the microscopic appearance of the bone cells, osteosarcoma comprises three subtypes.

  • Low-grade osteosarcoma: This type of osteosarcoma grows slowly, and most bone cells appear normal. Only a few are observed dividing.
  • Intermediate-grade osteosarcoma: Cells develop faster in this type of osteosarcoma. It is a rare type and is treated similarly to low-grade osteosarcoma.
  • High-grade osteosarcoma: It grows very fast and can easily observe dividing under a microscope. Children and teenagers are mostly affected by high-grade osteosarcomas. There are many kinds of these fast-moving osteosarcomas. Osteoblastic, chondroblastic, and fibroblastic are the three most common.

(ii) Ewing tumors are the second most prevalent type of primary bone cancer in children, adolescents, and young age and the third most common type worldwide. Adults above the age of 30 rarely get these malignancies. Most of these tumors begin in the bones and other tissues or organs. The hip (pelvic) bones, the bones of the spine, the long bones of the legs, and the bones in the chest wall are the most common sites for this cancer.

(iii) Chondrosarcoma usually begins in the cartilage cells and occurs in the bones of the pelvis, thigh areas, and shoulders of elderly persons. Typically, these tumors grow slowly and are the second most common primary bone cancer.

Secondary Bone Cancer

Cancer that originated in another part of the body and spread (metastasized) to the bone through the blood or lymph nodes is called secondary bone cancer. This malignancy may spread to the upper arms, legs, ribs, pelvis, and spine-related bones.

Other Types of Bone Cancer:

Fibrosarcoma occurs in soft tissues rather than in bones. It affects middle-aged adults, and bones in the legs, arms, and jaw are most commonly affected.

Giant cell tumors can be benign or malignant. Young and middle-aged adults develop it in the arm or leg bones, which rarely spreads to other body parts.

Chordoma is a rare kind of bone tumor that develops in the bone spine or base of the skull. It occurs in adults over 30, and men are more prone than women to develop this type of cancer. Rarely, it may also develop in young children. It grows slowly and does not spread to other parts of the body.

Multiple myeloma (MM) is the most prevalent type of bone cancer. It is not considered a primary bone cancer as it starts in plasma cells. Cancer cells occur in the bone marrow and cause tumors in other bones. Older persons are typically affected by MM.

Leukemia develops in the bone marrow, the spongy tissue found inside the bones. This bone marrow produces abnormal white blood cells in leukemia patients and these cells do not act like healthy white blood cells.

Non-Hodgkin lymphomas occur in lymph nodes or other body parts which contain lymph tissue. Rarely lymphoma may show up first in the bones. This is known as a primary non-Hodgkin lymphoma of bone (PLB), and it can affect one or many bones. .

Stages of Bone Cancer

The TNM staging tool is the common tool used in determining the stages of bone cancer.

Stage I A: The tumor in this stage is low grade or cannot be graded. Cancer has not reached lymph nodes or other body parts, and it is 8 cm or smaller.

Stage I B: The tumor is low grade or cannot be graded, the cancer has not spread to other body parts and any lymph nodes and its size is more than 8 cm.

Stage II A: In this stage, the tumor size will be less than 8 cm, and the tumor is high grade. However, cancer has not spread to lymph nodes and has not reached the other distant body parts.

Stage II B: In this stage, cancer has not spread to lymph nodes or other body parts, and the tumor is high grade.

Stage III: In this stage, tumor has high grade and has not spread to lymph nodes or other body parts.

Stage IV A: In stage IV A, cancer has spread to the lungs, and the tumor is of any size or grade.

Stage IV B: In stage IV B, the tumor is of any size or grade and has spread to the lymph nodes, or cancer has spread to another bone or the area around the lungs.

Causes & Risk Factors of Bone Cancer

Bone cancers develop as a result of genetic mutations in the DNA of the cells in the bones. These changes can also happen as the result of radiation or seem to have no specific cause.

The various risk factors of bone cancers include,

Genetic factors: Some genetic factors increase the risk of bone cancer includes:

  • Li-Fraumeni syndrome is a genetic disorder that runs in families and results from a genetic error passed down from your parents. If you have Li-Fraumeni syndrome, you have a higher risk of developing osteosarcoma.
  • Hereditary retinoblastoma is a specific type of eye cancer caused by genetic faults. Children who carry this gene defect also develop osteosarcoma.

Age: The risk of bone cancer increases with age and can occur in adults and younger people.

History of radiation therapy: Patients who have received a high radiation therapy are at high risk of getting bone cancer. Most sarcomas caused by radiation therapy include angiosarcoma, soft tissue sarcoma, or osteosarcoma.

Bone diseases: Some other bone diseases increase your chance of developing bone cancer. That includes:

  • Enchondroma or osteochondroma are benign (non-cancerous) bone tumors. If you have these tumors, you are at a higher risk of developing chondrosarcoma (bone cancer).
  • Ollier's disease is uncommon and otherwise known as enchondromatosis. People with this condition develop many non-cancerous (benign) bone tumors. These tumors have the potential to develop into chondrosarcoma and become malignant.
  • Paget disease refers to new bone replacing old bone more quickly. Osteosarcoma risk is higher in people with Paget disease.

Chemical Exposure: Individuals exposed to certain chemicals such as arsenic or plastics may increase the chance of getting bone cancer.

Cancer drugs: Cancer drugs like alkylating agents and anthracyclines raise your risk of secondary cancer, like osteosarcoma.

Symptoms of Bone Cancer

  • Blood in the urine (hematuria)
  • Frequent urination
  • Pain or burning sensation during urination
  • Feeling trouble urinating or having a weak urine stream.
  • Feeling to get up to urinate many times during the night.
  • Urinary incontinence
  • Pain in the abdominal area
  • Back pain

Bone Cancer Screening

No screening tests or exams are suggested for those who have no family history of sarcoma (bone cancer) or other sarcoma risk factors. The best strategy for these people is early detection. Therefore inform your healthcare provider about any unexplained lumps, growths, or other symptoms that could indicate a soft tissue sarcoma. It is beneficial to screen persons who are at a higher risk of developing primary bone cancer. This includes persons who have specific bone disorders or genetic abnormalities that raise their risk of developing bone cancer

Bone Cancer Diagnosis

A bone cancer diagnosis is usually made after any symptoms appear or if screening tests indicate the risk of cancer. To diagnose bone cancer, your doctor may ask about your medical and family history and conduct a physical exam.

Diagnostic procedures and tests for bone cancer include:

Physical examination and medical history: A physical examination of the body is performed to determine a person's health. It involves examining any abnormalities or tumors that could be disease symptoms. A history of the patient's health, diseases, signs, and symptoms is also examined.

X-rays: It is the first test to detect any bone tumor. On an x-ray, the tumor may appear ragged rather than solid or resemble a hole in the bone. The physician might spot a tumor that may spread to nearby tissues like muscle or fat.

Magnetic resonance imaging (MRI): It uses a powerful magnet, radio waves, and a computer to produce extremely clear images of the inside of your body. MRI can show you whether it's a tumor, an infection, or some other cause of bone damage.

Computed tomography (CT) scan: It uses X-ray machines and computers to create more detailed images of the bone. In most cases, MRIs are more useful than CT scans for revealing the details within and around bone cancers.

Positron emission tomography (PET) scan: It creates images of the tissues and organs inside the body and helps to determine the stages of bone sarcoma. A radioactive sugar (FDG) is injected intravenously into the patient. Cancer cells grow rapidly and need energy, so they absorb large amounts of injected glucose. This PET scanner provides an image of where radioactive sugar is being utilized.

Bone scans: This is imaging tests to diagnose bone problems and indicate whether cancer has spread from bones to other body parts. In this test, the entire skeleton can be viewed. During a bone scan, a radioactive substance is injected into a vein that is taken up by your bones.

Biopsy: Medical professionals remove bone samples and examine it for cancer indications. It is the most accurate method for diagnosing bone cancer. Types of biopsy used in bone cancer include:

  • Needle biopsy: In this technique, the physician removes a small tumor tissue using a hollow needle. This biopsy is usually performed under local anesthetic, with numbing drugs injected into the skin and other tissues over the biopsy site. However, some patients may need sedation or general anesthesia. Needle biopsy can be performed through two techniques: Core needle biopsy - uses a large needle to remove a cell or tissue and Fine-needle aspiration biopsy - uses a very thin needle to take fluid, tissue, or cell samples.
  • Surgical (open) biopsy: In this type of biopsy, a physician cuts through the skin to reach the tumor. These biopsies are carried out in an operating room while the patient is under general anesthesia (in a deep sleep), and it can also be done using a nerve block, which numbs a larger portion of the body.

Blood tests: Generally, blood tests are not required to identify bone cancer, although they may be useful once the disease has been identified. For instance, elevated blood levels of chemicals like lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) indicate that cancer may be advanced.

Other tests: Some other tests like blood cell counts and blood chemistry are carried out to determine a person's general health.

Bone Cancer Treatment

Depending on the type of bone cancer, stage of cancer, size and location of the tumor, overall health, general health, and how far it has spread, the doctor may recommend treatment options. Major bone cancer treatment includes surgery, radiation therapy, and chemotherapy.

Surgery: A surgery will be performed to remove the tumor, and your oncologist will investigate the type of tumor to start with other cancer therapy. There are two types of surgery includes:

  • Limb-sparing surgery: It involves removing the section of the affected bone and some of the surrounding tissue.
  • Amputation: It means removing a part of the body completely. Usually, the surgeon removes part of an arm or leg rather than the whole limb.

Radiation therapy is performed either before or after surgery. It uses high-energy X-rays and protons to shrink tumors and harm the DNA of cancer cells. This damage inhibits malignant cells from proliferating. It is used to treat advanced bone cancer to control signs and symptoms.

Stereotactic body radiotherapy (SBRT) is a type of radiation therapy that uses a small number of very focused, intense radiation treatments to control or destroy a small area of the tumor. It is indicated to treat bone sarcomas which have spread to the lungs.

Chemotherapy treatment uses medications to kill rapidly growing cancer cells, and it might be given through a vein in your arm. It is effective in treating fast-growing types of bone sarcoma.

Immunotherapy and targeted therapy are indicated to treat advanced bone cancer and shall be administered as they produce standard action against the bone cells.

Complementary therapies such as aromatherapy, meditation, and yoga can help reduce the pain and improve your emotional well-being along with your major cancer treatment.

Bone Cancer Prognosis:

Bone cancer prognosis depends upon various factors such as:

  • Age
  • Types of bone cancer
  • Stage of cancer
  • Overall patient health and response to the treatment

The survival rate of bone cancer is five years in patients who have been diagnosed early. If cancer has spread to any nearby lymph nodes, tissues, or organs, then the five-year survival rate lowers to 66%.

Prevention of Bone Cancer

There is currently no way to prevent bone cancer. Early detection is the best hope for a successful treatment of bone cancer. It is helpful to detect persons who are at a higher risk of developing primary bone cancer. Consult your physician if anyone has the known potential risk factors of bone cancer.

Bone Cancer FAQs

1. Where does bone cancer usually begin?

Bone cancer can start in any bone in our body, but the pelvis or the long bones in the arms and legs are the most frequently affected.

2. Can MRI scans detect bone cancer?

Yes, MRI scans help to diagnose bone cancer. and it can be very useful to show you whether it is a tumor, an infection, or some other cause of bone damage.

3. What are my bone cancer treatment options?

Surgery, radiation therapy and chemotherapy are the main three treatment options for bone cancer.

4. What are the signs and symptoms of bone cancer to watch out for?

Look out for the following signs and symptoms of bone cancer:

  • Bone pain (worse at night)
  • Joint swelling and stiffness
  • Fatigue
  • Weight loss
  • Weakened bone, leading to fracture
  • Reduced range of motion
  • Feeling hard mass in your long bones of limbs, chest or pelvis

5. How is my bone cancer diagnosed?

The following tests may be performed by your physician to see if you have bone cancer:

  • Complete medical history
  • Physical exam
  • Chest X-ray
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan
  • Bone scan
  • Biopsy

6. Is Stage 1 bone cancer curable?

Stage 1 bone cancer is most curable because the tumor is low grade and it has not spread to lymph nodes and other body parts. Hence, it is treatable.

7. What is the most common bone cancer in adults?

The most common bone cancer in adults is chondrosarcoma. It usually begins in the cartilage cells and occurs in the bones of the pelvis, thigh areas, and shoulders of elderly persons.


  • Bone cancer;; Accessed on 28/09/2022;
  • Bone cancer types; Cancer; Accessed on 29/09/2022;
  • What Is Bone Cancer?; Accessed on 29/09/2022;
  • Bone Cancer (Sarcoma of Bone): Risk Factors;; Accessed on 29/09/2022;
  • Risks and causes of bone cancer; Cancer Research UK; Accessed on 29/09/2022;
  • Bone Cancer Stages;; Accessed on 29/09/2022;
  • Bone Cancer;; Accessed on 29/09/2022;
  • Bone Cancer;; Accessed on 29/09/2022;
  • Bone cancer;; Accessed on 29/09/2022;