Overview

Diagnosis of Bone Cancer

Bone cancer is diagnosed using a combination of imaging tests and tissue analysis.

Imaging tests help determine the location and size of the cancer:

  • X-ray: Provides basic images of the bone structure.

  • Magnetic resonance imaging (MRI): Shows detailed images of bone and surrounding tissues.

  • Computerized tomography (CT) scan: Gives cross-sectional images of the bone.

  • Positron emission tomography (PET) scan: Detects active cancer cells in the bone.

  • Bone scan: Helps identify areas of abnormal bone growth.

Biopsy confirms the presence of cancer cells:

  • Needle biopsy: A thin needle is inserted through the skin to collect tissue samples.

  • Surgical biopsy: A small incision is made to remove a tissue sample.

Tip: Biopsies should be performed by an experienced bone cancer team to avoid interfering with future surgery.

Stages of Bone Cancer

After diagnosis, doctors determine the stage of the cancer to guide treatment. Staging considers:

  • Location of the cancer

  • Size of the tumor

  • Growth rate of the cancer

  • Number of bones affected

  • Spread to lymph nodes or other parts of the body

Bone cancer stages range from 1 to 4:

  • Stage 1: Small, slow-growing cancer

  • Stage 4: Cancer has spread to lymph nodes or distant organs

Treatment of Bone Cancer

Treatment depends on the type, stage, and location of the cancer, as well as your overall health and preferences.

Surgery:

  • Goal: Remove all cancerous tissue

  • May involve removing some healthy tissue around the tumor

  • Bone repair may use:

    • Bone grafts from another part of the body

    • Metal or plastic implants

  • In rare cases, amputation may be needed; prosthetic limbs can help restore function

Chemotherapy:

  • Uses strong medicines to kill cancer cells

  • Often administered intravenously or in pill form

  • May be used:

    • After surgery to eliminate remaining cells

    • Before surgery to shrink tumors

  • Commonly used for osteosarcoma and Ewing sarcoma; less effective for chondrosarcoma

Radiation therapy:

  • Uses X-rays, protons, or other energy beams to destroy cancer cells

  • May be used:

    • After surgery to kill residual cancer cells

    • When surgery isn’t an option

  • Most effective for Ewing sarcoma, less commonly used for osteosarcoma or chondrosarcoma

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