Bone cancer occurs when a tumor, or atypical mass of tissue, forms in a bone. These are called bone sarcomas.
A tumor may be malignant, which means it’s growing aggressively and spreading to other parts of the body. A malignant tumor is often referred to as cancerous.
Bone cancer can begin in any bone in your body, but it most commonly starts in the pelvic bone or the long bones in your legs or arms, such as your shinbone, femur, or upper arm.
Cancer that begins in the bones is uncommon. However, it can be aggressive, so early detection is important.
Cancer may also begin in another area of the body and spread to the bone. Cancer is usually named for the location where it starts.
Primary bone cancers are the most serious of all bone cancers. They form directly in the bones or surrounding tissue, such as cartilage.
Cancer can also spread, or metastasize, from another part of your body to your bones. This is known as secondary bone cancer, and this type is more common than primary bone cancer.
Common types of primary bone cancers include:
Osteosarcoma (osteogenic sarcoma)
Osteosarcoma, or osteogenic sarcoma, generally affects children and adolescents, but it can also occur in adults. It has a tendency to originate at the tips of the long bones in the arms and legs.
Osteosarcoma may also start in the hips, shoulders, or other locations. It affects the hard tissue that provides the outer layer of your bones.
Osteosarcoma is the most common type of primary bone cancer, causing 2 in 3 bone cancer cases.
Ewing’s sarcoma is the second most common type of primary bone cancer. It either begins in the soft tissues surrounding the bones or directly in the bones, and it often affects children and young adults.
The long bones of your body — such as your arms and legs — and the pelvis are commonly affected.
Chondrosarcoma most commonly begins in the bones of the pelvis, thigh areas, and shoulders of older adults.
Multiple myeloma (MM) is the most common type of cancer affecting the bones.
However, it’s not considered a primary bone cancer because it begins in the plasma cells. It occurs when cancer cells grow in the bone marrow and cause tumors in various bones. MM
The symptoms of bone cancer can include:
- pain and swelling in the affected bones
- a palpable hard mass in the long bones of your limbs, pelvis, or chest
- feeling tired or fatigued
- pain in your bones that wakes you up at night
- bone pain that can start after minor trauma
- decreased range of motion
Less common symptoms can include:
- easily broken bones
- weight loss
While pain is the most common symptom of bone cancer, not all types of bone cancer cause pain.
If you experience any of the symptoms above, it is best to make an appointment with a doctor to determine whether or not your symptoms are caused by bone cancer.
The cause of bone cancer isn’t exactly known, but there are certain factors that may contribute to or increase a person’s chances of forming atypical growths in the bone. These include:
Atypical cellular growth
Healthy cells continually divide and replace older cells. After completing this process, they die. However, atypical cells continue living. They start forming masses of tissue that turn into tumors.
Radiation therapy, which kills dangerous cancer cells, can be used to treat bone cancer.
However, osteosarcoma may form in some people who receive the treatment. The use of high doses of radiation may contribute to its development.
For osteosarcoma in particular,
Genetic mutations that raise the risk of developing bone cancer may be inherited, though this is rare. Mutations can also happen as the result of radiation or seem to have no specific cause.
The following may be risk factors for bone cancer:
- having a family history of cancer, especially bone cancer
- having received radiation treatment or therapy in the past
- having Paget’s disease, which is a condition that causes the bones to break down and then grow back atypically
- currently or previously having had multiple tumors in your cartilage, which is the connective tissue in your bones
- having Li-Fraumeni syndrome, Bloom syndrome, or Rothmund-Thomson syndrome, which may increase your risk of developing cancers
Doctors classify primary bone cancer in stages. These different stages describe where the cancer is, what it’s doing, and how much it has affected other parts of your body:
- Stage 1 bone cancer hasn’t spread from the bone.
- Stage 2 bone cancer hasn’t spread but may become invasive, making it a threat to other tissue.
- Stage 3 bone cancer has spread to one or more areas of the bone and is invasive.
- Stage 4 bone cancer has spread to the tissues surrounding the bone and to other organs, such as your lungs or brain.
Your doctor may use the following methods to determine the stage of cancers in the bones:
- a biopsy, which analyzes a small sample of tissue to diagnose cancer
- a bone scan, which checks the condition of the bones
- a blood test to establish a baseline for use during treatment
- imaging tests that include X-rays, as well as PET, MRI, and CT scans, to get in-depth views of the bones’ structure
Following a biopsy, medical professionals may assign tumors a grade based on how they look under a microscope. The grade is a measure of the likelihood that they will grow and spread, based on how closely they resemble typical cells.
Usually, the more atypical they appear, the faster they may grow and spread. Bone cancer may be designated as low grade or high grade.
A higher grade can mean that the cells appear more atypical and may spread faster, while a lower grade can mean that the cells appear more similar to typical cells and may spread more slowly.
Determining the grade can help doctors decide on the best treatment.
Treatment depends on:
- the stage and grade of cancer
- your age
- your overall health
- the size and location of the tumor
Medications that treat bone cancer include:
- chemotherapy drugs for MM
- pain medications to relieve inflammation and discomfort
- bisphosphonates to help prevent bone loss and protect bone structure
- cytotoxic drugs to prohibit or stop the growth of cancerous cells
- immunotherapy drugs to encourage the body’s immune system to kill cancer cells
A doctor may surgically remove tumors or affected tissue. Surgery to remove and replace damaged bone is an option to stop cancers that spread quickly.
For extensive bone damage in the arms or legs, amputation may be needed.
A doctor may recommend radiation therapy to kill the cancer cells. This therapy may be used in addition to another type of treatment to slow the growth of cancer cells.
Radiation may also be used if not enough of the tumor can be removed through surgery.
The doctor may add additional therapies that include herbal treatments to your care plan. However, this must be done with careful consideration, as some alternative treatments may interfere with chemotherapy and radiation treatments.
Complementary therapies may help provide relief from symptoms and improve your quality of life and well-being. Other options can include:
The 5-year survival rate for bone cancer greatly depends on the location and the stage of cancer when you’re first diagnosed.
The biggest indicator of the outlook for people with osteosarcoma and Ewing’s sarcoma is whether or not the cancer has spread to other parts of the body at the time of diagnosis.
For cancer that has not spread, the survival rate is between 70 and 80 percent.
For those with chondrosarcoma, the outlook is often related to the grade of the tumor. This type of tumor is commonly low grade, which has a 90 percent survival rate.
These are general statistics. Your outlook may look different based on your age and overall health. The most important thing you can do to increase your chances of recovery is to follow your treatment plan.
Clinical trials test treatments that have not yet been approved by the U.S. Food and Drug Administration (FDA) for a specific diagnosis. They may provide another option for those who have not seen success with traditional therapy options.
This treatment may be free or covered by insurance, depending on whether the sponsor is covering the costs of treatment for the individuals enrolled in a clinical trial.
Many of the cancer treatments common today once started out in clinical trials. The information gathered in clinical trials helps inform future treatment.
If you’re interested in participating in a clinical trial, talk with your doctor about your options or
Cancer that originates in the bones is uncommon compared to other types of cancer. The type of bone cancer and how early it is detected can affect your outlook.
To diagnose bone cancer, a doctor will perform a biopsy. They will likely perform other imaging tests in order to determine your cancer’s stage and develop a treatment plan.