Osteosarcoma and Ewing’s sarcoma are the two most common types of childhood bone cancer. They’re rare, and when caught early, treatments can be very effective.

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The two most common types of primary childhood bone cancer are osteosarcoma and Ewing’s sarcoma. Osteosarcoma usually affects your child’s shoulder or leg, close to the knee. Ewing’s sarcoma is more likely to affect their pelvis, ribs, or legs.

Both types of cancer are extremely rare. Osteosarcoma affects about 500 children in the United States per year. It accounts for about 2% of childhood cancer.

Ewing’s sarcoma is even rarer, affecting about 200 kids in the United States per year. It makes up about 1% of childhood cancer diagnoses.

Let’s look at what to know about childhood bone cancers, including symptoms, causes, treatments, and outlooks.

Learn more about osteosarcoma.

Learn more about Ewing sarcoma.

Childhood bone cancer is a rare type of cancer that affects your child’s bones. There are two main categories of bone cancer:

  • Primary bone cancer: This category of bone cancer starts in a bone.
  • Metastatic bone cancer: This category of bone cancer starts as another type of cancer and spreads to your child’s bones.

The two main types of primary childhood bone cancer are osteosarcoma and Ewing’s sarcoma. Osteosarcoma is more common than Ewing’s sarcoma, but both of these forms of cancer are rare.

Bone cancer diagnoses are most likely to be received by teenagers, especially during growth spurts. They’re most commonly received by children younger than 19 years old.

While osteosarcoma and Ewing’s sarcoma are bone cancers, they affect different bones. Osteosarcoma is most commonly found in your child’s arms, shoulders, and legs. Ewing’s sarcoma is most commonly found in their ribs, pelvis, legs, and spine.

Osteosarcoma and Ewing’s sarcoma can affect the same bones too. This means that some bones may be affected by either Ewing’s sarcoma or osteosarcoma.

Although osteosarcoma and Ewing’s sarcoma may affect different bones, they usually have similar symptoms. Symptoms for childhood bone cancer include:

  • pain, which is usually the most common symptom
  • swelling near your child’s bone or in their bone
  • bones that break easily or without a clear cause
  • a fever that can’t be explained
  • a soft lump that may feel warm to the touch

Symptoms of childhood bone cancer are similar to symptoms of other diseases and conditions. Just because your child has these symptoms doesn’t mean they have cancer.

If your child is experiencing any of these symptoms, please contact a healthcare professional right away to determine what’s causing your child’s symptoms.

It’s not clear what the exact cause of childhood bone cancer is. Heredity and a prior history of cancer treatments (chemotherapy, stem cell transplantation, or radiation) are possible triggers.

Experts believe Ewing sarcoma may be related to rapid bone development, such as during a teen’s growth spurt. Although childhood bone cancers may cause bones to be more vulnerable to breaks and fractures, broken bones do not cause bone cancer in kids.

If the physician seeing your child thinks they may have bone cancer, they’ll conduct a series of tests to determine if that’s the case. Usually, they’ll start with a physical examination. They’ll also ask questions about when your child’s symptoms started and what symptoms they’re experiencing.

After this, the pediatrician will likely order an X-ray of the area that’s bothering your child. If they need more information and suspect that there’s a chance of bone cancer, other tests may be conducted, including:

The treatment for childhood bone cancer varies based on the type of cancer your child has and how advanced it is. Bone cancers that are localized (remaining in the location where they started) are usually easier to treat than cancers that have spread to other parts of your child’s body.

Still, treatments for childhood cancer are advancing every day. There’s hope for children who receive a diagnosis of a more aggressive form of cancer.

Some of the treatment options for childhood bone cancer include:

  • chemotherapy, which uses anticancer drugs to destroy cancer cells
  • radiation therapy, which uses high intensity X-rays to destroy cancer cells
  • surgery to remove tumors
  • experimental treatment options that target the type of cancer your child has

Certain factors may increase a child’s risk of developing the disease, such as:

  • Children assigned male at birth are more likely to develop childhood bone cancer.
  • White children are more likely to develop Ewing’s sarcoma.
  • Black children and children of other racial groups are more likely to develop osteosarcoma than white children.
  • Children with a history of retinoblastoma, a rare eye cancer, are more likely to develop osteosarcoma.
  • Children with a family history of Li-Fraumeni syndrome are more likely to develop osteosarcoma.
  • Children who were treated with radiation and chemotherapy for other cancers have an increased chance of developing bone cancer.

Like other cancers, the outlook for children who have bone cancer depends on how advanced their cancer is and how much it’s spread to other parts of their body. When cancer is localized — meaning it stays within the area of the initial tumor — the survival rates are high when children receive cancer treatments.

If it has spread to regional areas (nearby structures) or distant areas (such as their lungs or other distinct organs), survival rates decrease.

Again, cancer treatments are constantly evolving and advancing. Every year, there’s more hope for children who receive a diagnosis of bone cancer.

What are the side effects of bone cancer treatments?

Depending on the type of cancer treatment your child receives, they may experience immediate side effects such as nausea, fatigue, diarrhea, and hair loss.

Cancer treatments may also increase your child’s risk of infertility, other types of cancer, and heart issues later in life.

Does childhood bone cancer require amputation?

Years ago, amputation of affected bones was often necessary to treat childhood cancer. Today, treatment has advanced so that full limb removal isn’t usually necessary.

Do young children ever get bone cancer?

Osteosarcoma, the most common type of childhood bone cancer, usually affects children who are between 10 and 19 years old. It’s exceedingly rare among children younger than 5 years old.

Childhood bone cancer is a serious illness, but it’s extremely rare. If your child has symptoms such as pain in their bones, it’s unlikely that they have bone cancer.

Discuss any unusual symptoms your child has with a pediatrician. When childhood bone cancer is caught early, your child’s chances of survival are high.