Browser does not support script.
Skip to main content
search here
Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
This information is about a rare type of sarcoma of the bone called chondrosarcoma.
Sarcomas are rare types of cancer that develop in the supporting tissues of the body. There are two main types: bone sarcomas| and soft tissue sarcomas|.
Bone sarcomas can develop in any of the bones of the body but may also develop in the soft tissue near bones.
Soft tissue sarcomas can develop in muscle, fat, blood vessels or any of the other tissues that support, surround and protect the organs of the body.
Primary bone cancers| are cancers that start in the bone. They are rare, with only about 400 new cases each year in the UK. There are several different types of bone cancer. Chondrosarcoma is the second most common type with about 90 new cases each year in the UK.
Chondrosarcoma is a cancer of the cartilage, which is the tough covering found on the ends of the bones. Chondrosarcoma usually grows within a bone or on its surface. This type of cancer can occur at any age and is slightly more common in males.
It's usually a slow-growing tumour, and the most common sites affected are the pelvic bones, shoulder bones and the upper parts of the arms and legs.There are several subtypes of chondrosarcoma, such as de-differentiated, clear cell and mesenchymal.
The exact causes of primary bone cancer are unknown. People who have had a rare type of non-cancerous (benign) bone tumour called a chondroma or an osteochondroma have a very small risk of developing a chondrosarcoma. Another rare condition called Ollier’s disease (also called enchondromatosis) can also increase this risk. People with rare genetic conditions called hereditary multiple exostoses (HME) and Maffucci’s syndrome are slightly more likely to develop a chondrosarcoma.
Pain| is the most common symptom of bone cancer. However, symptoms may vary depending on the position of the cancer in the body and its size. There may be some swelling in the affected area and it may become tender to touch. Primary bone cancer is sometimes discovered when a bone that has been weakened by cancer breaks after a minor accident.
The symptoms described can be caused by many things other than cancer. However, any persistent bone pain, particularly if it occurs at night, or any swelling should be checked by your doctor.
Usually you begin by seeing your family doctor (GP), who will examine you and may arrange any necessary tests or x‑rays. If a chondrosarcoma is suspected you may be referred directly to a specialist hospital or bone tumour centre for tests. Many of the specific tests for diagnosing bone tumours, such as bone biopsies, need to be done by an experienced team using specialist techniques.
The doctor at the hospital will take your full medical history before doing a physical examination. This will include an examination of the painful bone to check for any swelling or tenderness. You will probably have a blood test to check your general health.
A variety of tests| and investigations may be needed to diagnose a chondrosarcoma. An x-ray of the painful part of the bone usually shows up the tumour. Other tests are often done to check whether the cancer has spread elsewhere.
This involves the use of x-rays to build up a picture of the bone.
A CT scan takes a series of x-rays that build up a three-dimensional picture of the inside of the body. The scan is painless and takes 10-30 minutes. CT scans use small amounts of radiation, which is very unlikely to harm you or anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
You may be given a drink or an injection of dye that allows particular areas to be seen more clearly. For a few minutes this may make you feel hot all over. If you are allergic to iodine or have asthma, you could have a more serious reaction to the injection, so it's important to let your doctor know beforehand.
You'll probably be able to go home as soon as the scan is over.
This test is similar to a CT scan, but it uses magnetism instead of x-rays to build up cross-sectional pictures of your body. During the test you will be asked to lie very still on a couch inside a large metal cylinder that is open at both ends.
The whole test may take up to an hour. It can be slightly uncomfortable and some people feel a bit claustrophobic during the scan. It's very noisy, but you'll be given earplugs or headphones. You'll be able to hear and speak to the person operating the scanner.
If you have any metal implants (such as surgical clips, pacemakers, metal in the eye from previous accidents or trauma) it will not be possible for you to have this test.
For this test, a small sample of the tumour is taken from the affected bone. The doctor looks at the sample under a microscope to identify the exact type of tumour you may have.
This type of biopsy is not often used, as the needle biopsy is much quicker and simpler. In an open biopsy, a small piece of bone is removed during a minor operation while you are under a general anaesthetic. It may be necessary to do this if a needle biopsy can’t be done or doesn’t give a clear diagnosis.
This is a more sensitive test than the simple x-ray and shows up any abnormal areas of bone more clearly. For this test, a small amount of a mildly radioactive substance is injected into a vein, usually in your arm. Abnormal bone absorbs more radioactivity than normal bone, so these areas are highlighted and picked up by the scanner as hot spots.
In some people with chondrosarcomas, the cancer may spread to the lungs. A chest x-ray is usually done to check for this.
Grading refers to the appearance of cancer cells under a microscope and gives an idea of how quickly a cancer may develop. Low-grade means that the cancer cells look very much like normal cells, are usually slow-growing and less likely to spread. In high-grade tumours the cells look very abnormal, are likely to grow more quickly and are more likely to spread.
Chondrosarcomas are graded from 1 to 3, with grade 1 being low-grade cancer and grade 3 high. Most chondrosarcomas are low-grade. Higher grade chondrosarcomas are more likely to recur (come back) and may spread to other parts of the body.
Chondrosarcoma can occasionally develop into a more aggressive type of bone cancer known as de-differentiated chondrosarcoma.
The stage of a cancer is a term used to describe its size and whether it has spread beyond its original site. Knowing the particular type and the stage of the cancer helps the doctors decide on the most appropriate treatment.
Most patients are grouped depending on whether cancer is found in only one part of the body (localised disease) or whether the cancer has spread from one part of the body to another (metastatic disease).
The cancer is low-grade and is contained within the bone.
The cancer is low-grade and extends outside the bone into the soft tissue spaces, which contain nerves and blood vessels.
The cancer is high-grade and is contained within the hard coating of the bone.
The cancer is high-grade and extends outside the bone into the soft tissue spaces, which contain nerves and blood vessels.
The cancer can be low-grade or high-grade and is found either within the bone or outside it. The cancer has also spread to other parts of the body, or to other bones not directly connected to the bone where the tumour started.
If the cancer comes back after initial treatment, this is known as recurrent or relapsed cancer.
As chondrosarcomas are very rare they are usually treated at specialist hospitals by a team of doctors and other healthcare professionals. This means that you may have to travel some distance to have your treatment.
The type of treatment you are given will depend on a number of things, including the position and size of the cancer, whether it has spread, the grade of the cancer and your general health.
Some people with a chondrosarcoma will need to have a combination of different treatments. The treatments that might be used are surgery (where this is possible), chemotherapy and radiotherapy. However, chemotherapy or radiotherapy are not very effective for most chondrosarcomas and therefore surgery is the main treatment.
Major improvements have been made in surgery for bone cancer|. In the past, it was often necessary to remove (amputate|) the affected limb if chondrosarcoma was found.
Now, however, it's often possible just to remove the affected part of the bone and some of the healthy tissue around it. The bone is then replaced with a specially designed metal replacement (prosthesis) or a bone graft (bone taken from another part of the body).
If the cancer affects a bone in or near a joint, the whole joint can often be replaced with an artificial one. These operations are known as limb-sparing surgery|.
Unfortunately, it's not always possible to use limb-sparing surgery and occasionally an amputation may be the only way to treat the cancer. This is often the case when the cancer cells have spread from the bone into the nerves and blood vessels around it.
The type of surgery you have will depend on a number of factors. Your surgeon will discuss the different types of surgery with you in more detail before any decision is made about your treatment.
It's often helpful to talk to someone who has had the same operation you are going to have. The medical and nursing staff will be able to arrange this for you. On some wards a special counsellor may be available to discuss any of your worries.
Chemotherapy| is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. This type of treatment is not commonly used for chondrosarcoma. However, it may be helpful in certain situations.
Chemotherapy can make you feel better by relieving the symptoms of the cancer, but it can sometimes have unpleasant side effects. Any side effects that do occur can often be well controlled with medicines.
Radiotherapy| treats cancer by using high-energy rays to destroy the cancer cells while doing as little harm as possible to normal cells. Radiotherapy is rarely used to treat chondrosarcomas, although it is sometimes helpful in certain situations.
Radiotherapy can cause side effects such as feeling sick (nausea|) and tiredness| (fatigue). These side effects can be mild or more troublesome, depending on the strength of the radiotherapy dose and the length of your treatment. The radiotherapist will be able to advise you on what to expect.
Research into new ways of treating chondrosarcoma is going on all the time. Treatments that are carried out on patients are known as clinical trials|. These are especially important for finding improvements in treatment for rare cancers. Your specialist can tell you more about trials that may be relevant to you.
Before any trial is allowed to take place, it must be approved by an ethics committee, which protects the interests of the patients taking part.
Your doctor or a research nurse will discuss the treatment with you, so that you fully understand the trial and what it means to take part. You may decide not to take part or withdraw from a trial at any stage. You will then receive the best standard treatment available.
After your treatment is completed, you will have regular check-ups and x-rays. These will continue for several years. If you have any problems or notice any new symptoms in between these times, let your doctor know as soon as possible.
The need for practical and emotional support will vary from person to person. It may depend on the treatment you receive and any side effects the treatment may cause. Your specialist will tell you about any potential side effects and how to deal with them before you begin any treatment.
Many different emotions may affect you. Anger|, guilt, anxiety| and fear are some of the most common feelings people have. You may find yourself tearful, restless and unable to sleep|. You may have feelings of hopelessness and depression|. These are all normal reactions, but it can be difficult and distressing to admit to them.
You don't have to cope with these feelings on your own and there are people available to help you. You may find it helpful to talk to your family and friends about how you feel. Some hospitals have their own emotional support services with specially trained staff, and some of the nurses on the ward will have received training in counselling.
You may feel more comfortable talking to a counsellor outside the hospital environment or to a member of your religious faith.
We can put you in touch with counselling services in your area. You also might find our section on the emotional effects of cancer| useful.
A support and information website for people affected by sarcomas.
This section has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.