What is bone cancer?

Primary bone cancer is a cancer that starts in a bone. It is sometimes called a bone sarcoma.

Primary bone cancer is rare. About 600 people are diagnosed with it in the UK each year. It can affect people of any age. It is slightly more common in men than women.

It is different from a cancer that has spread to the bones from somewhere else in the body. This is called secondary bone cancer and is much more common than primary bone cancer. Your doctor will tell you whether you have primary or secondary bone cancer.

We have separate information about secondary bone cancer.

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Bone cancer types

There are different types of bone cancer. The most common types are:

We have more information about these and rarer bone cancer types.

Symptoms of bone cancer

A tumour in a bone can cause symptoms which include, pain or swelling in the area affected.

We have more information about possible symptoms of bone cancer. If you are worried about any symptoms you have, talk to your GP.

Causes of bone cancer

The exact causes of primary bone cancer are not known. For most people with bone cancer, it is not clear why it has developed.

There are certain things that can affect the chances of developing primary bone cancer. These are called risk factors. Having a risk factor does not mean you will get bone cancer. People without risk factors can also develop bone cancer.

We have more information about risk factors and causes of bone cancer.

Diagnosis of bone cancer

You may have some of the following tests to diagnose bone cancer:

  • Bone x-ray

    You may have an x-ray of the affected bone. This can give information about whether a cancer started in the bone and is a primary bone cancer, or has spread from another part of the body and is a secondary cancer. It may also help the doctor tell which type of bone cancer it is.

  • MRI scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

  • Bone biopsy

    A bone biopsy means the doctor takes a sample of cells from the bone to be checked for cancer under the microscope.

We have more information about diagnosing bone cancer that explains more about these and other tests for bone cancer.

Waiting for test results can be a difficult time, we have more information that can help.

Staging and grading of bone cancers

The results of your tests give your cancer specialist information about:

  • the stage of the cancer - its size and whether it has spread outside the bone
  • the grade of the cancer – how the cancer cells look under the microscope, which give an idea of how the cancer might grow or spread.

We have more information about staging and grading bone cancer.

Your cancer doctor or specialist nurse will explain how it may help plan your treatment.

Treatment for bone cancer

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.

The following treatments may be used to treat bone cancer. Most people need a combination of these treatments. We have more information about treating bone cancer that explains when each treatment may be used.

  • Surgery

    Surgery is an important part of treatment. It is used to remove the cancer in the bone.

  • Chemotherapy

    Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Most people with primary bone cancer will have chemotherapy as part of their treatment. It may be given before or after surgery or to treat cancer that comes back.

  • Radiotherapy

    Radiotherapy uses high-energy rays to destroy cancer cells. This is mainly only used to treat Ewing sarcoma. Other types of primary bone cancer are not as sensitive to radiation. But if surgery is not suitable, radiotherapy may sometimes be used instead.

  • Targeted therapy

    Targeted therapies target something in or around the cancer cell that is helping it grow and survive. Targeted therapy is only suitable for some people. It is sometimes used to treat osteosarcoma.

You may be invited to take part in a clinical trial of a new drug or treatment.

If bone cancer comes back

For many people with early-stage bone cancer that has not started to spread, it will never come back after treatment.

If the cancer comes back in the lungs or in a bone, it is sometimes possible to have an operation to remove it. This would be done to try to cure the cancer. Chemotherapy may be given before and after the operation.

If it is not possible to cure the cancer, treatments such as chemotherapy and radiotherapy may be given. The aim is to control the cancer for as long as possible and to help relieve symptoms.

After bone cancer treatment

Many people recover well after treatment for primary bone cancer. Some people take longer and need extra help. Before you go home, the hospital staff will talk to you about your recovery.

If you are worried about going home, talk to the hospital staff before you leave. They can arrange any help and support you might need at home.

Follow-up

After your treatment finishes, you will have regular check-ups with your cancer doctor or specialist nurse. They will tell you how often and for how long you will need to have these.

It will depend on the type of treatment you had and the risk of the cancer coming back. We have more information about follow-up after treatment.

You may have regular tests to check for any signs of the cancer coming back. These may include chest x-rays, blood tests and sometimes MRI scans. If you have had chemotherapy, you may have regular scans to check your heart. You will usually have these for a few years.

Coping with body changes

After treatment, your body may not look or feel the same to you. You may have scars from surgery. There may be changes in how you move. If you have had an arm or leg removed, the change in your body may be very noticeable to you.

It can be harder to cope with losing an arm than a leg. A prosthetic leg can often be covered by wearing trousers, but a prosthetic arm cannot be covered so easily.

Feeling like you look different from other people can affect your self-confidence. At times, you may even wish you had never had the operation.

At first, you may feel shocked and upset. But these feelings usually improve as you adapt and learn how to manage the changes. Each person is different in how long this takes.

We have more information about:

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.

How we can help

Macmillan Cancer Support Line
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