Chondrosarcoma

What is chondrosarcoma?

Chondrosarcoma is a type of sarcoma. Sarcomas are rare cancers that develop in the supporting tissues of the body. Supporting tissues include bone, cartilage, tendons, fat and muscle.

There are 2 main types of sarcoma:

bone sarcomas (also called primary bone cancer)
soft tissue sarcomas.

Bone sarcomas can develop in any bone in the body. They can also develop in the soft tissue near bones.

Chondrosarcoma is one of the more common types of primary bone cancer. It is a cancer of the cartilage cells. Cartilage is a tough but flexible material that covers the ends of the bones. This lets the bones move freely at the joints.

Chondrosarcoma usually grows in a bone or on its surface. This type of cancer can happen at any age, but is more common in people over the age of 40. It is slightly more common in men than women.

Chondrosarcoma is usually a slow-growing tumour. The most common bones affected are the:

upper arm (humerus)
thigh (femur)
pelvis
shoulder blade (scapula)
rib.

Chondrosarcoma can sometimes develop into a faster-growing type of bone cancer called de-differentiated chondrosarcoma.

There are many sub-types of chondrosarcoma. Your cancer doctor or specialist nurse will explain more about the type you have. The different types may be treated differently.

Symptoms of chondrosarcoma

Pain is the most common symptom of bone cancer. But symptoms may vary, depending on where the cancer is. There may be some swelling in the area, and it may be painful to touch.

Primary bone cancer is sometimes found when a bone that has been weakened by cancer breaks. This could be after a minor fall or accident.

These symptoms can be caused by other conditions that are more common than bone cancer. If you have any swelling or unexplained bone pain, get it checked by your GP.

Tell your GP if the pain happens at night and when you are resting.

Causes of chondrosarcoma

The exact causes of primary bone cancer are not known.

People who have had rare types of non-cancerous (benign) bone tumour called a chondroma or an osteochondroma have a very slightly higher risk of developing a chondrosarcoma.

Another rare condition called Ollier’s disease (enchondromatosis) can increase this risk.

People with rare genetic conditions called hereditary multiple exostoses (HME) and Maffucci syndrome are slightly more likely to develop a chondrosarcoma.

Chondrosarcoma diagnosis

Tests and diagnosis

You may have some of the following tests to diagnose chondrosarcoma:

Bone x-ray

You may have an x-ray to check an area of bone for cancer. An x-ray shows a picture of the bone. This can give information about where the cancer may have started or what 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.

Tests to diagnose bone cancer such as, bone biopsies, are done by a specialist team. 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

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

the grade of the cancer – how the cancer cells look under the microscope. This gives an idea of how quickly a cancer may grow and develop.
- Low-grade means the cancer cells look like normal bone cells. They are usually slow-growing and less likely to spread. Most chondrosarcomas are low-grade.
- High-grade means the cancer cells look very abnormal. The cells are likely to grow more quickly and are more likely to spread.
- Higher-grade chondrosarcomas are more likely to come back (recur) and may spread to other parts of the body.
Chondrosarcomas are graded from 1 to 3. Grade 1 is low-grade cancer and grade 3 is high-grade cancer. Chondrosarcoma can sometimes develop into a faster-growing type of bone cancer called de-differentiated chondrosarcoma.
- the stage of the cancer - its size and whether it has spread outside the bone.
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 chondrosarcoma

Chondrosarcomas are rare, so they are treated by a team of doctors and other healthcare professionals at a specialist hospital. This means you may have to travel to have treatment.

The treatment you have depends on:

the position and size of the cancer
if it has spread to other parts of the body
the grade of the cancer
your general health.

Surgery is the main treatment for chondrosarcoma. Other treatments sometimes used are chemotherapy and radiotherapy. You may be offered some treatments as part of a clinical trial.

Surgery

Surgery is often used to remove an area of bone affected by chondrosarcoma.
Chemotherapy

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is not often used for chondrosarcoma. But it may be used for rarer types of chondrosarcoma. It may also be used if the cancer has come back or spread.
Radiotherapy

Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy is not often used to treat chondrosarcoma. It is sometimes used if surgery is not possible.

After chondrosarcoma treatment

Follow-up

After you finish your treatment, you will have regular check-ups and x-rays. These will continue for a few years. Tell your cancer doctor as soon as possible if you have any problems, or notice any new symptoms in between your regular follow-up appointments.

Possible late side effects

A small number of people may develop late side effects from the treatment, sometimes many years later. Late effects may include:

tiredness (fatigue)
problems with becoming pregnant or getting someone pregnant (fertility)
a change in the way the heart and kidneys work
a slight increase in the risk of developing another cancer in later life.

If treatment involves removing bones and muscle, you may find day-to-day tasks hard. How hard you find things will depend on where in the body the cancer started. It will also depend on whether you had limb-sparing surgery or an amputation.

Your cancer doctor or specialist nurse will explain more about any possible late side effects.

Getting support

You may have many different emotions, including feeling angry, sad, and scared. You may cry a lot or you might find it hard to relax. You may have problems sleeping. These are normal reactions, but they can be hard to cope with. It is important to remember there is lots of support to help you.

How much support you need is different for everyone. It may depend on the treatment and any side effects you have. Your cancer doctor will tell you about any possible side effects and how to deal with them before you start treatment.

We have more information about coping with difficult feelings and the support available. You may also find the following organisations helpful.

Organisations such as Sarcoma UK and Bone Cancer Research Trust can provide information and support. Cancer52 represents many charities and works to improve the quality of life for people with rarer types of cancer.

Macmillan is also here to support you. If you would like to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our bone cancer forum to talk with people who have been affected by bone cancer, share your experience, and ask an expert your questions.