Further tests after diagnosis

If you’ve been diagnosed with bone cancer, your doctor will ask you to have some more tests. These will help find out more about the cancer. Possible tests include:

  • CT scan – this takes a series of x-rays to create a three-dimensional image of a part of the body.
  • Bone scan – this will show all the bones in the body as well as any abnormal areas. An injection of radioactive substance will help highlight any affected area on the scan.
  • Bone marrow sample – very rarely, Ewing’s sarcoma can spread to the bone marrow. During this test, a doctor will collect a sample of bone marrow from your hip bone. This is done under local or general anaesthetic.
  • PET/CT scan – this takes a series of x-rays to build up a three-dimensional picture of the body and measures the activity of cells in a specific area.

Some people may have a chest x-ray to see if the cancer has spread to the lungs. Your medical team may also run some more tests to check your hearing, kidneys and heart.

Having further tests

If your tests show that you have bone cancer, the doctor may want to do some further tests to see whether the cancer has spread outside the bone.

CT scan

A CT (computerised tomography) scan uses x-rays to build a three-dimensional (3D) picture of the inside of the body. You may be given either a drink or injection of dye. This is to make certain areas of the body show up more clearly. This scan takes about 30 minutes and is painless. We have more detailed information about having a CT scan.

Bone scan

This test finds any abnormal areas of bone. A mildly radioactive substance is injected into a vein. A scan of your bones is taken two or three hours later. We have more detailed information about having a bone scan.

Bone marrow sample

You will only need this test if you have, or are likely to have, Ewing’s sarcoma. Very occasionally, a Ewing’s sarcoma can spread to the bone marrow.

The test involves a doctor taking a small sample (biopsy) of bone marrow from the hip bone.

Bone marrow sampling
Bone marrow sampling

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Before the test, adults will be given a local anaesthetic injection into the area around the bone to numb it. Children will usually have a general anaesthetic. The doctor will then pass a special needle through the skin into the bone. When the needle is in position, the doctor will draw a small liquid sample from the bone marrow into a syringe. You may feel some discomfort when this is being done, but it should only last for a few seconds. You can have painkillers if you need them. The test is usually done in the outpatient department and takes about 10–15 minutes.

Sometimes the doctor needs to take a small core of bone marrow. In this case they will do a procedure called a trephine biopsy, which takes a few minutes longer than a bone marrow sample. A special type of needle is passed through the skin to the bone marrow. The needle has a tip that can cut out a sample of the bone marrow. You may feel bruised after the test and have an ache for a few days. Taking mild painkillers will help ease it.

Sometimes the bone marrow and trephine biopsies are done at the same time.

Your bone marrow samples will be sent to a laboratory to be looked at under a microscope. It may take 7–10 days to get the results.

PET-CT scan

This is a combination of a CT scan, which takes a series of x-rays to build up a three-dimensional picture, and a positron emission tomography (PET) scan. A PET scan uses low-dose radiation to measure the activity of cells in different parts of the body.

PET-CT scans give more detailed information about the part of the body being scanned. You may have to travel to a specialist centre to have one. You cannot eat for six hours before the scan, although you may be able to drink. A mildly radioactive substance is injected into a vein, usually in your arm. The radiation dose used is very small. You will wait for at least an hour before you have the scan. It usually takes 30 to 90 minutes. You should be able to go home after the scan.

Chest x-ray

For people with primary bone cancer, the most common place for the cancer to spread to is the lung. A chest x-ray can show whether the lungs have been affected.

Other tests

If you’re going to have chemotherapy, you will also have tests to check your hearing, kidneys and heart.

Some chemotherapy drugs can affect how well you hear high-pitched sounds. So you may have hearing tests (audiograms) before and during your course of chemotherapy.

To check how well your kidneys are working, you may have a small amount of mildly radioactive liquid injected into a vein in your hand or arm. This is carried through your kidneys then passed out in your urine. A few hours after the injection, a nurse will take blood samples from you. These show how well your kidneys are working.

You may also have an electrical trace taken of your heartbeat (an ECG), an ultrasound scan of your heart (an echocardiogram), or a MUGA (multiple-gated acquisition) scan. A MUGA scan shows the movement of the heart and is used to check your heart function. If you need a MUGA scan, your doctors will tell you more about it.

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