Definition

Bone cancer is a growth that destroys normal bone tissue. It can also spread beyond the bone. It may be:

• Primary bone cancer—starts in bone tissue
• Secondary or metastatic bone cancer—cancer starts somewhere else and travels to the bone

Other types of bone cancer are:

• Osteosarcoma—a tumor of the bone, usually of the arms, legs, or pelvis
• Chondrosarcoma—begins in the cartilage
• Ewing sarcoma—tumors that usually begin in the leg and arm bones
• Fibrosarcoma and malignant fibrous histiocytoma—forms in soft tissues and moves to the bones of the legs, arms, and jaw
• Giant cell tumor—a primary bone tumor, most common in the arm or leg bones
• Chordoma—a primary bone tumor that is usually in the skull or spine

Causes

Bone cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.

The cause of primary bone cancer is unknown. Genes most likely play a role.

Risk Factors

Things that may raise the risk of bone cancer are:

• Paget's disease
• Exposure to radiation
• Family history of bone cancer
• Certain bone conditions

There may be other things that raise the risk. It depends on the type of bone cancer.

Symptoms

Symptoms will vary. They depend on the size and site of the tumor. Symptoms may be:

• Pain at the tumor site
• Swelling or a lump at the tumor site
• Deep bone pain
• Unexplained weight loss
• Being very tired
• Problems breathing
• Fever or night sweats

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Signs of cancer can be found with:

• Blood tests—to look for abnormal bone activity
• Biopsy—a sample of cells is taken and tested

Images can show where the tumor is and how large it may be. They can also show if a cancer has spread. Tests may include:

• X-ray
• CT scan
• MRI scan
• Bone scan

Test results will be used for staging. This will outline how far and fast the cancer has spread.

Treatment

Treatment depends on the type, stage, and site of the cancer. It also depends on a person's overall health. Options may be:

• Surgery to remove:
  • The cancer and tissue in the area
  • Some nearby lymph nodes
  • Bone or an entire limb—if other options cannot remove the cancer
• Bone grafts and metal plates—to support the bone after cancer is removed
• Chemotherapy, given by pills, injection or IV— to kill the cancer cells
• Radiation—to kill or shrink cancer cells
• Stem cell support—to regrow the bone marrow, if needed

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Prevention

There are no current guidelines to prevent bone cancer.