Bone Cancer: Symptoms, Causes, Diagnosis & Treatment

Bone cancer is a rare but serious condition that can affect any bone in the body. It occurs when there is abnormal growth of cells in the bone tissue, leading to the formation of tumors. There are several types of bone cancer, each with its unique characteristics and prognosis.

The symptoms of bone cancer vary depending on the location and stage of the disease, but some common symptoms comprise bone pain, swelling, and weakened bones that might result in fractures. 

The exact cause of bone cancer is not yet well-understood, but certain factors have been associated with the development of the disease. These factors include radiation therapy for cancer, certain changes in the DNA of bone cells, Paget’s disease, and inherited genetic syndromes. 


Diagnosis of bone cancer typically involves physical exams, imaging tests such as X-rays or MRIs, and a biopsy to confirm the presence of cancerous cells.

Treatment options for bone cancer depend on the type, stage, and location of the tumor, and may include surgery, radiation therapy, chemotherapy, or targeted therapy. Prevention of bone cancer is not well-defined due to the lack of understanding of its exact causes. 

However, maintaining a healthy lifestyle, reducing exposure to radiation, and early detection through regular check-ups can help lessen the risk and provide better outcomes for patients.


Symptoms of bone cancer are variable and depend on the type and location of the cancer. 

As these symptoms can also be caused by other less serious conditions, it is essential to consult a healthcare provider when persistent symptoms are experienced.

Pain and Swelling

Pain in the site is one of the main symptoms of bone cancer. This pain may initially be mild and progressively get worse over time, especially during physical activity or at night.

Another common symptom is swelling in the area of the tumor, which can lead to difficulty moving or bending that part of the body.

Fatigue and Weight Loss

Bone cancer can also cause individuals to experience fatigue and weight loss. These symptoms may not be immediately noticeable but can become more prominent as the condition progresses.

Fatigue can make it difficult for a person to carry out daily tasks, whereas weight loss can result from a decreased appetite or the body’s increased energy expenditure to fight the disease.

Fever and Weakness

In some cases, bone cancer may cause fever and weakness. A fever could indicate the presence of an infection or the body’s immune response to the cancer.

Weakness can be a sign of the body attempting to cope with the disease. It is essential to consult a healthcare professional if any of these symptoms persist or worsen.

Causes and Risk Factors

It’s important to mention that not everyone with these risk factors will develop bone cancer, and some individuals may develop bone cancer without any known risk factors being present. 

Being aware of these factors can help with early detection and prompt treatment, ultimately improving the chances of a successful outcome.

Primary Bone Cancer

Primary bone cancer is a rare condition that begins in the bone, with the most common types being osteosarcoma, chondrosarcoma, and Ewing’s sarcoma. 

The exact cause of primary bone cancer is still unknown, but certain factors can increase your risk. These include:

Genetic Syndromes

Inherited conditions such as Li-Fraumeni syndrome and hereditary retinoblastoma have been associated with an increased risk of developing primary bone cancer.

These syndromes represent a small percentage of cases. Individuals with a family history of these conditions could benefit from genetic counseling to understand their risk.

Paget’s Disease

This bone disorder, which is more common in older adults, can increase the risk of developing osteosarcoma.

This is a condition characterized by abnormal bone remodeling, which increases the risk of bone cancer.

Family History 

Having a close relative with a history of bone cancer can increase your risk, suggesting that genetic factors play a role in the development of the disease.

While a family history doesn’t guarantee the development of the disease, it can inform the need for more vigilant monitoring.

Bone Cancer Metastasis

Secondary bone cancer, also referred to as bone cancer metastasis, happens when cancer cells from another body part, for instance, the breast, prostate, or lung, spread and affect the bones. 

The risk factors associated with developing secondary bone cancer are generally related to the primary cancer and its ability to metastasize. 

Advanced Stage Primary Cancer 

The risk of secondary bone cancer increases as the primary cancer progresses and spreads beyond its original site.

Breast, prostate, and lung cancer patients with these types of cancer are more likely to develop secondary bone cancer due to the higher likelihood of these cancers metastasizing to the bones.


Thorough and accurate diagnosis aids in determining the type and stage of the cancer, which in turn dictates the treatment plan.

Imaging Tests

Imaging tests play a crucial role in determining the location, size, and spread of bone tumors. There are several types of imaging tests that doctors may recommend based on the patient’s signs and symptoms. 

These tests include X-rays, which are often the first step in diagnosing bone cancer.

If X-rays suggest a tumor, further imaging tests like CT scans, MRI scans, and bone scans might be performed to gain more detailed information about the tumor. In some cases, PET scans are also used.

Bone tumors in the spine can press on nerves, resulting in pain and other symptoms. Imaging tests can help identify such cases and determine the extent of the damage.


A biopsy is essential for confirming the diagnosis of bone cancer. A small specimen of the affected bone is extracted and examined in a lab to determine the kind of cancer cells that are present. 

There are two main types of bone biopsies: needle biopsy, in which a thin needle is inserted through the skin and into the bone, and surgical biopsy, where a small incision is made to remove a piece of the bone.

The choice on which approach will be used depends on the location and size of the tumor, in addition to the patient’s overall health.

Blood Tests

While blood tests are not typically used to diagnose bone cancer directly, they can help doctors assess a patient’s overall health and check for signs of other diseases, such as Paget’s disease. 

Blood tests can also detect abnormal levels of certain substances, like alkaline phosphatase, that may be associated with bone cancer and help gauge its aggressiveness.

In cases of Ewing sarcoma, blood tests may reveal the presence of a specific genetic change (chromosomal translocation) that is characteristic of this condition. This information can help guide treatment decisions and determine prognosis.

Types of Bone Cancer

There are several types of primary bone cancers, which originate in the bones themselves. These include:


This is the most common type of primary bone cancer and usually affects the long bones in the arms and legs, as well as the pelvis.

Osteosarcoma commonly occurs and develops in children and young adults. Studies suggest the growth of the tumor being linked with the fast bone growth rate during teenage years.

Ewing’s Sarcoma

This rare bone cancer affects the pelvis, legs, and arms, and occurs mostly in teenagers and young adults, which studies suggest is related to bone growth during this period.

Despite its aggressiveness, Ewing’s sarcoma has a relatively good prognosis when detected early with timely treatment. 


Originating in the cartilage, this type of bone cancer typically affects the pelvis, upper legs, and shoulders.

It is observed to be more common in middle-aged and older adults.

Multiple Myeloma

This cancer affects bone marrow and can cause benign bone tumors. While not a primary bone cancer, it is frequently associated with bone lesions and is worth mentioning in this context.

It is termed Multiple Myeloma since this condition has been observed to affect more than one part of the skeletal system and may affect the skull, spine, ribs and pelvis.


After bone cancer is diagnosed, it needs to be staged. The stages of bone cancer are identified through the size and position of the tumor as well as the extent to which the cancer has spread. 

Staging helps estimate the prognosis and guides the choice of treatment. The following stages are used as the reference:

Stage 1

The cancer is low-grade, has not spread outside the bone, and has no activity suggesting aggressive growth.

The prognosis for stage 1 bone cancer is generally favorable, with treatment involving surgery, and possibly chemotherapy or radiation. Thorough monitoring post-treatment helps detect any recurrence early, improving the chance for successful treatment and a healthy outcome.

Stage 2

The tumor is larger or shows more aggressive growth but has not spread beyond the bone.

Stage 2 bone cancer treatment typically involves surgery, often coupled with chemotherapy or radiation to ensure all cancer cells are eradicated. 

Stage 3 

There are multiple tumors within the affected bone, but it has not spread beyond the bone.

Treatment’s aim is to preserve as much function as possible. Follow-up care after treatment for stage 3 bone cancer is crucial in identifying any signs of recurrence or spread. 

Stage 4

The cancer has metastasized and affected other parts of the body, such as the lungs or other bones.

Treatment generally focuses on controlling the cancer, relieving symptoms, and maintaining the patient’s quality of life. 

These stages provide essential information for medical professionals to determine the best course of action in treating bone cancer. 

Treatment Options

There are several treatment options for bone cancer, which may include surgery, radiation therapy, chemotherapy, or a combination of these methods.

The treatment plan, depending on the specific type and stage of the bone cancer will be discussed in more detail below.


Surgery is often the primary treatment option for bone cancer.

The objective of surgery is to extract the tumor and a margin of healthy tissue surrounding it, to confirm that all cancerous cells have been removed. 

There are two main types of surgery for bone cancer:

Limb Salvage Surgery

This procedure aims to remove the tumor while preserving the affected limb.

Surgeons may use metal rods or other materials to replace the removed bone tissue, allowing the patient to regain function in the limb.


In some cases, if the tumor is too large or has invaded vital structures, amputation of the affected limb may be necessary.

Advanced prosthetics can help patients regain mobility and function after amputation.

Radiation Therapy

To kill cancer cells, radiation therapy utilizes high-energy beams, such as gamma rays, charged particles or high-energy X-rays. It may be used in combination with surgery or chemotherapy, or as the primary treatment if surgery is not possible.

Radiation treatment can be especially helpful in treating bone cancer that has spread to other parts of the body.


Chemotherapy uses powerful drugs to kill cancer cells or stop them from growing and dividing. This treatment might be given prior to surgery to reduce the tumor, or post-surgery to eliminate any remaining cancer cells.

Chemotherapy can also be used in combination with radiation therapy during treatment. Clinical trials may offer access to newer chemotherapy drugs, providing valuable options for patients with early-stage or advanced bone cancer.

Targeted Therapy

Targeted therapy involves using medications that specifically target the cancer cells’ growth, division, or survival pathways, causing less harm to healthy cells. These drugs may be used alone or in combination with chemotherapy or radiation therapy, depending on the specific bone cancer type and stage.

Targeted therapy may also be an option for patients who have not responded to other treatments or who are unable to undergo surgery.


Although it’s challenging to prevent bone cancer entirely, some steps can be taken to reduce the risk.

Maintaining a healthy lifestyle and being mindful of certain factors can help in lowering the chances of developing bone cancer.

Avoid exposure to radiation

Prolonged exposure to high doses of radiation has been linked to the development of bone cancer. It’s essential to minimize exposure to radiation whenever possible.

In situations where radiation therapy is required for cancer treatment, make sure to discuss possible alternatives with your healthcare professional.

Be cautious with certain medications 

Some medications, such as those used to manage bone conditions like Paget’s disease, may increase the risk of bone cancer.

Always inquire about the potential side effects and risks of prescribed medications, and communicate any concerns to your healthcare professional.

Maintain a healthy lifestyle

A well-balanced diet, regular exercise, and avoiding tobacco products can contribute to overall health and lower the risk of various types of cancers. 

Consuming nutrient-rich foods and engaging in physical activities can help strengthen the immune system, making it less susceptible to the development of diseases, including bone cancer.

Understand your family history

For those with a family history of cancer or inherited genetic syndromes, it’s crucial to be aware of the risks.

Regular check-ups and engaging in preventive measures can help detect early signs of cancer, which increases the chances of successful treatment.

Adopting a cautious approach, monitoring health conditions, and being vigilant about risk factors can help in reducing the likelihood of developing bone cancer. 

Prognosis and Survival Rate

The prognosis for bone cancer is dependent on diverse factors such as the kind of cancer, the stage at diagnosis, and the overall health of the patient. For some rare types of bone cancer, it could be challenging to provide accurate survival rates. However, understanding the general outlook can be helpful for patients and their families.

The survival rate may vary depending on the type of bone cancer. For instance, Ewing sarcoma has a higher survival rate in the early stages and decreases if the cancer metastasizes or spreads to other parts of the body.

Prompt diagnosis and treatment play a crucial role in improving the chances of success in bone cancer patients. Early-stage bone cancer often has a more favorable outcome, as it can be treated surgically with high success rates. 

Studies have shown that the 5-year survival rate for localized or non-metastasized bone cancer is about 70 to 80 percent.

It is important to note that survival statistics are derived from large groups of people and cannot predict the outcome for an individual case. 

Your healthcare team can provide more personalized information about your prognosis based on your specific circumstances.

In addition to early detection and treatment, advances in medical technology have contributed to improved survival rates for bone cancer patients.

Advancements in the treatment options can help control the cancer and mitigate symptoms for those in later stages of the disease.

Frequently Asked Questions

What are the common symptoms of bone cancer?

Bone cancer can present various symptoms, the most common being pain in the affected bone, which can become more severe at night or during physical activity. Additionally, swelling and tenderness in the area, fatigue, and unintended weight loss can be experienced.

In some cases, bone cancer can also cause numbness, tingling, or weakness in different parts of the body, depending on the tumor’s location.

How is bone cancer diagnosed?

The diagnosis of bone cancer typically consists of imaging tests to identify the location and size of the bone tumors and to detect if the tumors have spread to other parts of the body.

The specific tests recommended will depend on individual signs and symptoms and may include bone scans, computerized tomography (CT), and other imaging tests.

What are the main causes of bone cancer?

The exact cause of bone cancer remains unclear. As research continues, more about the causes and risk factors of bone cancer is being discovered.

However, certain factors are known to increase the risk of developing this rare type of cancer, such as inherited genetic syndromes, radiation exposures in the past, and having a history of noncancerous bone diseases.

What treatments are available for bone cancer?

Bone cancer treatment is recommended by the healthcare team based on the patient’s individual case, including the type, stage, and location of the cancer.

Common treatment options include surgery to remove the tumor, chemotherapy, radiation therapy, cryosurgery (freezing the cancer cells), and targeted therapy.

How can bone cancer be prevented?

While there is no surefire way to prevent bone cancer, individuals can take steps to reduce their overall risk for developing cancer.

These steps include adopting a healthy lifestyle, such as consuming a well-balanced diet, exercising regularly, and avoiding known carcinogens like tobacco and excessive exposure to radiation.

Is bone cancer curable?

The prognosis for bone cancer patients relies on factors such as the type and stage of the cancer, along with the patient’s overall health.

In general, early diagnosis and prompt treatment significantly improve the chances of a favorable outcome. It is essential to consult a healthcare professional for personalized advice on prognosis and treatment options.