Bone cancer

The main symptoms of primary bone cancer are bone pain or tenderness, swelling near the affected bone and problems moving around.

The cause of primary bone cancer is often unknown. You may be more likely to get it if you've had cancer treatment before or certain bone conditions.

Tests used to diagnose primary bone cancer include an X-ray, scans, and a bone biopsy, where a small sample of bone is removed and checked for cancer.

Surgery and chemotherapy are the main treatments for primary bone cancer. Radiotherapy or targeted medicines are also sometimes used.

The symptoms of primary bone cancer depend on the type and size of the cancer and where it is.

The main symptoms of bone cancer are:

• bone pain or tenderness – the pain may be constant or come and go, and it may be worse at night
• a lump or swelling (but it may not always be easy to see or feel)
• problems moving around – if the cancer is close to a joint, it may be difficult to move the joint and you may walk with a limp

Less common symptoms of bone cancer include:

• feeling very tired even after a good night's sleep
• high temperature (fever) – you may sweat a lot
• losing weight without trying to
• breaking a bone, but this is a very rare symptom of bone cancer

• you have pain or tenderness in a bone, particularly if it's worse at night
• you notice a change that's not normal for you – for example, you have a lump or swelling or unexpected weight loss
• pain in your bones or joints is making it difficult for you to move around

You might not have bone cancer, but it's important to see a GP so they can check your symptoms. Finding bone cancer early can mean it's easier to treat.

It's not known what causes most primary bone cancers.

Some types of bone cancers are more common in certain age groups.

For example:

• Ewing sarcoma is more common in children and teenagers, but it can also affect adults
• osteosarcoma often affects children and teenagers (10 to 19 years)
• chondrosarcoma tends to affect adults aged 30 to 60 years

You're also more likely to get bone cancer if:

• you've had radiotherapy or chemotherapy treatment for cancer in the past, particularly during childhood
• you have an inherited condition like hereditary retinoblastoma, Li-Fraumeni syndrome or Werner syndrome
• you have another bone condition, such as Paget's disease of bone or a non-cancerous (benign) bone tumour

If a GP thinks you could have bone cancer, they'll refer you to a bone specialist (an orthopaedic doctor) for some tests.

Tests you may have include:

• an X-ray
• a scan, such as a CT scan or MRI scan
• a bone biopsy – where a surgeon removes a small sample of bone so it can be sent to a lab and checked for cancer
• blood tests
• a bone marrow biopsy

Bone marrow is a spongy substance inside bones.

During a bone marrow biopsy, a thin needle is used to remove some bone marrow cells, usually from your hip. The sample is checked for cancer.

Primary bone cancer can often be treated.

The treatment you have will depend on:

• the type of bone cancer you have
• where the cancer is
• your general health
• your treatment preferences

Surgery and chemotherapy are the main treatments for primary bone cancer. Radiotherapy or targeted medicines are also used to treat some types of bone cancer.

The specialist care team looking after you will:

• explain the treatments, benefits and side effects
• work with you to create a treatment plan that's best for you
• discuss the chances of the bone cancer coming back and how it will be treated if it does

You'll have regular check-ups during and after any treatments. Depending on the stage of your bone cancer, you may have tests and scans.

If you have any symptoms or side effects you're worried about, talk to your specialists. You do not need to wait for your next check-up.

You and your loved ones will be supported throughout your treatment by a group of specialists.

The clinical nurse specialist, or another member of your specialist team, will be able to give you information on local support services that you may find helpful.

There are also national cancer charities that offer support and information about bone cancer.

Information, help and support for people affected by primary bone cancer.

• Website: www.bcrt.org.uk
• Support line: 0800 111 4855
• Bone Cancer Research Trust: get support

Help and support for anyone diagnosed with or affected by bone cancer (sarcoma).

• Website: www.sarcoma.org.uk
• Support line: 0808 801 0401
• Sarcoma UK: support for you

Information and support for anyone affected by cancer.

• Website: www.cancerresearchuk.org
• Nurse helpline: 0808 800 4040
• Cancer Research UK: ask a nurse service
• Cancer Research UK: online cancer chat forum
• Cancer Research UK: find a clinical trial service

Information and support for anyone affected by cancer.

• Website: www.macmillan.org.uk
• Helpline: 0808 808 00 00
• Macmillan Cancer Support: support line service
• Macmillan Cancer Support: online bone cancer forum
• Macmillan Cancer Support: find local support services

Care and support for anyone affected by a terminal illness.

• Website: www.mariecurie.org.uk
• Helpline: 0800 090 2309
• Marie Curie: support services