If You Have Bone Cancer
What is bone cancer?
Cancer can start any place in the body. Bone cancer is cancer that starts in the cells of a bone. All bone cancers start when cells in part of the bone grow out of control and crowd out normal cells. This makes it hard for the bone to work the way it should.
Cancer cells can spread to other parts of the body. Cancer cells in the bone can sometimes travel to the lungs and grow there. When cancer cells do this, it’s called metastasis (meh-TAS-tuh-sis). To doctors, the cancer cells in the new place look just like the ones from the bone where it started.
Cancer is always named for the place where it starts. So when bone cancer spreads to the lung (or any other place), it’s still called bone cancer. It’s not called lung cancer unless it starts from cells in the lung.
Other cancers confused with bone cancer
Most of the time, cancer in the bone did not start there. It spread to the bone from somewhere else in the body. For instance, breast cancer often spreads to the bone. This is not bone cancer. It’s metastatic breast cancer. The cancer cells in the bone look like the cancer cells in the breast and are treated the same way.
Some cancers start in the bone marrow – the center of the bones where blood cells are made. Multiple myeloma and leukemia are cancers like this. They are not bone cancers.
Here we will be talking about true bone cancer – cancer that starts in the cells of a bone.
Are there different kinds of bone cancer?
There are many types of bone cancers. The name depends on which type of bone cell the cancer starts in. Your doctor can tell you more about the type you have. Here are some of the most common types and how to say them:
- Osteosarcoma (OS-tee-oh-sar-KO-muh)
- Chondrosarcoma (KON-droh-sar-KOH-muh)
- Ewing (YOU-ing) tumor or Ewing sarcoma
- Malignant fibrous histiocytoma (muh-LIG-nunt FIE-brus HIS-tee-oh-sy-TOH-muh) or MFH
- Fibrosarcoma (FIE-bro-sar-KO-muh)
- Malignant (muh-LIG-nunt) giant cell tumor of bone
- Chordoma (kor-DOH-muh)
Questions to ask the doctor
- Why do you think I have cancer?
- Is there a chance I don’t have cancer?
- Would you please write down the kind of cancer you think I might have?
- Where is the cancer? Which bone?
- What will happen next?
How does the doctor know I have bone cancer?
These cancers may not be found until they cause pain that makes the person go to the doctor. Other signs of bone cancer include swelling, a lump, and/or the bone breaking.
The doctor will ask you questions about your health and do a physical exam. If signs are pointing to bone cancer, more tests will be done. Here are some of the tests you may need:
X-rays: Most bone cancers can be seen on x-rays. If cancer is found, a chest x-ray may be done to see if it has spread to the lungs.
CT scan: This is also called a “CAT scan.” It’s a special kind of x-ray that takes detailed pictures. It can be used to see if the cancer has spread to the liver, lungs, or other organs.
MRI scan: MRIs use radio waves and strong magnets instead of x-rays to take detailed pictures. MRIs can be used to learn more about the size and shape of the cancer and to look at the brain and spinal cord.
Bone scan: This test may be done to see if the cancer has spread to other bones. To do it, a small amount of low-level radioactive material is put into your blood. It settles in damaged areas of bone all over the body. A special camera finds the radioactivity and makes a picture of your bones.
PET scan: PET scans are like bone scans, but they use a type of sugar that can be seen inside your body with a special camera. If there is cancer, this sugar shows up as “hot spots” where the cancer is found. This test is useful when your doctor thinks the cancer might have spread, but doesn’t know where.
Biopsy (BY-op-see): For this test, the doctor takes out small pieces of the tumor. These are checked for cancer cells. This is the only way to know for sure if you have cancer and if started in the bone. Biopsies can be done with a hollow needle or with surgery. Ask the doctor what kind of biopsy you need and how it’s done.
Questions to ask the doctor
- What tests will I need to have?
- Who will do these tests?
- Where will they be done?
- Who can explain them to me?
- How and when will I get the results?
- Who will explain the results to me?
- What do I need to do next?
How serious is my cancer?
If you have bone cancer, the doctor will want to find out how far it has spread. This is called staging. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes how much the cancer grew in the place it started. It also tells if the cancer has spread to other parts of your body.
Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread from where it started. Be sure to ask the doctor about the cancer stage and what it means for you.
Questions to ask the doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- Based on the stage of the cancer, how long do you think I’ll live?
- What will happen next?
What kind of treatment will I need?
There are many ways to treat bone cancer:
Surgery and radiation treat only the cancer in the bone. They do not affect the rest of the body.
Chemo and targeted drugs go through the whole body. They can reach cancer cells anywhere in the body.
Doctors often use both types of treatments for bone cancers. The treatment plan that’s best for you will depend on:
- The type of bone cancer
- Where the cancer is
- The stage of the cancer
- The chance that a type of treatment will cure the cancer or help in some way
- Your age
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
Surgery (SUR-jur-ee) is the main treatment for most bone cancers. The goal of this treatment is to take out all of the cancer and some of the normal tissue around it. In rare cases, the arm or leg with cancer needs to be amputated (am-pew-TAY-tid) to get all the cancer. If the cancer has spread, those tumors need to be taken out, too.
Surgery can also be used to help rebuild or repair the changes caused by taking out the bone with cancer.
Ask your doctor what kind of surgery you need and what will be done during the surgery.
Side effects of surgery
Any type of surgery can have risks and side effects. Ask the doctor what you can expect. If you have problems, let your doctors know. Doctors who treat people with bone cancer should be able to help you with any problems that come up.
Radiation (RAY-dee-AY-shun) uses high-energy rays (like x-rays) to kill cancer cells. It’s not used a lot because most bone cancers are not easily killed with radiation. It may be used if a tumor cannot be taken out. It also may be used after surgery to kill cancer cells that were left behind.
Radiation is aimed at the cancer from a machine outside the body. This is called external beam radiation.
Side effects of radiation treatments
If your doctor suggests radiation treatment, talk about what side effects might happen. Side effects depend on the part of your body that’s treated. The most common side effects of radiation are:
- Skin changes where the radiation is given
- Feeling very tired
- Low blood counts
Most side effects get better after treatment ends. Some might last longer. Talk to your cancer care team about what you can expect.
Chemo (KEY-mo) is the short word for chemotherapy (KEY-mo-THAIR-uh-pee), the use of drugs to fight cancer. The drugs are often given through a needle into a vein. These drugs go into the blood and spread through the body.
Chemo is given in cycles or rounds. Each round of treatment is followed by a break. Most of the time, 2 or more chemo drugs are given. Treatment often lasts for many months.
Side effects of chemo
Chemo can make you feel very tired, sick to your stomach, and cause your hair to fall out. But these problems go away after treatment ends.
There are ways to treat most chemo side effects. If you have side effects, talk to your cancer care team so they can help.
Targeted drugs are made to work mostly on the changes in cells that make them cancer. These drugs affect mainly cancer cells and not normal cells in the body. They may work even if other treatment doesn’t.
Side effects of targeted drugs
Side effects depend on which drug is used. These drugs often make you feel sick to your stomach and cause chills, fever, rashes, and headaches. Side effects often go away after treatment ends.
There are ways to treat most of the side effects caused by targeted drugs. If you have side effects, talk to your cancer care team so they can help.
Clinical trials are research studies that test new drugs or other treatments in people. They compare standard treatments with others that may be better.
If you would like to be in a clinical trial, start by asking your doctor if your clinic or hospital takes part in clinical trials. You can also call our clinical trials matching service at 1-800-303-5691 or go online to find studies near you.
Clinical trials are one way to get state-of-the art cancer treatment. They are the best way for doctors to find better ways to treat cancer. If your doctor can find one that’s studying the kind of cancer you have, it’s up to you whether to take part. And if you do sign up for a clinical trial, you can always stop at any time.
What about other treatments that I hear about?
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether it’s a vitamin, a diet, or anything else.
Questions to ask the doctor
- What treatment do you think is best for me?
- What’s the goal of treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will surgery change the way my body looks and works?
- Will I need rehab after surgery?
- Will I need other types of treatment, too?
- What will these treatments be like?
- What’s the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- What’s the next step?
What will happen after treatment?
You’ll be glad when treatment is over. But it’s hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back.
At first, your visits may be every few months. Then, the longer you’re cancer-free, the less often the visits are needed. Your doctor will tell you which tests should be done and how often based on the stage of your cancer and the type of treatment you had.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us or talk to your doctor to find out what you can do to feel better.
You can’t change the fact that you have cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as good as you can.
Amputation (am-pew-TAY-shun): Surgery to remove part or all of a limb (an arm or leg).
Biopsy (BY-op-see): Taking out a small piece of tissue to see if there are cancer cells in it.
Metastasis (muh-TAS-tuh-sis): Cancer cells that have spread from where they started to other places in the body.
Orthopedic surgeon (or-thuh-PEE-dik SUR-jun): A doctor who uses surgery to treat bone and joint problems.
Orthopedic oncologist (or-thuh-PEE-dik on-KAHL-uh-jist): An orthopedic surgeon who specializes in treating cancer of the bones and joints.
Last Medical Review: March 21, 2014 Last Revised: January 21, 2016