Bone Cancer

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If You Have Bone Cancer

If you or someone you know has just been diagnosed with bone cancer, this guide can help you understand what to expect.

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What is bone cancer?

Primary bone cancers are cancers that start in a bone. This can happen when the cells in the bone begin to grow out of control.

Bone cancer is a type of sarcoma, which is a cancer that develops from cells that normally make up the connective tissues of your body. These connective tissues include your bones and cartilage, as well as your muscles, fat, and the lining of your joints and blood vessels.

Types of bone cancer

There are many types of primary bone cancer. Your doctor can tell you more about the type you have.

The most common types of bone cancer are:

  • Osteosarcoma
  • Chondrosarcoma
  • Ewing sarcoma
  • Undifferentiated small round cell (Ewing-like) sarcomas
  • Undifferentiated pleomorphic sarcoma (UPS) of bone, formerly known as malignant fibrous histiocytoma (MFH) of bone
  • Fibrosarcoma of bone
  • Malignant giant cell tumor of bone
  • Chordoma

Note: Two of the most common types of bone cancer are osteosarcoma and Ewing sarcoma. These tend to be seen more often in children and teens. Information on these tumors can be found in:

All other forms of bone cancer are covered in this guide.

Primary bone cancer versus bone metastasis

Primary bone cancers start in bones. Most bone cancers in children and teens are primary bone cancers.

In adults, most cancers found in the bones started somewhere else and then spread to the bones. This is known as bone metastasis. It can happen with some common adult cancers like breast, prostate, or lung cancer.

For example, breast cancer that spreads to the bones is not bone cancer; it is metastatic breast cancer. The cancer cells in the bone look like the cells of the breast tissue, and they are treated the same way.

Other cancers that can start in the bones

Some cancers start in the bone marrow (the center of the bones, where new blood cells are made). These cancers include multiple myeloma, leukemias, and some non-Hodgkin lymphomas. They are not thought of as bone cancers. For more on these cancers, click on the links above.

Bone tumors that are not cancer

Not all bone tumors are cancer. Benign (non-cancerous) bone tumors don’t spread to other parts of the body. They are usually not life-threatening, and surgery can often remove them completely. There are many types of benign bone tumors, including:

  • Osteoid osteoma
  • Osteoblastoma
  • Osteochondroma
  • Chondroblastoma
  • Chondromyxoid fibroma
  • Enchondroma
  • Non-ossifying fibroma
  • Aneurysmal bone cyst
  • Unicameral bone cyst
  • Eosinophilic granuloma of bone
  • Benign giant cell tumor of bone

Questions to ask the doctor

  • Why do you think I have bone cancer?
  • Is there a chance I don’t have bone cancer?
  • Would you please write down the kind of bone cancer you think I have?
  • Where is the cancer? Which bone is it in?
  • What will happen next?

How does the doctor know I have bone cancer?

Bone cancer is often not found until a person goes to the doctor with pain or other signs and symptoms like swelling, a lump, and/or a broken bone.

If you go to the doctor with one or more of these symptoms, they will ask questions about your health and do a physical exam. If signs are pointing to bone cancer, the doctor will do tests to find out for sure.

Some of the tests you may need include:

Imaging tests

X-ray: This is often the first test done if the doctor thinks you might have bone cancer.

MRI scan: MRIs use radio waves and strong magnets instead of x-rays to make detailed pictures of your body. MRIs can help doctors learn more about the size and shape of a tumor in a bone and whether it has spread to surrounding tissues. This helps them plan for a biopsy (see below) and surgery.

CT scan (CAT scan): This test uses x-rays to make detailed pictures of the inside of your body. It can be used to see if cancer has spread to your liver, lungs, or other organs.

PET scan: A PET scan uses a special type of sugar that can be seen inside the body with a special camera. If there is cancer, this sugar shows up as a “hot spot” where the cancer is found. This test can help show if the cancer has spread, as well as if the cancer treatment is working. Some machines can do both a PET and a CT scan at the same time (known as a PET/CT scan).

Bone scan: A bone scan shows if cancer has spread to other bones. This test is useful because it can show all of the bones in your body at once.

Biopsy

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 bone cancer, and if so, what type. Biopsies can be done with a hollow needle or with surgery. Ask your doctor what kind of biopsy you need and how it’s done.

If the tumor is in a bone, it’s very important that your biopsy is done by a surgeon who treats a lot of bone tumors. This might affect treatment later on.

Questions to ask the doctor

  • What tests will I need?
  • Who will do these tests?
  • Where will they be done?
  • How and when will I get the results?
  • Who will explain the results to me?
  • What do we need to do next?

How serious is my cancer?

If you have bone cancer, your doctor will want to find out how far it has spread. This is called staging. The stage describes how much cancer is in your body, including the size of the original tumor and any spread to other parts of your body.

Knowing the stage of your cancer helps your doctor decide what type of treatment is best for you.

There are a few different ways your doctor could describe the stage of your bone cancer. They will probably assign your cancer a numbered stage between 1 and 3 or 1 and 4.

  • Lower numbers (1 and 2) are assigned to cancers that are small or have not spread.
  • Higher numbers (3 and 4) are assigned to larger tumors or cancer that may have spread from where it started.

Ask the doctor about your cancer stage and what it means for you.

Questions to ask the doctor

  • Do you know the stage of my cancer?
  • If not, how and when will you know?
  • Would you explain what the stage means for me?
  • How might the stage of the cancer affect my treatment?
  • What will happen next?

What kind of treatment will I need?

There are many ways to treat bone cancer. This includes surgery, radiation, chemo, and targeted drugs.

Doctors may use multiple types of treatment for some bone cancers. Your treatment plan will depend on:

  • The type of bone cancer
  • Where it is in your body
  • The stage of the cancer
  • The chance that a type of treatment will cure your cancer or help in some way
  • Your age and overall health
  • Your feelings about the treatment and its side effects

Surgery

Surgery is an important part of treatment for most types of bone cancer. The goal of surgery is to take out all the cancer. Often, some of the normal tissue around it needs to be removed as well.

In rare cases, an arm or leg needs to be amputated to get all the cancer out. If the cancer has spread, those tumors also need to be taken out when possible.

The exact type of surgery you need depends on your tumor and its location. A specialist called an orthopedic surgeon usually does the surgery. Ask them what kind of surgery you need and what to expect afterward.

Radiation

Radiation uses high-energy rays, like x-rays, to kill cancer cells. Most bone cancer cells are not easily killed with radiation, so this type of treatment isn't used for all bone cancers. It may be used if surgery can't take out a tumor. It also may be used after surgery to kill cancer cells that might have been left behind.

Radiation is aimed at the cancer from a machine outside your body. This is called external beam radiation.

Side effects of radiation treatments

If your doctor suggests radiation treatment, ask them what side effects might happen. These side effects will depend on the part of your body that’s treated. The most common side effects of radiation are:

  • Fatigue
  • Hair loss, in the area receiving radiation
  • Red, tender, or dry skin in the area receiving radiation, like a sunburn
  • Low blood counts (this is more common when radiation is combined with chemo or other drugs)

Most side effects get better after treatment ends, but some might last longer. Ask your cancer care team what to expect.

Chemotherapy (chemo)

Chemotherapy is the use of drugs to fight cancer. These drugs are often given through a needle into a vein (IV). They go into your blood and spread through your body.

Chemo is given in cycles or rounds. Each round of treatment is followed by a break to give your body time to recover. Usually, 2 or more chemo drugs are given. Treatment may last for months.

Side effects of chemo

If your doctor suggests chemo treatment, ask them what side effects might happen. Common short-term side effects of chemo include:

  • Nausea and vomiting
  • Loss of appetite
  • Diarrhea or constipation
  • Hair loss
  • Mouth sores
  • Increased risk of infections (from low white blood cell counts)
  • Bruising and bleeding easily (from low platelet counts)
  • Tiredness (from low red blood cell counts)

These problems often go away after treatment ends. Certain chemo drugs might cause other side effects, some of which could last a long time.

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 therapy and other drugs

Targeted drugs are treatments that target cancer cells more accurately than standard chemo drugs. Depending on the type of bone tumor, targeted drugs or other non-chemo drugs may be part of your treatment plan.

Side effects of targeted drugs

Side effects depend on which drug is used. These drugs might make you feel sick to your stomach or cause chills, fever, rashes, and headaches. Side effects often go away after treatment ends.

There are ways to treat many of the side effects caused by targeted drugs or other types of non-chemo drugs. If you have side effects, tell your cancer care team so they can help.

Clinical trials

Clinical trials study new treatments and may offer access to promising options not widely available. They are also how doctors learn better ways to treat cancer. If you would like to learn more about clinical trials, start by asking your cancer care team.

If your care team finds a clinical trial studying your type of cancer, 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 I hear of?

You might hear about other ways to treat your cancer or manage symptoms and side effects. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things.

Some of these are known to help, but many have not been tested. Some have been shown not to help, and a few have even been found harmful. Talk to your cancer care team about anything you are thinking of using, whether it is a vitamin, a diet, or anything else.

Questions to ask the doctor

Choosing a treatment plan

  • What treatment do you recommend and why?
  • What is the goal of treatment?
  • Will treatment include surgery? If so, who will do the surgery?
  • Will I need other types of treatment, too?
  • Is there a clinical trial that might be right for me?
  • How soon do I need to start treatment?
  • What’s the next step?

What to expect during and after treatment

  • What will surgery or other treatments be like?
  • What side effects could I have? What can I do about them?
  • Will surgery change the way my body looks and works?
  • Will I need rehab after surgery?
  • What should I do to be ready for treatment?
  • Is there anything I can do to help the treatment work better?

What will happen after treatment?

Many people feel relieved when they finish treatment. But it can be hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about it.

Following up with your cancer care team

You will need to see your cancer care team for years after treatment ends. Be sure to go to all of your follow-up visits. You might have exams, blood tests, scans, x-rays, or other tests to see if the cancer has come back and check for late effects of cancer treatments.

These visits may be very frequent at first. The longer you are cancer-free, the less often the visits are needed.

Social and emotional health after cancer

It’s normal to have some anxiety or other strong emotions after treatment, but feeling overly worried, depressed, or angry can get in the way of relationships, work, and other aspects of life.

With support from family, friends, other survivors, mental health professionals, and others, many people who have been treated for bone cancer can thrive despite the challenges they’ve faced.

If your feelings are getting in the way of your daily life, consider reaching out for support. The American Cancer Society is here to help:

side by side logos for American Cancer Society and American Society of Clinical Oncology

Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).

Amputation (am-pyoo-TAY-shun): Surgery to remove part or all of a limb (an arm or leg)

Biopsy (BY-op-see): The removal of small pieces of tissue to see if they contain cancer cells

Metastasis (muh-TAS-tuh-sis): The spread of cancer from where it 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

We have a lot more information for you. You can find it online at www.cancer.org. Or, you can call our toll-free number at 1-800-227-2345 to talk to one of our cancer information specialists.

Last Revised: January 5, 2026

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.

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