What is bone cancer?

Primary bone cancer is a rare cancer that starts in the bones. Any bone can develop cancer, but it often begins in the legs or arms. There are three main types, which are chondrosarcoma, osteosarcoma, and Ewing sarcoma.

Secondary bone cancer is a different condition, where cancer starts elsewhere and spreads to the bones. Read more about the diagnosis and treatment of secondary bone cancer.

Bone marrow cancers, such as leukaemia, myeloma and lymphoma, are blood cancers. Find out more about blood cancers.

Around 600 people are diagnosed with primary bone cancer in the UK each year. It can affect people at any age, but some types are more common in children and young people. Early diagnosis and treatment give positive outcomes for many. 

Early signs and symptoms

The main symptom of bone cancer is pain. This can feel like tenderness, aching, or stabbing pain that worsens over time.

Other bone cancer symptoms include:

  • A bone fracture
  • A lump over the bone 
  • Swelling or redness over a bone if you have white skin
  • Swelling or darkening over a bone if you have black or brown skin
  • Difficulty moving the joint 

The symptoms often depend on the size and location of the tumour.

Less common symptoms include tiredness, a high temperature, and sweating, including night sweats. 

When to see a doctor

If you notice any symptoms that could be signs of bone cancer, it’s important to see a doctor straight away. It might not be cancer, but it’s always better to get checked so any treatment can start without delay.

You can speak to your GP, who may refer you to a specialist if appropriate.

What causes bone cancer?

In most patients there is no clear cause why they developed primary bone cancer. A small number of patients have risk factors, which increase the chances of getting bone cancer. These include genetic conditions, bone conditions, and previous cancer treatment.

Risk factors for bone cancer

Risk factors increase the chances of developing bone cancer. Even without risk factors, you can still get cancer – never ignore symptoms.

Known risk factors for bone cancer include:

  • Paget’s disease – a common bone condition with a 1 in 1,000 risk of bone cancer
  • Li-Fraumeni syndrome - a rare genetic condition that can increase your risk of osteosarcoma, a type of bone cancer
  • Retinoblastoma - a genetic condition affecting the eyes that can increase the risk of osteoblastoma
  • Radiotherapy or chemotherapy – there is a very small risk of developing primary bone cancer many years after treatment

How is bone cancer diagnosed?

The steps to diagnosing bone cancer involve several tests and scans, including: 

  • X-ray scans, which can show cancer in the bones
  • Taking a sample for testing, called a biopsy
  • CT scans and MRI scans to assess if the cancer has spread

Stages of bone cancer

The stage describes the bone cancer’s size and spread. This helps your doctor suggest the best treatment path for your diagnosis.

There are four stages of bone cancer:

  • Stage 1 – low-grade cancer that is only in the bone
  • Stage 2 – high-grade cancer that is only in the bone
  • Stage 3 – bone cancer that affects the bone and the area around the affected bone
  • Stage 4 – bone cancer that has spread to other parts of the body

Your consultant is always the best person to explain the stage of your cancer and what this might mean for your outlook and treatment.

Bone cancer treatment overview

Many bone cancers are treatable and a cure may be possible for patients with earlier stage cancer. Patients with more advanced bone cancer are offered a range of treatments to manage their condition and symptoms, but these are not usually curative.

How is bone cancer treated?

Treatment depends on the stage, size, and type of bone cancer. Often, surgery is combined with chemotherapy or radiotherapy to give the best possible outcomes.

The main treatments for bone cancer are:

 

Surgery

Surgery is usually the main treatment for bone cancer and forms part of an overall treatment and care plan. It aims to remove all of the cancer while keeping as much function as possible.

In some procedures, bone cancer surgery can preserve your limb function. The options depend on the size and location of the cancer. In rare situations, it may not be possible to preserve your limb function.  

 

Systemic anti-cancer therapy

Systemic anti-cancer therapies (SACTs) such as chemotherapy for bone canceruses anti-cancer (cytotoxic) drugs to destroy cancer cells.

You’ll likely have chemotherapy to reduce the size of your cancer before surgery or after surgery to prevent the cancer from coming back.

 

Radiotherapy

Radiotherapy uses targeted, high-energy radiation beams to destroy cancer cells. It’s commonly part of an overall treatment for Ewing sarcoma. You may have radiotherapy for other types of bone cancer that have spread or after surgery.

Bone cancer treatment at GenesisCare

We are the UK’s leading independent provider of private cancer care. By choosing us, you can be reassured that your treatment is managed by a team of orthopaedic oncology specialists working together with you to design the best plan for your bone cancer diagnosis. 

Our approach to world-class care for bone cancer includes: 

  • A personalised plan built around you
  • Treatment starting within days if needed
  • 14 outpatient cancer centres across the UK
  • State-of-the-art facilities specialising in advanced radiotherapy
  • Compassionate chemotherapy nurses available 24/7 by telephone 
  • Integrative cancer care including wellbeing therapies and exercise medicine
  • Recognition by all leading private medical insurers with self-pay options available
  • We'll help you with transport depending on treatment and locations, when required

We’re proud that so many patients rate our care as excellent as we help them through their cancer journey. Hear the unique experiences of people who have had their cancer diagnosis or treatment at GenesisCare in our patient stories section.

Surgery

Our consultants include expert orthopaedic surgeons who work in local and nationally renowned hospitals. They work together with other cancer specialists to design the best course of treatment for you, to preserve mobility and function with positive cancer outcomes wherever possible. 

Systemic anti-cancer therapy

Our compassionate nursing teams are available 24/7 on a dedicated on-call telephone service and can answer any queries during your treatment. They’ll be able to provide advice about side effects or symptoms and arrange any care you need throughout.

Our centres have all received the Macmillan Quality Environment Mark to reflect the quality of care we provide for people living with cancer.

Radiotherapy

We are the leading private provider of radiotherapy in the UK, offering world-class expertise and state-of-the-art facilities that specialise in advanced radiotherapy techniques. 

Wherever possible we offer volumetric modulated arc therapy (VMAT) with surface-guided radiotherapy (SGRT) wherever possible. By precisely targeting areas of bone cancer by adjusting the beam and intensity of the radiation dose, we can reduce the dose to healthy tissues and minimise side effects.

For selected secondary cancers that have spread to the bone, we offer stereotactic ablative radiotherapy (SABR). This is a high-dose, very accurate type of radiotherapy, similar to stereotasctic radiosurgery (SRS), delivered in a small number of treatments.

We also offer palliative VMAT radiotherapy for those living with advanced bone cancer to improve pain and increase mobility. We understand that fast access to palliative care is paramount and can usually provide this treatment within 48 hours of a planning imaging scan. 

Integrative cancer care

Every patient is supported through their journey with consultant-led integrative cancer care, which combines medical treatment with life-changing approaches including exercise medicine, wellbeing therapies and psychological support.

Exercise medicine includes a 12-week personalised programme provided by a specialist physiotherapist at select centres. It includes techniques shown to improve outcomes for cancer patients and reduce the impact of bone cancer by enhancing quality of life, helping with pain and mobility, and improving strength. 

FAQs

Reviewed by: Dr Peter Dickinson
Consultant Clincial Oncologist
October 2024

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