Diseases & Conditions


Bone Cancer

Diseases & Conditions


What is bone cancer?

Bone cancer is a tumor that begins in the bones leading to the destruction of normal bone tissue. Although it can begin in any bone of the body, bone cancer commonly affects the long bones of the legs or arms.1

Cancer that starts in another part of the body such as the breasts, lungs or prostate and metastases to the bones is not called bone cancer.

Bone cancer is an uncommon type of cancer. The number of new cases of bone and joint cancer was 0.9 per 100,000 men and women per year between 2008 and 2012.2

Some types of bone cancer occur primarily in children, while others affect mostly adults. In Saudi Arabia, bone cancer was the sixth most common cancer among boys and the fifth among girls accounting for about 5% of all cancers in children in 2010.3

The stages of bone cancer are:4

Stage I

Cancer is limited to the bones

Stage II

Cancer is also limited to the bones but cancer cells are more aggressive than those in stage I

Stage III

Cancer occurs in multiple places on the same bone

Stage IV

Cancer has spread beyond the bones to other areas of the body


What causes bone cancer?

The causes of bone cancer are still unknown. It is known that cancer starts as an error in a cell's DNA leading to an uncontrolled division of the cells.

Bones consist of osteoid (hard or compact), cartilaginous (tough, flexible), and fibrous (threadlike) tissue, as well as elements of bone marrow (soft, spongy tissue in the center of most bones). Bone cancer can begin in any of these parts. The most common types of bone cancer include:5

  • Osteosarcoma: This type of bone cancer starts in the osteoid.
  • Chondrosarcoma: This type of bone cancer starts in the cartilaginous tissue.
  • Ewing's sarcoma: This type of bone cancer usually occurs in bones but may also starts in soft tissue.


What are the risk factors for bone cancer?

Some risk factors are associated with an increased risk of developing bone cancer:6

  • Age: Some types of bone cancer are more common in children.
  • Radiation therapy for cancer: Exposure to large doses of radiation increases the risk of bone cancer.
  • Bone diseases: Some bone diseases such as Paget’s diseases of the bone increase the risk of bone cancer.
  • Genetics: Certain rare genetic syndromes passed through families increase the risk of bone cancer.
  • Race: Whites are at increased risk of developing bone cancers than blacks.
  • Height and weight: Children who are born heavier than average, have a higher risk of developing bone cancer later in life.
  • Congenital umbilical hernia: Children who are born with hernia are at higher risk of bone cancer.


What are the symptoms of bone cancer?

Signs and symptoms of bone cancer include:7

  • Bone pain
  • Swelling in the area of the pain
  • Bone fractures
  • Weight loss
  • Fatigue


How is bone cancer diagnosed?

The following tests may be used to diagnose bone cancer:8

  • Physical examination: The doctor will check signs and symptoms of bone cancers.
  • Blood tests: Some substances increase in patients with bone cancer. Laboratory blood tests may help detect these substances.
  • X-ray: This test creates images showing the location, size, and shape of a bone tumor.
  • Bone scan: A bone scan uses a radioactive tracer to look at the inside of the bones.
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan
  • Integrated PET-CT scan: This scanning method collects images from both a CT and a PET scan at the same time and then combines the images. It can show both the structure and how energy is used by the tumor and healthy tissue.
  • Biopsy: A biopsy is the removal of a small amount of tissue for examination under a microscope.


How is bone cancer treated?

Treatment options of bone cancer depend on the type of cancer a patient has and the stage of the cancer. It includes surgery, chemotherapy and radiation therapy.9

  • Surgery: The aim of surgery is to remove the whole cancer. Depending on the stage of the bone cancer, surgery can remove the cancer cells but spare the limb or remove to entire limb.
  • Chemotherapy: Chemotherapy is a drug treatment that uses chemicals to kill cancer cells.
  • Radiation therapy: Radiation therapy uses X-rays to kill cancer cells.


How to cope with bone cancer?

It can be very difficult coping with a diagnosis of cancer. However, a patient can take several steps to improve his quality of life:10

  • Choosing the best healthcare: Great advances have been made in the treatment of bone cancer during the last decades. Learning about the disease and making decisions about the treatment could help reducing the distress and the uncertainty.
  • Family and Friends: A cancer diagnosis can be overwhelming for family members and friends. Keeping them close is a great way to reduce the emotional burden of bone cancer.
  • Talking with someone: Talking with a good listener can help a patient diagnosed with cancer cope with the fears and other emotions he is feeling.


  1. Bone cancer symptoms (Bone Cancer Symptoms & Signs) http://www.cancercenter.com/bone-cancer/symptoms/ (Accessed January 20, 2016)
  2. Surveillance, Epidemiology, and End Results Program (Cancer of the Bones and Joints) http://seer.cancer.gov/statfacts/html/bones.html (Accessed January 19, 2016)
  3. "Cancer Incidence Report Saudi Arabia 2010." Kingdom Saudi Arabia Council of Health Services Saudi Cancer Registry. 2014. Web. <http://www.chs.gov.sa/Ar/mediacenter/NewsLetter/2010 Report (1).pdf> (Accessed January 19, 2016)
  4. Bone cancer (Diagnosis) http://www.mayoclinic.org/diseases-conditions/bone-cancer/diagnosis-treatment/diagnosis/dxc-20126508 (Accessed January 19, 2016)
  5. Bone Cancer (National Cancer Institute) http://www.cancer.gov/types/bone/bone-fact-sheet (Accessed January 19, 2016)
  6. Risks and causes of bone cancer (Risks and causes of bone cancer) http://www.cancerresearchuk.org/about-cancer/type/bone-cancer/about/risks-and-causes-of-bone-cancer (Accessed January 19, 2016)
  7. Signs and symptoms of bone cancer (American Cancer Society) http://www.cancer.org/cancer/bonecancer/detailedguide/bone-cancer-signs-symptoms (Accessed January 19, 2016)
  8. Bone Cancer - Diagnosis (Cancer.Net) http://www.cancer.net/cancer-types/bone-cancer/diagnosis (Accessed January 19, 2016)
  9. Bone cancer treatment: http://www.mayoclinic.org/diseases-conditions/bone-cancer/diagnosis-treatment/treatment/txc-20126509 (Accessed January 19, 2016)
  10. Bone cancer (Self-management) http://www.mayoclinic.org/diseases-conditions/bone-cancer/manage/ptc-20126420 (Accessed January 20, 2016)