Bone Cancer

Medically Reviewed by Jennifer Robinson, MD on March 23, 2024
5 min read

Bone cancer is when unusual cells grow out of control in your bone. It destroys normal bone tissue. It may start in your bone or spread there from other parts of your body (called metastasis).

Bone cancer is rare. Most bone tumors are benign, which means they aren’t cancer and don’t spread to other areas of your body. But they may still weaken your bones and lead to broken bones or other problems. There are a few common types of benign bone tumors:

  • Osteochondroma is the most common. It often happens in people under age 20.
  • Giant cell tumor is usually in your leg. In rare cases, these can also be cancerous.
  • Osteoid osteoma often happens in long bones, usually in your early 20s.
  • Osteoblastoma is a rare tumor that grows in your spine and long bones, mostly in young adults.
  • Enchondroma usually appears in bones of your hands and feet. It often has no symptoms. It’s the most common type of hand tumor.

Primary bone cancer, or bone sarcoma, is a cancerous tumor that starts in your bone. Experts aren’t sure what causes it, but your genes may play a role. Some of the most common types of primary bone cancer are:

  • Osteosarcoma often forms around your knee and upper arm. Teens and young adults are most likely to get it, but another form is common in adults who have Paget's disease of bone.
  • Ewing's sarcoma usually happens in people between the ages of 5 and 20. Your ribs, pelvis, leg, and upper arm are the most common sites. It can also start in the soft tissue around your bones.
  • Chondrosarcoma happens most often in people between ages 40 and 70. Your hip, pelvis, leg, arm, and shoulder are common sites of this cancer, which begins in cartilage cells.

Although it happens in your bones, multiple myeloma is not a primary bone cancer. It’s a cancer of your marrow, the soft tissue inside bones.

Cancer in your bones usually started elsewhere in your body. For example, if lung cancer has spread to your bones, that's secondary bone cancer. Any cancer that moves from one part of your body to another is called metastatic cancer.

Cancers that commonly spread to bone include:

Things that might make you more likely to get bone cancer include:

  • Cancer treatment. Bone tumors happen more often in people who’ve had radiation, stem cell transplants, or certain chemotherapy drugs for other cancers.
  • Inherited conditions. Diseases passed down through your genes, such as Li-Fraumeni syndrome and an eye cancer called retinoblastoma, can make you more likely to get bone cancer.
  • Paget’s disease of bone. This benign bone condition may also increase your odds.

You may not notice symptoms of a bone tumor, whether it's cancer or not. Your doctor might find it when they look at an X-ray of another problem, such as a sprain. But symptoms can include pain that:

  • Is in the area of the tumor
  • Is dull or achy
  • Gets worse with activity
  • Wakes you at night

An injury won’t cause a bone tumor.

Other symptoms related to bone tumors include:

Your doctor will ask about your symptoms and medical history and do a physical exam. They’ll look at pictures of your bones through imaging tests such as:

  • X-rays. These show tumors and how big they are.
  • CT scans. A computer uses X-rays to make more detailed pictures.
  • MRI scans. These use a strong magnet to show inside your body.
  • PET scans. A technician injects radioactive glucose (sugar) into your vein. A scanner then spots cancer cells, which use more glucose than regular cells.
  • Bone scans. A technician injects a different radioactive material into your vein. It collects in your bones, where a scanner can see it.

Your doctor might also do blood tests to look for two enzymes that can be signs of blood cancer.

A procedure called a biopsy can confirm a diagnosis. Your doctor takes a sample of the tumor with a needle or through a cut in your skin. A trained technician looks at the tissue or cells under a microscope. They can tell if your tumor is benign or a primary or secondary cancer. They can also get an idea of how fast it’s growing.

If you have a benign tumor, your doctor will treat it with medication or might just watch it for changes. They may take out benign tumors that are more likely to spread or become cancer. In some cases, tumors come back, even after treatment.

Cancerous tumors need stronger treatment and care from a number of specialists. Your treatment will depend on several things including how far it’s spread, which experts use to determine its stage. Cancer cells that are only in the bone tumor and the surrounding area are at a “localized” stage. Those that spread to or from other areas of your body are more serious and harder to treat.

Common treatments for bone cancer include:

Limb salvage surgery. Your doctor removes the part of the bone with cancer but not nearby muscles, tendons, or other tissues. They put a metallic implant in place of the bone.

Amputation. If a tumor is large or reaches your nerves and blood vessels, your doctor might remove the limb. You may get a prosthetic limb afterward.

Radiation therapy. This kills cancer cells and shrinks tumors with strong X-rays. Doctors often use it along with surgery.

Chemotherapy. This kills tumor cells with cancer drugs. Your doctor might use it before surgery, after surgery, or for metastatic cancer.

Targeted therapy. This drug treatment targets certain genetic, protein, or other changes in or around cancer cells.

You might want to join a clinical trial that’s testing new treatments.

Bone cancer treatments can cause problems over time with your heart, lungs, brain, hearing, bones, or fertility. It’s important to have regular checkups with your doctor to watch for these complications and to make sure the bone cancer doesn’t come back.

Your recovery from bone cancer depends on its type and stage. Overall, more than 78% of people who have it live at least 5 years after diagnosis.