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Bone Cancer (cont.)

Bone Cancer Diagnosis

Your physician will likely begin with a complete medical history, family history, and physical examination. The purpose of the medical and family history is to determine how your symptoms developed and how they have changed over time. These clues can help your physician diagnose bone cancer versus some other potential cause of your symptoms. The physical examination will evaluate the area of pain or mass, and check your strength, sensation, and reflexes.

Certain blood tests may be ordered that can help with the diagnosis. Alkaline phosphatase and lactate dehydrogenase are often elevated in the blood of patients with osteosarcoma and Ewing's sarcoma.

Next, the physician will likely order some imaging study of the affected bone. Plain X-rays or radiographs can often identify abnormalities in the bones and provide information on the shape, size, and location of the tumor.

  • X-rays can also look for possible fractures and asses the risk of future fracture. A bone scan involves injecting a small amount of a radioactive material into the blood that collects in the bones.

  • The bone scan can identify areas of increased bone activity that can occur with fracture, growth, and tumors. It can be used to localize a bone cancer and look for other areas of involvement.

  • A computed tomography (CT) scan can provide a three-dimensional picture of the bones that can provide a better view of the cancer.

  • A magnetic resonance imaging (MRI) scan may be ordered to evaluate the soft tissues or bones involved by a cancer.

  • A positron emission tomography (PET) scan involves injecting a small amount of radioactive glucose into the bloodstream and scanning the entire body to look for other areas of increased bone activity. This scan can often be combined with the CT scan for improved detail.

After an abnormality has been identified in the bone, your physician may want to obtain a biopsy of the bone. This involves taking a small piece of the bone that can be studied by a pathologist to determine what type of cancer is present. Depending on the location of the cancer, the biopsy may be obtained in the office with a small needle or may need to be obtained in the operating room by a surgeon.

Staging of Bone Cancer

The stage of the cancer refers to the extent of spread of the cancer. Based on the various imaging studies and biopsy, your physician can determine how aggressive the cancer is and whether or not it has spread from its initial location to other locations in the body.

Stage I: The cancer is all contained within the bone and has not spread to other areas of the body.

Stage II: The cancer is contained within the bone and has not spread, but the biopsy shows the cancer is more aggressive.

Stage III: The cancer has spread to more than one area within the bone, but it has not spread outside of the bone.

Stage IV: The cancer has spread outside of the bone to other areas of the body.

Medically Reviewed by a Doctor on 5/23/2016

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