Primary bone cancers are those that start in the bone. Usually, when adults have cancer in the bones, it refers to cancer that started somewhere else and then spread to the bones, called bone metastasis. This can occur with many different types of advanced cancer, including breast cancer, prostate cancer, and lung cancer.
When other types of cancer spread (metastasize) to the bone, the cancer cells come from and act like the cancers from the organ from which they originated. Metastatic cancers that have spread to the bone are treated using treatments for the original cancer, not the metastases.
There are many kinds of primary bone cancer. Primary bone cancer is uncommon, and some types are very rare.
|Type of Cancer||Symptoms/Characteristics|
|Osteosarcoma (also called osteogenic sarcoma)||
Ewing tumor (Ewing sarcoma)
|High-grade undifferentiated pleomorphic sarcoma (UPS) of bone, previously called malignant fibrous histiocytoma (MFH) of bone||
|Fibrosarcoma of bone||
|Giant cell tumor of bone||
What Are Symptoms of Bone Cancer?
Signs and symptoms of primary bone cancer depend mainly on the type, location, and extent of the cancer.
- Pain in the area of the tumor is the most common sign of primary bone cancer
- May worsen at night or when the bone is used, such as when walking for a tumor in a leg bone
- Pain can become more constant over time and might worsen with activity
- Can weaken a bone to the point where it breaks (fractures)
- Lump or swelling
- Other symptoms
If bone cancer spreads to other organs, it can cause other symptoms.
Primary bone cancer is uncommon, and symptoms are usually due to other conditions such as injuries or arthritis, so it’s important to see a doctor for a proper diagnosis and treatment.
What Causes Bone Cancer?
The causes of primary bone cancer are often unknown but, in some cases, people inherit gene mutations (changes) from a parent that increase their risk of bone cancer.
Risk factors are different for different types of primary bone cancers.
Osteosarcoma risk factors include:
- Age: risk is highest between the ages of 10 and 30, especially during the teenage growth spurt
- Height: children are usually tall for their age which suggests it may be related to rapid bone growth
- Gender: more common in males than in females
- Race/ethnicity: slightly more common in African Americans and Hispanics/Latinos than in whites
- Radiation to bones
- Certain bone diseases
Risk factors for chondrosarcoma include:
- Older age
- Benign bone tumors
- Multiple exostoses (also known as multiple osteochondromas), an inherited condition in which a person has many benign bone tumors called osteochondromas, made mostly of cartilage
Risk factors for Ewing tumors (Ewing sarcoma) include:
- Race/ethnicity: less common among African Americans and Asian Americans than among Whites (either non-Hispanic or Hispanic)
- Gender: slightly more common in males than in females
- Age: most common in older children and teens, less common in young adults and young children
Risk factors for chordoma risk factors include:
- Run in families (known as familial chordoma)
- Tuberous sclerosis
How Is Bone Cancer Diagnosed?
Primary bone cancer is diagnosed with a medical history and physical examination, along with tests, such as:
- Imaging tests
- Needle biopsy
- Surgical (open) biopsy
- Lab tests
- Testing biopsy samples
- Blood tests
- Alkaline phosphatase
- Lactate dehydrogenase (LDH)
- Blood cell counts
- Blood chemistry tests
What Is the Treatment for Bone Cancer?
The main ways to treat primary bone cancer are:
- To remove the tumor
- May involve removing surrounding bone
- In some cases, amputation may be needed, such as with a limb
- External beam radiation therapy
- Targeted therapy and other drugs
- Drugs that affect bone cells
- RANKL inhibitor: denosumab (Xgeva)
- Immunotherapy drugs
- Pembrolizumab (Keytruda)
- Interferon alfa-2b
Health Solutions From Our Sponsors