Bone Cancer: What It Is, Types of Tumors, and Signs

A malignant tumor that starts in the bone itself is rare — far more often bones are affected by metastases from tumors of other organs. We explain how primary involvement differs from metastases, what types of bone tumors exist, and by what signs a doctor may suspect the disease.

What bone cancer is and how it differs from metastases

"Bone tumor" is a collective term: it refers to both benign and malignant neoplasms. The name "bone cancer" is imprecise: malignant tumors arising from bone tissue are sarcomas. Primary tumors grow from the cells of the bone itself or of cartilage. Secondary, metastatic, tumors are foci of a tumor from another organ, for example in prostate cancer or neuroblastoma.

Primary malignant bone tumors are rare: approximately 10 men and 6–7 women per 1,000,000 population. Bone metastases are much more common.

What types of bone tumors exist

Benign formations account for up to half of cases: they follow a relatively favorable course and are often an incidental finding on X-ray. These are chondroma, osteoma, osteoid osteoma, osteoblastoma, and osteochondroma.

Among malignant primary tumors, osteogenic sarcoma, parosteal sarcoma, Ewing sarcoma, and chondrosarcoma are named. Three forms are distinguished as the main types of bone cancer:

• osteosarcoma — most often occurs at the age of 10–19 years, frequently in the knee area and the upper part of the shoulder;
• chondrosarcoma — starts in cartilage, usually after age 40;
• Ewing sarcoma — occurs in children and adolescents under 19 years, more often in boys than in girls.

Bone tumors most often develop in the second and third decades of life. The mean age of patients at detection is 49.7 years: 47.3 in men and 50.8 in women.

Signs of bone cancer

The most common symptom of a bone tumor is pain. The other manifestations depend on where the formation is located and how large it is. In addition to pain, impaired or limited function, swelling of the soft tissues in the affected area, and sometimes increased local temperature and a more prominent subcutaneous vascular pattern are possible. Benign tumors often produce no signs and are discovered incidentally during X-ray examination.

How bone tumors are diagnosed

The first step is imaging. If signs of bone destruction are visible on X-ray, the examination is expanded. It includes biochemical blood and urine tests, core needle trephine biopsy or open biopsy, as well as CT, MRI, and in some cases ultrasound.

After treatment, regular follow-up examinations are needed, because the tumor may return.

When to see a doctor

You should see a doctor if bone pain is persistent, does not go away, intensifies, or is accompanied by swelling. At the appointment, tell the doctor when the pain appeared, how it changes during the day, and whether there was an injury or overexertion. Ask directly: is imaging needed, and who should I go to with the result.

The doctor at the appointment will advise which specialist to see.

Bone pain or a finding on an image is not in itself a reason to call an ambulance; 103/112 — for a life-threatening condition, for example signs of stroke or heart attack or after a severe injury.

This material is for reference: it does not replace consultation with a doctor who sees the person and their images.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer