Bone cancer

Note: The information on cancer types on the ACRF website is not designed to provide medical or professional advice and is for information only. If you have any health problems or questions please consult your doctor.

Overview

Primary bone cancer, beginning in bone tissue, is rare. It grows in any of the 206 bones in the body, most often in the long bones of the arms and legs. Although it can present at any age, the most common types occur in children and young adults. Bone cancers form in the cells that make hard bone tissue. Cancers that arise in the cells produced in the bone marrow, like leukaemia, multiple myeloma, and lymphoma, are not considered bone cancers, although they do affect the bone and may require orthopaedic management.

Benign, or non-cancerous, bone tumours are more common than malignant, or cancerous tumours.

Osteosarcoma is the most common type of primary bone cancer and affects mostly people between 10 and 25 years of age. It often starts in the ends of bones, where new tissue forms as children grow. It occurs most often in the knee.

Chondrosarcomas, is another common type in adults over 50 years, forming in cartilage, usually around the pelvis, knee, shoulders, or upper thighs.

Ewing’s Sarcoma usually occurs in the bones’ middle part, commonly in the hip, ribs, upper arm, and thighbones. Like osteosarcoma, it primarily affects children and young adults.

Rare bone cancer types occurring primarily in adults include fibrosarcomas, giant cell tumours, adamantinomas and chordomas.

Metastatic cancer to bone starts somewhere else in the body and then spreads to the bone and is more common than primary bone cancer. While any cancer type can spread to the bone, the most common are breast, lung, kidney, thyroid, and prostate. Bone metastases most often arise in the hip, thighbone, shoulder, and spine.

Bone cancer treatment

Treatment depends on the stage, type, size and location of the cancer, along with the patient’s age and general health.

When operating to remove bone tumours, surgeons remove some of the surrounding bone and muscle to ensure they remove as much cancerous tissue as possible. If he or she is operating on an arm or leg, the surgeon will aim to preserve the limb and maintain its functionality. Sometimes the removed bone is replaced with bone from another part of the body, or an artificial replacement.

Additionally, cryosurgery is used in some patients – after a bone tumour is removed, liquid nitrogen is used to freeze the tumour cavity to subzero temperatures, killing microscopic cancer cells and decreasing the chance of recurrence. The frozen bone is stabilised by filling the tumour cavity with bone graft, cement, or rods and screws to prevent fracture.

Radiotherapy is sometimes given with surgery, to destroy tumours or reduce their size.

Chemotherapy is often used to treat primary bone cancers, in conjunction with surgery. It is commonly given after surgery to kill any cancer cells remaining in the body after the main tumour is removed surgically.