Symptoms

Pain is the most frequent reported symptom of bone cancer. In the beginning, the pain is periodical or only there when the bone is in use. As the cancer grows, the pain appears more often, until at last it is constant. Sometimes bone cancer will cause bones to fracture or break

Swelling may or may not occur, and depending on the location of the tumor, a firm, slightly tender lump or mass might be felt through the skin.

If the cancer has spread to other areas, there may be symptoms common to all types of cancer such as loss of appetite or fatigue.

None of these symptoms are specific to bone cancer and can be caused by any number of other conditions and/or illnesses. It is important to let the doctor make the diagnosis, not you.

Diagnosis

To make a diagnosis, the doctor will perform blood tests and any or all of the following procedures:

• Bone Scan—A radioactive material is injected into the blood stream and collects in the bones. It is then detected by an instrument called a scanner which outlines abnormal areas of the bone, bringing out the size, shape and location of tumors. Malignant tumors tend to be odd shapes with jagged edges, as opposed to the smooth, round appearance of benign tumors.
• CT (CAT scan)—Pictures of cross-sections of the body are taken by an x-ray machine and created by a computer.
• Magnetic Resonance Imaging (MRI)—This procedure also creates detailed pictures of cross-sections of the body, using a strong magnet linked to a computer.
• Chest X-ray—High energy beams are used to take pictures of the chest bones to see if bone cancer has spread to the lungs.
• Angiograms—An x-ray procedure used to get a detailed look at blood vessels. A dye is injected into the bloodstream to highlight the blood vessels.
• Positron Emission Tomography (PET scan)—This scan uses glucose (a sugar) that contains a radioactive atom. Because of their high metabolism rate cancer cells absorb the sugar and then a special camera is used to look for the cancer. It is being combined with CT scans to pinpoint some cancer types.
• Fine Needle Biopsy or Fine Needle Aspiration (FNA)—A very thin needle and syringe are used to withdraw a small amount of tissue and fluid from the mass. Local anesthesia is used on the area.
• Core Needle Biopsy—A small cylinder of tissue about 1/2 inch long and 1/16 inch in diameter is removed from the tumor mass using a slightly larger needle than the FNA.
• Surgical Bone Biopsy—A small part of a tumor mass is removed through the skin. This is usually done with local anesthesia, but for children or large tumors general anesthesia is often used.

A biopsy is necessary for a confirmation of any cancer found with any other method. The sample tissues that are taken from the bone tumor are observed under microscope. If cancer is present, the doctor will be able to determine if it is primary or secondary.