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Am Fam Physician. 2018;98(4):online

See related article on bone cancer

What is bone cancer?

Many types of cancer can spread to the bones. But, there are three cancers that start in bones: osteosarcoma (OS-tee-oh-sar-CO-ma), Ewing sarcoma, and chondrosarcoma (KON-dro-sar-CO-ma). Osteosarcoma and Ewing sarcoma are more common in children and teenagers. Chondrosarcoma is more common in middle-aged adults. These cancers are rare, but it is important to catch them early and get treatment.

What are the symptoms?

The symptoms of bone cancer can be vague at first. The most common symptoms are pain and swelling, usually over the long bones of the legs and arms, and near the hips and pelvis. The pain might start after a minor sports injury or a fall. Fevers, pain at night, or pain that causes limping can also be symptoms of bone cancer. It is important to see your doctor if you have any of these symptoms.

How will my doctor know if it's cancer?

Your doctor will examine you and order x-rays. You also might need a bone scan, computed tomography (CT) scan, or magnetic resonance imaging (MRI) to check other parts of your body, especially your lungs. If these tests show that you might have cancer, your doctor will do a biopsy.

How is it treated?

People with bone cancer are treated at centers that specialize in bone cancer treatment. Treatment depends on your overall health and the type of bone cancer you have. You and your doctor will discuss the pros and cons of each type of treatment. The most common treatments are:

  • Chemotherapy. These are medicines that destroy cancer cells and shrink tumors. Chemotherapy is used to treat bone cancer and cancer cells that spread to the lungs or other parts of the body. Chemotherapy is often given before and after surgery to remove a bone cancer tumor.

  • Surgery. This is the preferred treatment for bone cancer. It usually happens after chemotherapy.

  • Radiation therapy. This can be an alternative to surgery in people with Ewing sarcoma. Radiation therapy cannot treat osteosarcoma.

What happens after treatment?

You will see your doctor often. If you have surgery, you may need physical therapy afterward. You and your doctor will discuss how often you should have x-rays and CT scans to make sure the cancer hasn't come back.

What happens if the cancer comes back?

You and your doctor will discuss treatment options. You will probably have the same type of treatments as before.

Where can I get more information?

Your doctor

AAFP's Patient Information Resource

American Cancer Society

National Cancer Institute

National Library of Medicine

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