Bone cancers factsheet
Introduction
Bone cancer is when unusual cells grow in a bone, forming a tumour. The two main types of bone cancer are Osteogenic Sarcoma and Ewings Sarcoma.
Signs and symptoms
The most common sign of bone cancer is unexplained pain in the bone.
Other symptoms can include:
- stiffness, swelling or tenderness around a bone or joint
- difficulty with normal movement
- weak bones
- fractures
- fatigue from anaemia – a condition caused by low iron levels
- fever
- weight loss
- a lump in the bone of the arm or leg
- limping.
Bone cancer can spread to areas like:
- the lungs
- other bones
- the bone marrow - spongey material inside the bone that produces blood cells.
Diagnosis
Bone cancer is diagnosed by:
- checking your child’s symptoms
- x-rays
- bone scans
- CT or MRI scans
- a biopsy - taking a tumour sample and testing it in a lab.
After diagnosis, your child will need some other tests to check whether:
- the cancer has spread to other body parts.
- their organs are healthy enough for treatment.
There are two main types of bone cancer:
Osteogenic Sarcoma
Osteogenic Sarcoma is the most common type of childhood bone cancer. It is usually found in bones around the knee and the ends of the upper arm bone close to the shoulder. This cancer will usually appear between the ages of 10 and 25.
Ewings Sarcoma
Ewings Sarcoma is the second most common form of childhood bone cancer. It can happen in any bone but is most common in the:
- pelvis
- thigh
- lower leg
- upper arm
- ribs.
This cancer will usually appear between the ages of 5 and 15.
The Ewing’s sarcoma family of tumours can also include:
- extraosseous Ewing’s - tumour outside of the bone, on soft tissue
- Primitive neuroectodermal tumour (PNET) – a type of brain tumour that happens in babies
- Askin’s tumour – PNET that happens in the soft tissue of the chest.
Treatment
Children with bone cancer will see an orthopaedic oncologist for treatment. An orthopaedic oncologist is a specialist doctor who works with bone tumours and cancer.
Treatment for Osteogenic Sarcoma
Treatment for osteogenic sarcoma usually involves chemotherapy.
Chemotherapy is a treatment where specific drugs are given to kill the cancer cells.
Surgery is then done to remove the tumour, followed by another period of chemotherapy.
In most cases, your child’s surgeon will try to save the affected limb. They will try to remove as much of the diseased bone as possible and replace it with:
- metal rods or plates
- bone grafts – pieces of bone taken from other areas.
Reconstructive surgery makes the affected bone look or work as normal as possible. In bone cancer treatment it can include:
- replacement of joints
- allograft – a transplant of donated bone or tissue
- fibular grafting – when a piece of the fibula, or the calf bone, is taken and used to replace bone damaged by cancer.
Sometimes, the cancer will need to be removed by amputating the limb.
Amputation is when a limb, like an arm or leg, is completely removed from the body.
Treatment for Ewings Sarcoma
Treatment for Ewing’s sarcoma can include:
- chemotherapy – when drugs are given to try to kill cancer cells
- radiotherapy – when radiation is used to kill cancer cells and shrink tumours
- surgery to remove the tumour.
Management
Cure rate
The cure rate for Osteogenic Sarcoma in children is around 70%. This will depend on whether the cancer has spread and how well it responds to chemotherapy.
The cure rate for Ewings Sarcoma is around 70%, depending on the position of the tumour and whether the cancer has spread.
Chance of cancer coming back after treatment
Some children may have their bone tumours return after successful treatment.
This includes:
- malignant or spreading tumours
- benign or non-spreading tumours.
Children who have had bone cancer at an early age are at a higher risk of developing other types of cancer.
Speak to your child’s local doctor or cancer treatment team if you have any concerns or questions.
Support for families
A cancer diagnosis can leave families and children feeling overwhelmed, scared, anxious, and upset. Practical and emotional support during and after treatment is essential and can come from:
- family
- friends
- healthcare professionals
- specialised support services.
Speak to your child’s treatment team for information about support services.
Resources and more information
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Cancer Institute NSW
The Institute's website provides information, support, research and data on cancer.
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Cancer Australia
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Cancer Council Helpline
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Children's Cancer Institute
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Canteen
