How Do They Diagnose Bone Cancer?

Reviewed on 4/29/2021
bone cancer diagnosis
A biopsy is the most accurate way to diagnose bone cancer

Doctors will often use a patient’s medical history, physical examination, imaging tests, biopsy results and blood tests to diagnose bone cancer (uncontrolled growth of cells that begins in the bones). Generally, the most accurate way to diagnose bone cancer is through a biopsy.

Medical history

When taking your medical history, your doctor will ask about symptoms, how they began and whether there is a history of medications or underlying health conditions. Your physician may also inquire about your family history to see whether any of your close relatives, such as parents or siblings, have had cancer.

Physical examination

Your physician will conduct a thorough exam of the affected site as well as the rest of the body to look for signs of cancer or underlying health conditions.

Imaging tests

Imaging tests can reveal the primary tumor site, metastasis (spread) and type of tumor. X-rays are generally ordered as initial imaging studies to detect bone abnormalities. 

Other imaging studies include computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) scan and radionuclide bone scan

Biopsy

A biopsy is the most accurate way to diagnose bone cancer or other bone diseases. During a biopsy, a piece of tissue is taken from the tumor and examined in a lab under a microscope. The results can help your doctor determine whether the mass is caused by cancer or other diseases, as well as what type of cancer is present. 

Blood tests

Your physician may order blood tests to check for various parameters, such as blood counts, blood sugar, biomarkers (raised levels of certain substances in the blood in case of a tumor) and electrolytes (such as calcium, magnesium and sodium).

What are symptoms of bone cancer?

Bone cancer may cause the following symptoms:

These symptoms may not necessarily be indicative of bone cancer. For a definitive diagnosis, it is recommended that you have a consultation with your physician.

What are the types of bone cancer?

The three main types of bone cancer are:

  1. Osteosarcoma: The most common type of bone cancer. About 3% of cancers in children are osteosarcomas. Since osteosarcoma occurs in the bone-forming cells, called osteoblasts, this cancer is seen more commonly in teens or children in age groups where growth spurts happen.
  2. Chondrosarcoma: The second most common primary bone cancer. It occurs in the cartilage forming cells.
  3. Ewing sarcoma: This tumor may form in immature nerve tissue in the bone marrow. Ewing sarcoma generally affects the long bones, such as the thigh bone (femur), upper arm bone (humerus) and shinbone (tibia). However, it can affect the pelvic bones as well. When this cancer starts in the muscles and soft tissues, it is called extraosseous Ewing sarcoma.

Some rare types of bone tumors include:

  • Fibrosarcoma: A cancer of a type of cell called the fibroblast, and generally affects the hips or knees. Fibrosarcoma may be seen in older people who have undergone radiation therapy for other cancers.
  • Chordoma: Usually seen in the tailbone (sacrum).
  • Giant cell tumor: A type of noncancerous (benign) but aggressive bone tumor. It typically affects young adults.
  • Adamantinoma: Usually seen in the shin bone (tibia) of young individuals.

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References
American Cancer Society. Tests for Bone Cancer. https://www.cancer.org/cancer/bone-cancer/detection-diagnosis-staging/how-diagnosed.html

Memorial Sloan Kettering Cancer Center. Types of Bone Cancer. https://www.mskcc.org/cancer-care/types/bone/types

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