Primary bone cancer

Bone cancer can be either primary or secondary bone cancer. The two types are quite different and the information on these pages is only about primary bone cancer.

Primary bone cancer – means that the cancer starts in the bones. It may develop on the surface of the bone, in the outer layer or from the centre of the bone. As a tumour grows, cancer cells multiply and destroy the bone. If left untreated, primary bone cancer can spread to other parts of the body. Primary bone cancer is also known as bone sarcoma. 

Secondary (metastatic) bone cancer – means that the cancer started in another part of the body, such as the breast or lung, and has spread to the bones.

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Learn more about:

• Types of bone cancer
• About the bones
• How common is it?
• What are the risk factors?
• What are the symptoms?

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Types of bone cancer

There are more than 30 types of primary bone cancer. The most common types include:

• Osteosarcoma (about 35% of bone cancers) – starts in cells that grow bone tissue; often affects the arms, legs and pelvis, but may occur in any bone; occurs in children and young adults with growing bones and older people in their 70s and 80s; most are high-grade tumours.
• Chondrosarcoma (about 30% of bone cancers) – starts in cells that grow cartilage; often affects the bones in the upper arms and legs, pelvis, ribs and shoulder blade; most often occurs in middle-aged and older people; a slow-growing form of cancer that rarely spreads to other parts of the body; most are low-grade tumours.
• Ewing’s sarcoma (about 15% of bone cancers) – affects cells in the bone or soft tissue that multiply rapidly and often have a large lump associated with them; often affects the pelvis (hips), legs, ribs, spine, upper arms; common in children and young adults; are all high-grade tumours.

Some types of cancer affect the soft tissues around the bones. These are known as soft tissue sarcomas and may be treated differently. For more details, talk to your doctor or call Cancer Council 13 11 20.

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The bones

A typical healthy adult has over 200 bones, which:

• support and protect internal organs
• are attached to muscles to allow movement
• contain bone marrow, which produces and stores new blood cells
• store proteins, minerals and nutrients, such as calcium.

The bones are made up of different parts, including a hard outer layer (known as cortical or compact bone) and a spongy inner core (known as trabecular or cancellous bone). Cartilage is the tough material at the end of each bone that allows one bone to move against another. This meeting point is called a joint.

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How common is bone cancer?

Bone cancer is rare. About 200 Australians are diagnosed with primary bone cancer each year.

It affects people of all ages and is slightly more common in males than females. If it develops later in life, it may be linked to another bone condition.

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What are the risk factors?

The causes of most bone cancers are unknown, but some factors that increase the risk include:

Previous radiation therapy – Radiation therapy to treat cancer increases the risk of developing bone cancer. The risk is higher for people who have high doses of radiation therapy at a young age. Most people who have radiation therapy will not develop bone cancer.

Other bone conditions – Some people who have had Paget’s disease of the bone, fibrous dysplasia or multiple enchondromas are at higher risk of bone cancer. Some studies also suggest that people who have had a soft tissue sarcoma are at an increased risk of developing bone cancer.

Genetic factors – Some inherited conditions such as Li-Fraumeni syndrome increase the risk of bone cancer. People with a strong family history of certain other types of cancer are also at risk. Talk to a family cancer clinic for more information. Some people develop bone cancer due to genetic changes that happen during their lifetime, rather than inheriting a faulty gene. Most bone cancers are not hereditary.

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What are the symptoms?

The most common symptom of bone cancer is strong pain in the bones and joints. The pain gradually becomes constant and does not improve with mild pain-relieving medicines such as paracetamol. It may be worse at night or during activity.

Other symptoms can include:

• swelling over the affected part of the bone
• stiffness or tenderness in the bone
• problems with movement, e.g. an unexplained limp
• loss of feeling in the affected limb
• a fractured bone
• unexplained weight loss
• tiredness.

Most people who have these symptoms do not have bone cancer. However, if you have symptoms for more than two weeks, you should see your general practitioner (GP).

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