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Bone Cancer - Introduction

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Bone Cancer. To see other pages, use the menu. Think of that menu as a roadmap to this full guide.

About bones

The adult human skeletal system is made up of 206 bones. Bones protect the internal organs, allow people to stand upright, and attach to muscles, which allow movement. Bones are connected to other bones by bands of tough, fibrous tissue called ligaments. Cartilage covers and protects the joints where bones come together. Bones are hollow and filled with bone marrow, which is the spongy, red tissue that produces blood cells. The cortex is the hard, outer portion of the bone.

See illustrations of the bone.

Bone consists of collagen, which is a soft, fibrous tissue, and calcium phosphate, a mineral that helps harden and strengthen the bone. There are 3 types of bone cells:

  • Osteoclasts—cells that break down and remove old bone

  • Osteoblasts—cells that build new bone

  • Osteocytes—cells that carry nutrients to the bone

About bone cancer

Although it is rare, cancer can occur in any part of any bone. Cancer begins when healthy cells in the bone change and grow out of control, forming a mass called a tumor. A bone tumor can be cancerous or benign.

A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A malignant tumor can destroy the cortex and spread to nearby tissue. If bone tumor cells get into the bloodstream, they can spread to other parts of the body, especially the lungs, through a process called metastasis.

A benign tumor means the tumor can grow, but it will not spread to other parts of the body. Even though a benign tumor does not spread outside the bone, it can grow large enough to press on surrounding tissue, weaken the bone, and cause the bone to fracture.

There are different types of bone cancer, including:

  • Osteosarcoma and Ewing sarcoma. These are 2 of the most common types of bone cancer. They mainly occur in children and young adults. Ewing sarcoma is unusual in that it can occur in either bone or in soft tissue. Refer to the guide to soft-tissue sarcoma for Ewing sarcomas that occur in soft tissue.

  • Chondrosarcoma. Chondrosarcoma is cancer of the cartilage. It is more common in adults.

  • Chordoma. This type of bone cancer typically starts in the lower spinal cord.

Rarely, soft-tissue sarcoma begins in the bone, causing cancers such as:

  • Undifferentiated pleomorphic sarcoma (UPS). UPS is an uncommon bone tumor, most closely related to osteosarcoma. UPS of bone is usually found in adults. An arm or leg, especially around the knee joint, is the most common place for UPS to appear.

  • Fibrosarcoma. This type of soft-tissue sarcoma is also more common among adults, particularly during middle age. It most often begins in the thighbone.

  • Paget’s sarcoma. Paget’s disease of the bone generally occurs in older adults. It involves the overgrowth of bony tissue. If Paget’s disease develops into cancer, it is called Paget’s sarcoma, mostly osteosarcoma. However, this is uncommon.

This section contains information about primary bone cancer, which is cancer that begins in the bone. However, it is much more common for bones to be the site of metastasis from other cancers, such as breast, lung, or prostate cancer. Cancer that started in another area of the body and has spread to the bone is called metastatic cancer, not bone cancer. For example, lung cancer that has spread to the bone is called metastatic lung cancer.

Similarly, other cancers start in bone marrow, such as myeloma or leukemia. These are different cancers and are discussed in their own guides on Cancer.Net.

For information about cancer that has started in another part of the body and spread to the bone, please see the information for that type of cancer or read the fact sheet about when cancer spreads to the bone.

The next section in this guide is Statistics. It helps explain how many people are diagnosed with this disease and general survival rates. Or, use the menu to choose another section to continue reading this guide.

Bone Cancer - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will find information about how many people are diagnosed with this type of cancer each year. You will also learn some general information on surviving the disease. Remember, survival rates depend on several factors. To see other pages, use the menu.

As explained in the Introduction, primary bone cancer is cancer that starts in the bone. Less than 0.2% of all cancers are primary bone cancer. However, it is much more common for bones to be the site of metastasis or spread from other cancers. The statistics below are about primary bone cancer.

This year, an estimated 3,300 people of all ages (1,850 men and boys and 1,450 women and girls) in the United States will be diagnosed with primary bone cancer.

It is estimated that 1,490 deaths (860 men and boys and 630 women and girls) from this disease will occur this year.

In adults, chondrosarcoma makes up more than 40% of primary bone cancers, followed by osteosarcoma (28%), chordoma (10%), Ewing sarcoma (8%), and UPS/fibrosarcoma (4%). The remaining types of bone cancer are rare. In teens and children, osteosarcoma (56%) and Ewing sarcoma (34%) are more common.

The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The 5-year survival rate of adults and children for all types of bone cancer combined is about 70%. For adults with chondrosarcoma, the 5-year survival rate is about 80%.

It is important to remember that statistics on how many people survive this type of cancer are an estimate. The estimate comes from data based on thousands of people with this cancer in the United States each year. So, your own risk may be different. Doctors cannot say for sure how long anyone will live with bone cancer. Also, experts measure the survival statistics every 5 years. This means that the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society's (ACS) publication, Cancer Facts and Figures 2016, and the ACS website.

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by this disease. Or, use the menu to choose another section to continue reading this guide. 

Bone Cancer - Medical Illustrations

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will find a basic drawing of the skeleton, which is the part of the body affected by this disease, as well as a close-up view of the inside of a bone. To see other pages, use the menu.

The next section in this guide is Risk Factors. It explains what factors may increase the chance of developing this disease. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will find out more about the factors that increase the chance of developing this type of cancer. To see other pages, use the menu.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors can often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a person’s risk of developing bone cancer:

  • Genetics. Children with familial retinoblastoma, which is a type of eye cancer, have an increased risk of developing osteosarcoma.

  • Previous radiation therapy. People who have had radiation treatment for other conditions have a higher risk of developing bone cancer at the site of the radiation therapy. The majority of radiation therapy-caused sarcomas include angiosarcoma and UPS of soft tissue or osteosarcoma, but other types may occur.

  • Chemotherapy for another cancer. Some drugs, including alkylating agents and anthracyclines, used to treat cancer may increase the risk of developing a secondary cancer, usually osteosarcoma.

  • Benign tumors or other bone conditions. Paget’s disease of the bone may lead to osteosarcoma. Other noncancerous bone diseases, such as fibrous dysplasia, may increase the risk of osteosarcoma.

Prevention

Different factors cause different types of cancer. Researchers continue to look into what factors cause this type of cancer. Currently, there is no known way to prevent bone cancer. Early detection offers the best hope for successful treatment, so people with known risk factors are encouraged to visit the doctor regularly and talk with him or her about it. Still, most bone cancer occurs in people with no known risk factors.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems this disease can cause. Or, use the menu to choose another section to continue reading this guide.    

Bone Cancer - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu.

People with bone cancer may experience the following symptoms or signs. Sometimes, people with bone cancer do not have any of these changes. Or, the cause of a symptom may be another medical condition that is not cancer.

When a bone tumor grows, it presses on healthy bone tissue and can destroy it, which causes the following symptoms:

  • Pain. The earliest symptoms of bone cancer are pain and swelling where the tumor is located. The pain may come and go at first. Then it can become more severe and steady later. The pain may get worse with movement, and there may be swelling in nearby soft tissue.

  • Joint swelling and stiffness. A tumor that occurs near or in joints may cause the joint to swell and become tender or stiff. This means a person may have a limited and painful range of movement.

  • Limping. If a bone with a tumor breaks, or fractures, in a leg, it can lead to a pronounced limp. Limping is usually a symptom of later-stage bone cancer.

  • Other less common symptoms. Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low red blood cell level.

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you have been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you may experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Or, use the menu to choose another section to continue reading this guide. 

 

Bone Cancer - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. To see other pages, use the menu.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests, such as an x-ray, may be used to diagnose bone cancer and to find out whether the cancer has spread. Imaging tests show pictures of the inside of the body. Benign and cancerous tumors usually look different on imaging tests, which are described below. A benign tumor has round, smooth, well-defined borders. A cancerous tumor has irregular, poorly defined borders because of aggressive growth. There may also be evidence of bone destruction on an image of a cancerous tumor.

Although imaging tests may suggest a diagnosis of bone cancer, a biopsy will be performed whenever possible to confirm the diagnosis and to find out the subtype. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. It is extremely important for a patient to be seen by a sarcoma specialist before any surgery or a biopsy is performed.

This list describes options for diagnosing this type of cancer. Not all tests listed below will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and medical condition

  • The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose bone cancer:

  • Blood tests. Some laboratory blood tests may help find bone cancer. Patients with osteosarcoma or Ewing sarcoma may have higher alkaline phosphatase and lactate dehydrogenase levels in the blood. However, it is important to note that high levels do not always mean cancer. Alkaline phosphatase is normally high when cells that form bone tissue are very active, such as when children are growing or a broken bone is healing.

  • X-ray. An x-ray is a way to create a picture of the structures inside of the body using a small amount of radiation.

  • Bone scan. A bone scan uses a radioactive tracer to look at the inside of the bones. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears gray to the camera, and areas of injury, such as those caused by cancerous cells, appear dark.

  • Computed tomography (CT or CAT) scan. A CT scan creates a 3-dimensional picture of the body using x-rays taken from different angles. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow. MRI scans are used to check for any tumors in nearby soft tissue.

  • Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create picture of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. Whether a needle biopsy or incisional biopsy is performed depends on where the cancer is located. During a needle biopsy, a small hole is made in the bone, and a tissue sample is removed from the tumor with a needle-like instrument. During an incisional biopsy, the tissue sample is removed after a small cut is made in the tumor. Sometimes it may not be possible to do a biopsy.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging and grading.

The next section in this guide is Stages and Grades. It explains the system doctors use to describe the extent of the disease. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - Stages and Grades

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread, as well as the way the tumor cells look when viewed under a microscope. This is called the stage and grade. To see other pages, use the menu.

Staging is a way of describing where the cancer is located, if and where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

TNM staging system

One tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

  • Tumor (T): How large is the primary tumor? Where is it located?

  • Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?

  • Metastasis (M): Has the cancer metastasized to other parts of the body? If so, where and how much?

The results are combined to determine the stage of cancer for each person. In primary bone cancer, there are 5 stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Here are more details on each part of the TNM system for bone cancer:

Tumor (T)

Using the TNM system, the “T” plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Some stages are also divided into smaller groups that help describe the tumor in even more detail. Specific tumor stage information for bone cancer is listed below.

TX: The primary tumor cannot be evaluated.

T0: There is no evidence of a primary tumor.

T1: The tumor is 8 centimeters (cm) or smaller.

T2: The tumor is larger than 8 cm.

T3: There is more than 1 separate tumor in the primary bone site.

Node (N)

The “N” in the TNM staging system stands for lymph nodes. These tiny, bean-shaped organs help fight infection. Lymph nodes near where the cancer started are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.

NX: The regional lymph nodes cannot be evaluated.

N0: The cancer has not spread to the regional lymph nodes.

N1: The cancer has spread to the regional lymph nodes. This is rare for primary bone cancer.

Metastasis (M)

The “M” in the TNM system indicates whether the cancer has spread to other parts of the body, called distant metastasis.

MX: Metastasis cannot be evaluated.

M0: The cancer has not metastasized.

M1: The cancer has metastasized to another part of the body.

M1a: The cancer has metastasized to a lung.

M1b: The cancer has metastasized to another organ.

Grade (G)

Doctors also describe this type of cancer by its grade (G), which describes how much cancer cells look like healthy cells when viewed under a microscope.

The doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually contains many different types of cells grouped together. If the cancer looks similar to healthy tissue and contains different cell groupings, it is called differentiated or a low-grade tumor. If the cancerous tissue looks very different from healthy tissue, it is called poorly differentiated or a high-grade tumor. The cancer’s grade may help the doctor predict how quickly the cancer will spread. In general, the lower the tumor’s grade, the better the prognosis.

GX: The tumor grade cannot be identified.

G1: The cancer cells are well differentiated.

G2: The cancer cells are moderately differentiated.

G3: The cancer cells are poorly differentiated.

G4: The cancer cells are undifferentiated.

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, M, and G classifications.

Stage IA: The tumor is low grade (G1 or G2) and 8 cm or smaller (T1). It has not spread to any lymph nodes or to other parts of the body (N0, M0).

Stage IB: The tumor is low grade (G1 or G2) and larger than 8 cm (T2). It has not spread to any lymph nodes or to other parts of the body (N0, M0).

Stage IIA: The tumor is high grade (G3 or G4) and 8 cm or smaller (T1). It has not spread to any lymph nodes or to other parts of the body (N0, M0).

Stage IIB: The tumor is high grade (G3 or G4) and larger than 8 cm (T2). It has not spread to any lymph nodes or to other parts of the body (N0, M0).

Stage III: There are multiple high-grade (G3 or G4) tumors in the primary bone site (T3), but they have not spread to any lymph nodes or to other parts of the body (N0, M0).

Stage IVA: The tumor is of any size or grade and has spread to the lung(s) (any G, any T, N0, and M1a).

Stage IVB: The tumor is of any size or grade and has spread to the lymph nodes (any G, any T, N1, and any M), or the tumor is of any size or grade and has spread to another organ besides the lung (any G, any T, any N, and M1b).

Recurrent: Recurrent cancer is cancer has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

In general, patients with the best prognosis have:

  • A T1 or T2 tumor

  • A lower-grade tumor (G1 or G2)

  • A tumor that is easily removed with surgery, such as those located in an arm or leg

  • A localized tumor that has not spread

  • Certain genetic changes

Used with permission of the AJCC, Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition, published by Springer-Verlag New York, www.cancerstaging.org. Please note that AJCC’s Eighth Edition (2017) has been released; related changes to the information provided above are underway. Please check back soon for updated staging definitions or talk with your doctor about whether these changes affect your diagnosis.

Information about the cancer’s stage and grade will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will learn about the different ways doctors use to treat people with this type of cancer. To see other pages, use the menu.

This section tells you the treatments that are the standard of care for this type of cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn if it is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Your doctor can help you consider all your treatment options. To learn more about clinical trials, see the About Clinical Trials section and Latest Research sections.

Treatment overview

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Descriptions of the most common treatment options for bone cancer are listed below. Treatment options and recommendations depend on several factors, including the type, stage, and grade of cancer; possible side effects; and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

For a low-grade tumor, the primary treatment is surgery. The goal of surgery is to remove the tumor and a margin of healthy bone or tissue around the tumor to make sure all of the cancer cells are gone.

For a high-grade tumor, doctors often use a combination of treatments. These include surgery, chemotherapy, and radiation therapy.

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. Surgical oncologists and orthopedic oncologists are doctors who specialize in treating bone cancer using surgery. Surgery for bone cancer often involves a wide excision of the tumor. A wide excision means that the tumor is removed, along with a margin of healthy tissue around it in all directions. Learn more about the basics of cancer surgery, and talk with your doctor about the recovery period for the specific surgery you will have.

If the tumor is in an arm or leg, techniques to keep the arm or leg intact are used whenever possible. However, amputation, which is the removal of the arm or leg with the tumor, is sometimes necessary, depending on the tumor’s size and/or location.

Wide excision surgical techniques have reduced the number of amputations performed for patients with bone cancer. More than 90% of patients can be treated with surgery rather than amputation. These conservative surgeries often require prostheses, such as metal plates or bone from other parts of the body, to replace the missing bone and provide strength to the leftover bone. This is called reconstructive surgery. Surgeons use soft tissue, such as muscle, to cover the reconstruction area. The tissue helps with healing and reduces the risk of infection.

For some patients, amputation may offer the best option. These include patients whose cancer is located where it cannot be completely removed by surgery, patients who cannot undergo reconstruction, and patients in whom the surgical area cannot be fully covered with soft tissue.

Children with bone cancer may require amputation more often than adults because their bones grow more. To avoid amputation, some children can be fitted for expandable joint prostheses that adjust as the skeleton grows. These prostheses require multiple operations to adjust bone length as the child grows.

It is important to remember that the operation that results in the most useful and strongest limb may be different from the one that gives the most normal appearance. If amputation is needed, rehabilitation that includes physical therapy can help maximize the patient’s physical abilities. Rehabilitation can also help a person cope with the social and emotional effects of losing a limb.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed.

A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs at the same time. Chemotherapy for bone cancer can usually be given as an outpatient treatment, which is treatment given at a clinic or doctor’s office instead of requiring the patient to be admitted to a hospital.

Just surgery is not usually enough treatment for patients with some bone cancers, particularly osteosarcoma. These cancers sometimes recur as distant metastases, most often in the lungs, that were most likely only able to be seen with a microscope when the person was diagnosed. Chemotherapy has increased survival rates for people with some types of bone cancer. In addition, chemotherapy is often useful for treating cancer that has visibly spread at the time of diagnosis.

Fast-growing types of bone cancer are often treated with chemotherapy before surgery. This usually reduces the size of the primary tumor and may destroy tiny areas of metastases if some of the cancer cells have spread to other areas.

Chemotherapy that is given before surgery is called preoperative chemotherapy, neoadjuvant chemotherapy, or induction chemotherapy. For most high-grade tumors, the oncologist gives chemotherapy for 3 to 4 cycles before surgery to shrink the primary tumor and make it easier to remove. Chemotherapy before surgery may also improve survival because it destroys cancer cells that have spread from the original tumor. The tumor’s response to chemotherapy, which is evaluated using a microscope after the primary tumor has been removed, can be used to better determine the prognosis.

After the patient has recovered from surgery, he or she may receive additional chemotherapy to destroy any remaining tumor cells. This is called postoperative or adjuvant chemotherapy. The use of chemotherapy to shrink the tumor before surgery combined with chemotherapy after surgery has saved many lives and many patients’ limbs.

The specific chemotherapy drugs used for sarcomas depend on the type of sarcoma. Each type of bone cancer is different, in much the same way as breast cancer is different from lung cancer. Here is a list of drugs often used for 2 of the most common types of bone cancer.

Common drugs for osteosarcoma include:

  • Cisplatin (Platinol)

  • Doxorubicin (Adriamycin)

  • Ifosfamide (Ifex)

  • Methotrexate (multiple brand names)

Common drugs for Ewing sarcoma include:

  • Vincristine (Oncovin, Vincasar)

  • Doxorubicin (Adriamycin)

  • Cyclophosphamide (Cytoxan, Neosar)

  • Ifosfamide (Ifex)

  • Etoposide (Toposar, VePesid)

  • Dactinomycin (Cosmegen)

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about the basics of chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen usually consists of a specific number of treatments given over a set period of time.

For bone cancer, radiation therapy is most often used for patients who have a tumor that cannot be removed with surgery. Radiation therapy may also be done before surgery to shrink the tumor, or it may be done after surgery to destroy any remaining cancer cells. Radiation therapy makes it possible to do less extensive surgery, often preserving the arm or leg. Radiation therapy may also be used to relieve pain for people as part of palliative care (see below).

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Learn more about the basics of radiation therapy

Getting care for symptoms and side effects

Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and palliative care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible. Learn more about palliative care.

Metastatic bone cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Also, clinical trials might be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include a combination of surgery, chemotherapy, and radiation therapy. Palliative care will also be important to help relieve symptoms and side effects.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or being “NED.”

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above, such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

If treatment fails

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and advanced cancer is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than 6 months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with bone cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Many clinical trials focus on new treatments. Researchers want to learn if a new treatment is safe, effective, and possibly better than the treatment doctors use now. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there is no guarantee that the new treatment will be safe, effective, or better than what doctors use now.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects. There are also clinical trials studying ways to prevent cancer.

Deciding to join a clinical trial

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating bone cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with bone cancer.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” However, placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different than the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends.

Finding a clinical trial

For specific topics being studied for bone cancer, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

In addition, this website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide.

The next section in this guide is Latest Research. It explains areas of scientific research currently going on for this type of cancer. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of cancer and how to treat it. To see other pages, use the menu.

Doctors are working to learn more about bone cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

  • Immunotherapy. Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. Mifamurtide (Mepact) is a non-specific immune system stimulator approved as a bone cancer treatment in some countries but not in the United States.

    Mifamurtide is not the only type of immunotherapy. Immunotherapy comes in many forms. There has been much recent excitement in the cancer research field about immune checkpoint inhibitors. These drugs are monoclonal antibodies (proteins) that block a specific molecule, which then takes the brakes off the immune system and allow it to fight the cancer cells. The molecules that are blocked have names such as CTLA4, PD1, OX40, LAG3, and TIM3. They have proved helpful in many cancers and in research studies for treating sarcomas.

    Vaccines against specific sarcoma proteins or other molecules are also being studied, often in addition to immune checkpoint inhibitors. 

    Learn more about the basics of immunotherapy.

  • Targeted therapy. Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells with greater specificity than regular chemotherapy, which damages the DNA of cancer cells and normal cells alike. As a result, targeted therapy helps limit damage to healthy cells. For example, PARP (poly ADP-ribose polymerase) inhibitors are 1 type of targeted therapy being studied in Ewing sarcoma. Learn more about targeted treatments.

  • Myeloablative therapy. A supplement to the treatment options for Ewing sarcoma is known as “myeloablative therapy with stem cell support.” Myeloablative therapy is an intense regimen of very high doses of chemotherapy. It aims to destroy all cells that are dividing rapidly. This includes cancer cells but also some healthy cells. Stem cells may be given to the patient after myeloablative therapy to renew the blood cells more rapidly. Stem cells are cells that create all other types of cells in the body, in this case cells that will help new blood cells be made faster. Stem cells are typically taken from the bone marrow or blood of the patient or a blood relative before myeloablative therapy.

  • Intraoperative radiation therapy. Clinical trials are evaluating the usefulness of radiation therapy given inside the body during surgery for some Ewing sarcoma tumors. This is called intraoperative radiation therapy or internal radiation therapy. Other techniques are being used when bone cancer recurs at a distant, or metastatic, location in the body. These include radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT), which uses a small number of very focused, very intense radiation treatments to control or destroy a small area of tumor.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current bone cancer treatments in order to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding bone cancer, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance in how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - Coping with Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people don’t experience the same side effects even when given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of cancer treatment “palliative care.” It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for bone cancer are described in the Treatment Options section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects as well as physical effects after a cancer diagnosis. This may include dealing with difficult emotions, such as anxiety or anger, or managing your stress level. Sometimes, patients have problems expressing how they feel to their loved ones, or people don’t know what to say in return.

Patients and their families are encouraged to share their feelings with a member of their health care team. You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with financial effects

Cancer treatment can be expensive. It is often a big source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Learn more about managing financial considerations, in a separate part of this website.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with bone cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis. Below are some of the responsibilities caregivers take care of:

  • Providing support and encouragement

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they are likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you don’t think the side effects are serious. This discussion should include physical, emotional, and social effects of cancer.

Also, ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan.

The next section in this guide is Follow-up Care. It explains the importance of checkups after you finish cancer treatment. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - Follow-Up Care

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will read about your medical care after cancer treatment is completed, and why this follow-up care is important. To see other pages, use the menu.

Care for people diagnosed with cancer doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the cancer has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. For bone cancer, follow-up care typically includes general physical examinations, blood tests, and imaging tests, such as a bone scan, CT scan, or x-rays, to check for signs that the cancer has come back. Tell your doctor about any new symptoms, such as swelling or bone pain, because they may be signs that the cancer has come back or signs of another medical condition.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors including the type and stage of cancer originally diagnosed and the types of treatment given.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them.

People with a family history of cancer

Some people with sarcoma have strong family histories of cancer. This means that other relatives have also had cancer. If there is a strong history of cancer in the family, clinical genetics experts are available to discuss what this may mean for other people in the family who do not have cancer. In some cases, special blood test screening can be done to determine who in the family is at risk to develop cancer. Talk with your doctor for more information.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type, stage, and grade of cancer; side effects; health insurance rules; and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - Survivorship

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. To see other pages, use the menu.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

Survivorship is one of the most complicated parts of having cancer. This is because it is different for everyone.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain of how to cope with everyday life.

Survivors may feel some stress when frequent visits to the health care team end following treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true as new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing,

  • Thinking through solutions,

  • Asking for and allowing the support of others, and

  • Feeling comfortable with the course of action you choose.

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the center where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving in this article.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from bone cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

In addition, it is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health. Cancer rehabilitation may also be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The booklet is available as a PDF, so it is easy to print out.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including for survivors in different age groups.

The next section offers Questions to Ask the Doctor to help start conversations with your cancer care team. Or, use the menu to choose another section to continue reading this guide.

Bone Cancer - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

  • What type of bone cancer do I have?

  • Can you explain my pathology report (laboratory test results) to me?

  • What stage and grade is the bone cancer? What does that mean?

  • Where exactly is the cancer located?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What are the possible side effects of this treatment, both in the short term and the long term?

  • What is the expected timeline for my treatment plan?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • Whom should I call with questions or problems?

Questions to ask about having surgery

  • What type of surgery will I have? Will lymph nodes be removed?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • If needed, what types of rehabilitative services are available?

  • What are the possible long-term effects of having this surgery?

Questions to ask about having chemotherapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about having radiation therapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers some more resources on this website beyond this guide that may be helpful to you. Or, use the menu to choose another section to continue reading this guide.  

Bone Cancer - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 05/2016

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Bone Cancer. To go back and review other pages, use the menu.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Bone Cancer. Use the menu to select another section to continue reading this guide.