If you're experiencing bone pain, your GP will ask about your symptoms and examine the affected area, before deciding whether you need to have any further tests.
They will look for any swelling or lumps, and ask if you have problems moving the affected area. They may ask about the type of pain you experience whether it's constant or comes and goes, and whether anything makes it worse.
After being examined, you may be referred for an X-ray of the affected area to look for any problems in the bones. If the X-ray shows abnormal areas, you'll be referred toan orthopaedic surgeon (a specialist in bone conditions) or bone cancer specialistfor a further assessment.
Some of the tests you may have to help diagnose and assess bone cancer are described below.
An X-ray is a procedure where radiation is used toproduce images of the inside of the body. It's a particularly effective way of looking at bones.
X-rays can often detect damage to the bones caused by cancer, or new bone that's growing because of cancer. They can also determine whether your symptoms are caused bysomething else, such as a broken bone (fracture).
Ifan X-ray suggests you may have bone cancer, you should be referred to a specialist centre with expertise in diagnosing and treating the condition. As bone cancer is rare, there are asmall number of specialist centres, so you may have to travel outside your local area for advice and treatment.
The most definitive way of diagnosing bone cancer is to take a sample of affected bone and send it to a laboratory for testing. This is known as a biopsy .
A biopsy can determine exactly what type of bone cancer you have and what grade it is (see below).
A biopsy can becarried outin two ways:
You may need to have an open biopsy if the results of a core needle biopsy are inconclusive.
If the results of the biopsy confirm or suggest bone cancer, it's likely you'll have further tests to assess how far the cancer has spread. These tests are described below.
A magnetic resonance imaging (MRI) scan uses a strong magnetic field and radio waves to produce detailed pictures of the bones and soft tissues.
An MRI scan is an effective way of assessing the size and spread of any cancerous tumour in or around the bones.
A computerised tomography (CT) scan involves taking a series of X-rays and using a computer to reassemble them into a detailed three-dimensional (3-D) image of your body.
CT scans are often used to check if the cancer has spread to your lungs. Chest X-rays may also be taken for this purpose.
A bone scan can give more detailed information about the inside of your bones than an X-ray. During a bone scan,a small amount of radioactive material is injected into your veins.
Abnormal areas of bone will absorb the material at a faster rate than normal bone and will show up as "hot spots" on the scan.
If you have a type of bone cancer called Ewing sarcoma , you may have a test called a bone marrow biopsy to check if the cancer has spread to the bone marrow (the tissue inside your bones).
During the test, a needle is inserted into your bone to remove a sample of your bone marrow. This may be done under either local or general anaesthetic.
Once these tests have been completed, it should be possible to tell you what stage and grade the bone cancer is. Staging is a description of how far a cancer has spread and grading is a description of how quickly the cancer is likely to spread in the future.
A widely used staging system for bone cancer inthe UKuses three main stages:
Most cases of stage 1 bone cancer and some stage 2 bone cancers have a good chance of being cured. Unfortunately, stage 3 bone cancer is more difficult to cure, although treatment can relieve symptoms and slow the spread of the cancer.
Being told you have bone cancer can be a distressing and frightening experience. Receiving that type of news can be upsetting at any age, but can be particularly difficult if you are still in your teenage years, or if you're a parent of a child who has just been toldthey have bone cancer.
These types of feelings can cause considerable stress and anxiety, which in some cases can trigger depression . If you think you may be depressed,your GP may be a good person to talk to about support and possiblytreatment.
You may also find it useful to contact the Bone Cancer Research Trust , which is the UKs leading charity for people affected by bone cancer, if you need more information. If you're a teenager you may want to contact the Teenage Cancer Trust , which is a charity for teenagers and young adults affected by cancer.
Primary bone cancer is a rare type of cancer that begins in the bones. Around 550 new cases are diagnosed each year in the UK. This is a separate condition from secondary bone cancer, which is cancer that spreads to the bones after developing in another part of the body.
Bone pain is the most common symptom of bone cancer. Some people also experience swelling and redness (inflammation) or notice a lump on or around the affected bone. If the bone is near a joint, the swelling may make it difficult to use the joint.
Cancer occurs when the cells in a certain area of your body divide and multiply too rapidly. This produces a lump of tissue known as a tumour. The exact reason why this happens is often not known, but certain things can increase your chance of developing the condition
If you're experiencing bone pain, your GP will ask about your symptoms and examine the affected area, before deciding whether you need to have any further tests. After being examined, you may be referred for an X-ray of the affected area to look for any problems in the bones.
Treatment for bone cancer depends on the type of bone cancer you have, how far it has spread and your general health. The main treatments are surgery, chemotherapy and radiotherapy. Your treatment should be managed by a specialist centre with experience in treating bone cancer.
Carol Starkey, from Bromsgrove, Worcs, was diagnosed with bone cancer in her shoulder just three weeks after she started university. Her advice is to not get discouraged by the treatment. The first few weeks of chemotherapy are the worst. After that, it gets better.