Bone cancer is a rare but serious disease that begins in the cells of the bone, most commonly affecting children, teens, and young adults. Early diagnosis and timely treatment significantly improve outcomes and quality of life.
There are two types of bone cancer:
Primary-which starts in the bone.
Secondary- which spreads from another area of the body to the bone.
Examples of primary bone cancers are Osteosarcoma, Ewing sarcoma, and chondrosarcoma, whereas metastases from diseases like lung, breast, or prostate cancer are examples of secondary bone cancers.
Secondary- which spreads from another area of the body to the bone.
Osteosarcoma – Aggressive, most common in teenagers and young adults, begins in the bone cells and typically affects the long bones, such as the arms or legs.
Ewing Sarcoma – Common in children and young adults, starts in the bones or soft tissues and often occurs in the pelvis, legs, or arms.
Chondrosarcoma – common in adults(over 40), develops in cartilage cells and typically affects the pelvis, legs, or shoulders.
Some of the rare types include:-
Chordoma – A rare cancer of the spine or base of the skull in adults.
Giant Cell Tumor- Typically non-cancerous (benign), may become cancerous in some rare cases.
Fibrosarcoma and Malignant Fibrous Histiocytoma – These rare cancers of tissue or bone occur in older adults.
Symptoms may vary depending on the type and location of the tumor.
It's important to seek medical attention if these symptoms persist or worsen over time.
While the exact cause of bone cancer is unknown, several risk factors have been identified:
Genetic Conditions- such as Li-Fraumeni syndrome or hereditary retinoblastoma.
Prior treatment- Treatment such as Chemotherapy or Radiation exposure can increase the risk.
Bone disorders – Conditions like Paget’s disease (A noncancerous bone condition) can lead to bone cancer in older adults.
Family history: Especially if first-degree relatives were affected
Bone implants- Metal implants from surgery may pose a small risk.
According to the Musculoskeletal Tumor Society (MSTS) system is frequently used to stage bone cancer. It is predicated on three important facts:
Based on how the cancer appears under a microscope, its grade (G) indicates how likely it is to grow and spread. Cancers in this method are classified as either high grade (G2) or low grade (G1). High-grade cancer cells appear more aberrant, whereas low-grade cancer cells resemble normal cells more and are less likely to proliferate and spread rapidly.
The size of the major tumor (T), which can be categorized as extracompartmental (T2), meaning it has spread outside the bone into other surrounding structures, or intracompartmental (T1), meaning it has stayed inside the bone.
If metastasized (M), the tumor has spread to other organs or surrounding lymph nodes, which are collections of immune system cells the size of beans. M0 tumors have not migrated to other organs or lymph nodes, whereas M1 tumors have.
Here is the Tabular form
| Parameter | Category | Meaning |
|---|---|---|
| Grade (G) | G1 (Low Grade) | Cancer cells look more like normal cells; less likely to grow/spread quickly. |
|
G2 (High Grade) |
Cancer cells appear abnormal; more likely to grow/spread rapidly. |
|
|
Tumor Size (T) |
T1 (Intracompartmental) |
The tumor is confined within the bone. |
|
T2 (Extracompartmental) |
The tumor has spread outside the bone into the surrounding tissues. |
|
|
Metastasis (M) |
M0 | No spread to distant organs or lymph nodes. |
| M1 | Cancer has metastasized to distant organs or lymph nodes. |
The extent (size) of the primary tumor (T): To what extent has the tumor spread to neighboring bones, and how big is it? Does it exist in multiple locations within the bone?
The spread to neighboring lymph nodes (N): Have neighboring lymph nodes been affected by the cancer?
The metastasis (spread) to distant sites (M): Has the cancer spread to other distant locations, such as the liver, lungs, or other bones?
The cancer's grade (G): When viewed under a microscope, how aberrant do the cells appear?
Each of these factors is further described by the numbers or letters that follow T, N, M, and G. In general, higher numbers indicate greater risk characteristics of the cancer.
This approach, for example, uses a scale of 1 to 3 to grade bone cancer. Compared to high-grade (G2 or G3) tumors, low-grade (G1) cancers often grow and spread more slowly.
Grade 1 (G1) cancers resemble normal bone tissue.
Grade 2 (G2) cancers have a more abnormal appearance.
Grade 3 (G3) signifies that the cancer appears to be quite abnormal.
Early and accurate diagnosis is crucial for effective treatment. Diagnostic tests for bone cancer include:
Physical Examination – Evaluates lumps, swelling, and range of motion issues.
Imaging Tests
X-ray – Initial imaging to detect bone abnormalities.
MRI (Magnetic Resonance Imaging) – Provides detailed images of soft tissues and bone marrow.
CT Scan (Computed Tomography) – Helps evaluate tumor size and spread.
Bone Scan – Detects areas of increased bone activity, which may indicate cancer.
PET Scan (Positron Emission Tomography) – Helps detect spread to other organs.
Biopsy – Analyse tissue sample to confirm cancer type and grade.
Blood Tests – Assess general health or detect markers associated with certain bone cancers.
Treatment for bone cancer is personalized based on the type, stage, location, and patient’s overall health. Common treatment options include
Surgery
Wide Resection: Removal of the tumor and some surrounding healthy tissue.
Limb-Sparing Surgery: Removes the tumor without amputating the limb.
Amputation: In cases where the tumor cannot be removed otherwise.
Chemotherapy – Uses drugs to kill cancer cells or stop them from growing. Often used before surgery (neoadjuvant) or after surgery (adjuvant).
Radiation Therapy uses high–energy rays to target and destroy cancer cells. It is often used in combination with surgery or when surgery isn’t possible.
Targeted Therapy – Focuses on specific genetic changes in cancer cells to block their growth.
Immunotherapy – Helps the immune system recognize and attack cancer cells. This may be used for advanced cases or in clinical trials.
Rehabilitation and Supportive Care— Includes physiotherapy, pain management, psychological counseling, and nutritional support to improve recovery and quality of life.
There is no guaranteed way to prevent bone cancer, especially since many risk factors are genetic or environmental. However, the following steps may help reduce risk or promote early detection:
Expert Team: Oncologists, immunotherapists, and counselors offer 360° care.
Cutting-Edge Immunotherapy: Personalized, advanced immunotherapy options.
Comprehensive Support: From diagnosis to recovery and survivorship.
Patient-Centric: Focused on quality of life and long-term outcomes.
Bone Cancer stats (Global Vs India)
|
Feature |
Global (2022) |
India (2022) |
|
New Cases |
~49,025 cases (ASIR ~0.5/100k); rare globally. Most common in children, adolescents, & young adults (10–25 years). Osteosarcoma is the leading subtype. |
~8,035 cases (ASIR ~0.6/100k); mostly affects youth aged 10–30. Slight male predominance. Still considered rare but significant among childhood cancers. |
|
Deaths |
~26,711 deaths. High fatality despite rarity, adolescents, aggressive nature, and late detection (especially high-grade sarcomas). |
~5,232 deaths. High mortality due to late diagnosis, limited specialized care, and high treatment costs. |
|
Age & Gender |
Bimodal: common in ages 10–25 (osteosarcoma, Ewing), smaller peak in elderly (chondrosarcoma). Male dominance. |
Most common in teens to 30s, especially in males (M: F ~2:1). Public awareness about early symptoms remains low. |
|
Hotspots |
No distinct global hotspots. Stable across regions. Slight variations based on genetic or environmental exposures. |
No regional hotspots. Urban centers like Delhi, Mumbai, and Chennai report more cases due to better diagnostics. |
|
Rural vs Urban |
Urban areas have better access to MRI, CT, and biopsy. Rural cases often face late diagnosis due to limited facilities. |
Rural India sees delayed diagnosis due to a lack of imaging and specialists. Urban areas detect earlier and treat better. |
|
5-Year Survival |
~65–75% for localized osteosarcoma; <30% for metastatic. Ewing sarcoma has similar patterns. |
~40–50% for localized cases. Much lower for metastatic/recurrent tumors due to delayed care and treatment gaps. |
|
Common Types |
Osteosarcoma, Ewing Sarcoma (youth), Chondrosarcoma (adults), Chordoma (rare). |
Same pattern. Osteosarcoma is most common, followed by Ewing in youth and chondrosarcoma in older adults. |
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.
Bone cancer is an uncommon form of cancer that originates in the bones. It can occur in any bone in the body, but it most commonly affects the pelvis, arms, and legs. Because it spreads from other parts of the body, secondary (metastatic) bone cancer is more common than primary bone cancer.
Prolonged bone pain, particularly at night, swelling around a bone, and an elevated risk of fractures are early indicators of bone cancer. The discomfort increases in intensity and consistency as the tumor grows.
Although the exact cause of bone cancer is unknown, radiation exposure, certain bone illnesses, including Paget's disease, and hereditary conditions like Li-Fraumeni syndrome are risk factors. Children, teenagers, and older individuals are more likely to have it.
Yes, bone cancer can spread, particularly to the lungs and other bones. The likelihood of spread is determined by the type of cancer and the timing of detection. Regular monitoring and appropriate treatment are critical for preventing or treating metastases.
