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How to diagnose bone cancer

Diagnosis is the process of finding out the cause of a health problem. Diagnosing bone cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for bone cancer or other health problems.

The process of diagnosis may seem long and frustrating. It’s normal to worry, but try to remember that other health conditions can cause similar symptoms as bone cancer. It’s important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of bone cancer.

The following tests are usually used to rule out or diagnose bone cancer. Many of the same tests used to diagnose cancer are used to find out the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment.

Health history and physical exam

Your health history is a record of your symptoms, risk factors and all the medical events and problems you have had in the past. Your doctor will ask questions about your history of:

  • symptoms that suggest bone cancer
  • inherited diseases that increase the risk for bone cancer
  • being around ionizing radiation at work or at home or from having had radiation treatment in the past
  • chemotherapy in childhood with an alkylating drug
  • bone disorders

Your doctor may also ask about a family history of:

  • bone cancer
  • risk factors for bone cancer
  • retinoblastoma (a type of eye cancer)
  • other cancers

A physical exam allows your doctor to look for any signs of bone cancer. During a physical exam, your doctor may:

  • check for a lump, swelling or pain in an area
  • look at how much a leg, arm or joint can move
  • feel the lymph nodes in an area
  • listen to your lungs

Find out more about physical exams.

An x-ray uses small doses of radiation to make an image of parts of the body on film. It is usually the first test done to look for bone cancer. Most bone tumours show up clearly on an x-ray.

A chest x-ray may also be done to see if bone cancer has spread to the lungs.

Find out more about x-rays.

Magnetic resonance imaging (MRI) uses powerful magnetic forces and radiofrequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. A computer turns the images into 3-D pictures.

An MRI is used to confirm the diagnosis of a bone tumour found on an x-ray. It can also look to see if the cancer has spread into the surrounding tissues and other parts of the bone.

Find out more about MRIs.

CT scan

A computed tomography (CT) scan uses special x-ray equipment to make 3-D and cross-sectional images of organs, tissues, bones and blood vessels inside the body. A computer turns the images into detailed pictures.

A CT scan is used if an MRI cannot confirm that an area in the bone is a tumour. It may also be used to see how far a tumour has spread inside the bone, into the soft tissues around the tumour or into the lymph nodes.

Find out more about CT scans.

Biopsy

During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. A report from the pathologist will confirm whether or not cancer cells are found in the sample. A biopsy is used to confirm the diagnosis of bone cancer and find out what type of cancerous tumour it is.

A biopsy is often guided by imaging with an x-ray, an MRI or a CT scan. A CT scan is most often used to guide a biopsy to bones that are deeper in the body, like the pelvic or hip bones.

Core biopsy uses a hollow needle or probe to remove tissue from the body. It is the main type of biopsy used to diagnose bone tumours.

Surgical biopsy uses surgery to remove tissue from a lump or mass to look at under a microscope. This test may also be called an open biopsy. It may be used if a core biopsy does not show whether an area is cancerous.

Bone marrow aspiration uses a needle to remove a sample of bone marrow. Bone marrow is the soft and spongy tissue inside the bones. It may be done if there is a Ewing sarcoma tumour, as they can spread to the bone marrow.

  • Medical Author: Shaziya Allarakha, MD
  • Medical Reviewer: Pallavi Suyog Uttekar, MD

How 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:

  • Bone pain
  • Swelling over the bone
  • Fractures that occur with minor injury or in the absence of injury
  • Fatigue
  • Unintended weight loss
  • Fever
  • Pale skin
  • Reduced appetite
  • A feeling of being unwell or sick

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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Bone Cancer (Sarcoma of Bone): Diagnosis

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. Use the menu to see other pages.

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 sarcoma 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.

Although imaging tests may suggest a diagnosis of bone sarcoma, 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 see a surgeon who specializes in sarcomas, such as an orthopedic oncologist, before any surgery or a biopsy is performed.

This section describes options for diagnosing bone sarcoma. 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 general health

The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose or determine the stage (or extent) of a bone sarcoma:

Blood tests. Some laboratory blood tests may help find bone sarcoma. People 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 may be used to help determinate the stage of a bone sarcoma. 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 lighter to the camera, and areas of injury, such as those caused by cancerous cells, stand out on the image.

Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can 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 or liquid to swallow.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can 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. MRI scans are used to check for any tumors in nearby soft tissue. MRIs provide a road map for the orthopedic oncology surgeon to perform the best cancer surgery possible.

Positron emission tomography (PET) or PET-CT scan. A PET scan may be used to help determine the stage of a bone sarcoma. 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.

The type of biopsy and how it is done are important in diagnosing and treating sarcoma, so patients should be seen in a sarcoma specialty center even before the biopsy is performed. At the sarcoma center, the treating surgeon can identify the location for the biopsy. Because bone sarcomas are uncommon, it is also important to have an expert pathologist review the sample of tissue removed to appropriately diagnose a sarcoma.

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. Use the menu to choose a different section to read in this guide.

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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.

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.

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 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.

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.

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:

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.
Chondrosarcoma: The second most common primary bone cancer. It occurs in the cartilage forming cells.
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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Article Related to How To Diagnose Bone Cancer :

Canine Osteosarcoma Facts – Bone Cancer – how to diagnose bone cancer

What is Canine Osteosarcoma?

Canine osteosarcoma is the most common bone cancer in dogs. Dogs diagnosed with bone cancer 80% -85% of the time are diagnosed with canine osteosarcoma. Likewise called K9 OSA, K9 osteosarcoma, canine OSA and osteogenic sarcoma, the tumor is very vigorous. Treatment, whatever is chosen, should not be delayed.

Who goes Canine Osteosarcoma?

Any dog, at any senility, can be diagnosed with K9 OSA, but typically develops around 7-9 years of age. Enormou or monstrous engender bird-dogs, nonetheless, can be affected as early 1-2 years of age. Particularly prone to the disease are Saint Bernards, Rottweilers, Great Danes, Irish Setters, Doberman Pinschers, and Labrador Retrievers.

Male puppies seem to be more susceptible than females. But when both genders are neutered, they grow doubly at risk over pups that are still intact.

Where is Canine Osteosarcoma Found?

K9 osteosarcomas are discovered approximately 75% of the time in the appendage( the appendicular skeleton ). They generally criticize the bones merely above the wrist joint( distal radius ), the bone of the upper arm close to the shoulder( proximal humerus ), merely above the knee on the lower portion of the thigh bone( distal femur ), or the upper part of the larger of the two leg bones right under the knee( proximal tibia ).

While not as common tumors in the appendicular skeleton, osteogenic sarcomas can also be found in the axial skeleton: the cranium, spinal column, and ribs.

OSAs start deep within the bone, literally exploding the bone as it proliferates outward. Becoming more and more distressing, the most aggressive tumor spreads to other areas of the body very rapidly, primarily invading through the blood, and, seldom, through the lymph.

What are the Symptoms of K9 OSA in the Limbs?

The most common signals of appendicular canine OSA are: limping or lameness, rednes, suffering, and swelling. Tendernes was the outcome of micro, or pathologic, ruptures. Swelling occurs from edema and fibrous tissue swelling from a decrease in circulation. Or this can also symbolize the tumor has already infiltrated into the smothering soft materials.

Occasionally, a rapid faulting of the affected bone may be your first evidence. Symptoms can seem to happen virtually overnight.

What are the Symptoms of Canine Osteosarcoma in the Axial Skeleton? Hounds with axial osteosarcoma in the lower jaw bone( mandibular OSA) and bone tumors around the eye( orbital area tumors) will have questions swallowing. Pups with cranial tumors or tumors in their vertebrae will have neurological problems. Pups with pelvic osteosarcomas may have difficulty having a bowel movement.

What Causes Canine Osteosarcoma? Although canine osteosarcoma does not have a clearly defined make, investigates have identified several factors that grow the likelihood of developing these tumors. Genetic predispositions in a dog’s family lineage, like aberrations of the p53 tumor suppressor gene, are thought to contribute. Former skeletal traumata, chronic bone illness, metal or bone implants or other foreign torsoes connect the register.

Factors, like puppy diets that begin rapid growth rates, may contribute to danger since puppy bone cancers are often located near swelling platefuls. And because osteosarcomas tend to be found in areas of increased bone remolding, oncologist Dr. Kim Cronin, at the University of Pennsylvania, feels that each time here i am cell shatter or increased turnover in an area, odds are the DNA will be more apt to make a mistake when coding for brand-new cadres, This can lead to tumor development.

Sodium fluoride in drinking water and the oral insect rise regulator diflubenzuron, commonly used for flea power, both carcinogens, is a possibility factors.

Additionally, osteosarcomas have been induced in laboratory animals via Dna viruses( polyomavirus and SV-40 virus) as well as RNA viruses( type C retroviruses ).

How is Canine Osteosarcoma Diagnosed?

To diagnose K9 OSA, your veterinary will take an X-ray of the suspected locate. But besides a radiograph, diagnostics could involve a ended physical, orthopedic, and neurological workup to rule out other causes. If X-rays disclose an indisputable bone tumor, most veterinaries won’t recommend a biopsy at the time of writing of diagnosis.

Still, if for some reason “theres a problem” about the lesion on the X-radiations, a very small area of bone may be biopsied.

Does Canine Osteosarcoma Spread( Metastasize) Quickly?

Yes, unfortunately, K9 OSA, is a highly aggressive cancer that circulates through their own bodies very quickly. As soon as your bird-dog is diagnosed, a chest X-radiation may be taken to check for observable metastasis. At the time of writing of diagnosis, osteosarcoma has already metastasized in 90% of the dogs.

The lungs are the most common neighbourhood for the cancer to walk. But it is highly unlikely that spread will show up in the radiograph because metastases are small( less than 10% will initially show up on a chest x-ray ). But since it has been found that 90% of the dogs diagnosed will already have metastasis, all bird-dogs diagnosed with OSAs are treated as if they have lung metastasis no matter what the X-ray reveals.

If there are suspicious lymph nodes or surface masses, those cells may be biopsied. An abdominal ultrasound may be undertaken and maybe a bone scan may be used to evaluate how far the cancer has spread. But, because the disease moves so quickly, many veterinarians may consider these steps academic.

What is the meaning of the word osteosarcoma? Osteo means “bone” and sarcoma comes from the Greek word sarx which necessitates “flesh.” A sarcoma is a cancer that develops from the embryonic mesoderm and includes tumors of the bone, cartilage, paunch, muscle, vascular and hematopoetic materials.

By Editorial Team

February 16, 2018

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If a person is suspected to have a type of blood cancer, there are several tests that will typically be run. Some of the tests can rule out other conditions that can also cause some of the general symptoms of blood cancer, and other tests are used to determine the specific type of blood cancer a person has. The subtype of cancer is important as it helps inform treatment recommendations. 1

How are blood cancers diagnosed?

Medical history

A medical history generally consists of written and verbal questions to understand the symptoms the patient is experiencing and how long the symptoms have been present. Some of the questions in a medical history will cover the health history of close family members, any medications or dietary supplements the person may be taking, previous surgeries, previous or current illnesses, allergies, immunizations, and any exams or tests that have already been run. 1,2

Physical exam

The physical exam includes a visual inspection (looking), palpation (feeling), auscultation (listening, often with a stethoscope), and percussion (producing sounds through tapping) to examine the patient’s body for potential signs of disease. 3 During the visual inspection, the physician will look for signs such as unusual bleeding, bruising, or any changes on the skin. The doctor will also feel areas of the body to detect any changes in certain areas and note whether they are hard, soft, or painful to touch. For example, some blood cancers can cause lymph nodes, the spleen, or the liver to swell. 1

Blood tests

There are several blood tests that may be run to diagnose blood cancer and rule out other conditions:

  • A complete blood count (CBC) is a commonly performed lab test that measures the number of red blood cells (RBCs), white blood cells (WBCs), and platelets, and gives the amount of hemoglobin in the blood (hemoglobin is the protein in RBCs that carries oxygen), and the percentage of blood that is RBCs, called the hematocrit. Sometimes, a CBC includes a differential, which measures the five different types of WBCs. 5
  • A peripheral blood smear is a test that may be run as a follow-up if there are abnormal results on the CBC.The blood smear will include a description of the appearance of RBCs, WBCs, and platelets, as well as any abnormalities that may be present. 4,5
  • Blood chemistry, which may also be called a chemistry panel, is commonly performed to measure a person’s health status. Abnormal levels of certain elements in the blood (like electrolytes and some proteins) may be caused by cancer, but they can also be indicators of other health problems. 1,4
  • Blood clotting tests measure if blood coagulates (clots) normally. Clotting is a function of the platelets and proteins called clotting factors. Some blood cancers can reduce the number of platelets and cause frequent bruising or bleeding, and blood clotting tests can help determine if the bruising and bleeding is due to cancer or another cause. 1,4

Urinalysis

Urinalysis is an analysis of the urine. This test is often performed for a variety of reasons, including to check on kidney function, evaluate for the presence of diabetes, or to help diagnose a urinary tract infection. 6,7 Urinalysis may be performed during the diagnosis or treatment planning stage to help evaluate kidney function. It may also be used during treatment or after treatment is completed to help assess kidney function and general health. 8

Lymph node biopsy

Some blood cancers require a lymph node biopsy to confirm diagnosis. A biopsy is a procedure in which a sample of tissue is removed from the body for examination under the microscope. In a lymph node biopsy, a lymph node or a part of one is removed through a surgical procedure. In some cases, a biopsy sample can be taken with a needle, however, the results are typically more conclusive with an open (surgical) biopsy. 6

Bone marrow aspiration and biopsy

Blood cancers often affect both the blood and the bone marrow, and a bone marrow aspiration and biopsy are generally needed to diagnose blood cancer. The bone marrow aspiration and biopsy are samples of bone marrow that are taken usually from the hip (pelvic) bone. The aspiration uses a large, hollow needle to remove some of the liquid bone marrow. Although anesthetic (pain relief) is used, most patients experience some pain for a brief time when the marrow is removed. The bone marrow biopsy is done at the same time with a large needle that is twisted in to remove a small piece of bone, as well as marrow. Patients usually feel pressure and tugging and may experience some brief pain. 1,9

Genetic testing

Cytogenetic testing, also called karyotyping, determines any potential chromosomal abnormalities or mutations in a blood cancer. These tests are helpful in diagnosis, prognosis, selecting appropriate treatment, and monitoring treatment effectiveness. Two additional types of genetic tests are polymerase chain reaction (PCR) and fluorescent in situ hybridization (FISH). Both PCR and FISH do not look at overall chromosomal changes but can be helpful in detecting specific, known genetic mutations. 1

Flow cytometry

Flow cytometry is a test used to identify cells based on the types of antigens or markers on their surface. Flow cytometry uses a laser to measure multiple characteristics of cells. A dye is used on a blood sample to stain cells with specific antigens, allowing doctors to easily identify cancer cells under a microscope. 1,4

Spinal tap

A spinal tap, also known as a spinal fluid test or lumbar puncture, is a procedure to collect a sample of the cerebrospinal fluid – the fluid that surrounds the brain and spinal cord and acts as a cushion. The fluid is collected from the lumbar region of the back while the patient typically lies on their side with their knees pulled up to their chest. 6 A spinal tap may be performed to see if blood cancer has spread to the cerebrospinal fluid. 1

Imaging tests

Imaging tests are a variety of assessments that use medical equipment to create pictures of the body. There are several different imaging tests that may be used during diagnosis or staging of blood cancer, including:

  • A chest x-ray takes an image of the chest, lungs, heart, large arteries, ribs, and diaphragm, and it may be used if a doctor suspects a lung infection 1,6
  • A computed tomography (CT) scan uses special x-ray equipment to make cross-sectional views of the inside of the body and may be used to see if blood cancer has spread to specific organs, such as the spleen 1,6
  • A magnetic resonance image (MRI) uses powerful magnets and radio waves to generate pictures of the internal structures of the body and may be used to examine the brain or spinal cord 1,6
  • Ultrasound uses high-frequency sound waves to produce an image. Ultrasound can be useful in viewing lymph nodes or potentially enlarged organs in the abdomen, like the kidneys, liver, or spleen 1,5

How to diagnose bone cancer
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:

  • Bone pain
  • Swelling over the bone
  • Fractures that occur with minor injury or in the absence of injury
  • Fatigue
  • Unintended weight loss
  • Fever
  • Pale skin
  • Reduced appetite
  • A feeling of being unwell or sick

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.