Diagnosis

Imaging tests can help determine the location and size of bone tumors, and whether the tumors have spread to other parts of the body. The types of imaging tests recommended depend on your individual signs and symptoms. Tests may include:

• Bone scan
• Computerized tomography (CT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
• X-ray

Needle or surgical biopsies

Your doctor may recommend a procedure to remove a sample of tissue (biopsy) from the tumor for laboratory testing. Testing can tell your doctor whether the tissue is cancerous and, if so, what type of cancer you have. It can also reveal whether the tumor cells are growing quickly or slowly.

Types of biopsy procedures used to diagnose bone cancer include:

• Inserting a needle through your skin and into a tumor. During a needle biopsy, your doctor inserts a thin needle through your skin and guides it into the tumor. Your doctor uses the needle to remove small pieces of tissue from the tumor.
• Surgery to remove a tissue sample for testing. During a surgical biopsy, your doctor makes an incision through your skin and removes either the entire tumor or a portion of it.

Determining the type of biopsy you need and the particulars of how it should be performed requires careful planning by your medical team. Doctors need to perform the biopsy in a way that won't interfere with future surgery to remove bone cancer. For this reason, ask your doctor for a referral to a team of doctors with extensive experience in treating bone tumors before your biopsy.

Stages of bone cancer

If your doctor confirms a diagnosis of bone cancer, he or she tries to determine the extent (stage) of the cancer because that will guide your treatment options. Factors to be considered include:

• The size of the tumor
• How fast the cancer is growing
• The number of bones affected, such as adjacent vertebrae in the spine
• Whether the cancer has spread to other parts of the body

The stages of bone cancer are indicated by Roman numerals, ranging from 0 to IV. The lowest stages indicate that the tumor is smaller and less aggressive. By stage IV, the cancer has spread to other parts of the body.