• Primary bone cancer is regarded as a rare cancer, with approximately 80 Australians diagnosed in 2021.³ Some types of primary bone cancer are more common in children than adults.¹
• A secondary bone cancer is usually named after the primary site where it started.⁴ If you have a secondary bone cancer, you may therefore hear the cancer being referred to as, for example, breast cancer with bone secondaries (where breast cancer was the primary cancer).

Doctors often refer to primary bone cancers as bone sarcoma. There are more than 30 different types of primary bone cancers, and the three regarded as being the most common are:²

• Osteosarcoma– usually starts in cells that grow bone tissue
  
• Chondrosarcoma– usually starts in cells that grow cartilage
• Ewing sarcoma – usually affects cells in the bone or soft tissue that can multiply rapidly

A common symptom of bone cancer is pain or tenderness in the bones or joints, which may worsen at night or during movement.² Other symptoms may include but are not limited to:²

• Swelling over the affected area
  
• Bone stiffness or tenderness
• Unintended weight loss
• Fatigue
• A fracture
• Issues with movement

If you have any of these symptoms, it doesn't necessarily mean that you have bone cancer. It is recommended to speak with your GP or specialist about any concerns or questions that you may have.

There is no clear cause of bone cancer. However, some factors appear to increase the risk. These may include:^1,2

• Inherited genetic conditions, such as Li-Fraumeni syndrome or hereditary retinoblastoma
  
• Paget's disease or other bone conditions
• Radiation therapy for cancer, particularly during childhood

If you meet with your GP and they are concerned about any of your symptoms or risk factors, they may refer you to a specialist for a consultation and potentially testing. Tests to diagnose bone cancer may include^:1,2

• Physical examination
  
• Blood tests – a full blood count can't diagnose cancer on its own, however it may be the first step to helping doctors understand more about what is going on in your body
• Biopsy – this involves the removal of a small sample of cells and tissue from the affected area for examination in a laboratory to determine if cancer is present and, if so, what type of cancer it is, how advanced, the size and whether it is growing
• Imaging tests – these may include X-rays, a computed tomography (CT) scan, a magnetic resonance imaging (MRI) or a positron emission tomography (PET) scan, each with the aim being to check for bone abnormalities or bone damage

Chemotherapy is an approach to cancer therapy that involves the administration of medicine, usually orally or by injection, which is intended to kill cancer cells or minimise their growth and spread. Chemotherapy can be used in conjunction with other cancer treatments.

Radiation therapy uses high-energy X-rays or other particles to treat cancer and can be used at all stages.

Surgery for bone cancer is often combined with other treatments. The surgeon will discuss options directly with patients, and where possible, the bone cancer will be removed, with the aim being to spare the limb.

All cancer treatments may have side effects.^5,6 The type and severity of side effects will vary between individuals.^5,6 You can ask your doctor for detailed information about the side effects which you may experience with any treatment recommended for you.