Symptoms and Diagnosis of Primary Bone Cancer

Primary bone cancer is rare, and primary bone cancer symptoms are not unique to bone cancer. Bone pain is the most common symptom of bone cancer. At first, you may feel the pain only at certain times of the day, although the bone pain will likely become more persistent as the cancer develops.
Other possible symptoms of bone cancer include:
  • Decreased mobility if the tumor is near a joint
  • Fatigue
  • Fractures, because the cancer has made the bones weak
  • Swelling and tenderness near the tumor
  • Unintended weight loss.
If the cancer has spread to other organs, other symptoms may develop.
No ways are known to prevent bone cancer, nor are routine screening tests available to detect the disease before bone cancer signs develop. Attention to the possible symptoms of bone cancer is the best way to get an early diagnosis.

Diagnosing Primary Bone Cancer

Primary bone cancer symptoms are the same as symptoms that can occur for many different conditions, so getting an accurate diagnosis is important. To make a diagnosis, your healthcare provider will ask about your symptoms and your personal and family medical history. Your doctor will do a physical exam, and probably an X-ray. Most bone cancers show up on X-ray imaging techniques.
Your healthcare provider may also order a blood test to measure the level of an enzyme called alkaline phosphatase. Blood contains an abundance of this enzyme when the cells that make bone tissue are highly active, as they are when bone cancer is present. However, this test is not a completely accurate indicator of bone cancer, because growing children and teenagers normally have high levels of alkaline phosphatase.
If the X-ray or blood test suggests cancer (and sometimes if it doesn't), your doctor may want to do other imaging tests, possibly including:
  • Bone scan: The doctor injects a small amount of radioactive material into a blood vessel. As this material travels through your bloodstream, it collects in the bones, where a scanner detects the material.
  • Computerized tomography (CT or CAT) scan: A CT scan is a series of detailed pictures of the inside of the body, created by a computer connected to an X-ray machine.
  • Magnetic resonance imaging (MRI): This procedure uses a powerful magnet connected to a computer to create detailed pictures of areas inside the body without using X-rays.
  • Positron emission tomography (PET) scan: The doctor injects a small amount of radioactive glucose (sugar) into one of your veins, and uses a scanner to make detailed, computerized pictures of areas inside your body. Cancer cells often use more glucose than normal cells, so the pictures can identify cancer cells in the body.
A final diagnosis of cancer usually requires a biopsy. In a biopsy, the doctor removes a tissue sample from the bone tumor and examines it under a microscope. A specialist, such as an orthopedic oncologist (a doctor who treats bone cancer), may remove the tissue sample. A pathologist then examines the tissue to determine if it is cancerous and if the surgical margins are clear.

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