Bone Cancer

Bone cancer can be primary (starting in bone) or, much more commonly, metastatic (spread from another cancer — breast, lung, prostate, kidney, thyroid). Primary bone cancers include osteosarcoma (most often teenagers/young adults), Ewing sarcoma (children/young adults), and chondrosarcoma (older adults). Treatment and outcomes depend heavily on type and stage.

Symptoms

• Bone pain — often worse at night, not fully relieved by rest.
• Lump or swelling near the affected bone.
• Fracture from a minor injury (pathological fracture).
• Unexplained fever, weight loss, fatigue (Ewing sarcoma in particular).
• Back pain with leg weakness — spinal cord involvement — urgent.
• In children: limp, refusing to walk, persistent localised pain — take seriously.

Diagnosis

• X-ray of the affected bone.
• MRI — defines local extent.
• CT or PET-CT for staging.
• Biopsy — done at the cancer centre where surgery will happen, to plan the best approach.
• Blood tests, including alkaline phosphatase.

Treatment — team-based, limb-sparing where possible

• Neoadjuvant chemotherapy (before surgery) — for osteosarcoma and Ewing sarcoma; dramatically improves cure rates.
• Limb-sparing surgery — now possible for most patients, using custom prostheses or bone transplants.
• Amputation — reserved for specific situations.
• Radiation therapy — key role in Ewing sarcoma.
• Rehabilitation — essential for function and independence.
• Metastatic bone disease from other cancers — managed with systemic therapy for the main cancer, plus radiation and bone-protective medicines for symptom control.
• Care at a specialised orthopaedic-oncology centre matters — outcomes are substantially better there.

Don't abandon treatment. Indian cure rates for osteosarcoma and Ewing sarcoma have risen substantially at experienced centres. Long travel, cost, and the length of chemotherapy lead to drop-out — many NGOs and Regional Cancer Centres provide free accommodation and subsidised care specifically for paediatric and young-adult cancer patients.