Bone & Soft-Tissue Cancer Diagnosis

What is bone cancer?

A bone tumor is an abnormal growth of cells within a bone. A bone tumor may be cancerous (malignant) or noncancerous (benign). The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly.

Types of cancerous bone tumors include:

• Osteosarcoma
• Chondrosarcoma
• Ewing's sarcoma
• Fibrosarcoma

How is bone cancer diagnosed?

Most of the time, diagnosis begins when a patient looks to their family doctor to examine a bump or pain. Tumors are generally not the first thing that comes to a family doctor's mind at this point. Usually the answer is that it is a bruise, a torn muscle or tendon, a fracture due to a fall or car accident or arthritis. These problems usually get better. However, if you don't get better, or get worse, you need a more focused evaluation.

At Baptist MD Anderson, diagnosis starts with an evaluation. All evaluations begin with a thorough history and physical exam.

The history focuses on:

• Where is the pain or swelling?
• Is it getting worse?
• What makes it better or worse (ibuprofen, ice, elevation, etc.)?
• Other problems (weight loss, loss of appetite, loss of energy, fever, etc.)
• Past medical history (Prior cancer and treatment, occupational exposure, military, etc.)
• Family history (cancers history, other genetic conditions, etc.)

The physical exam focuses on:

• The overall health (Vital signs, weight, etc.)
• Changes in Range of Motion (ROM) of the extremity
• Changes in strength and sensation
• Pain with touching or squeezing a limb
• Swelling, tenderness, or warmth
• Swelling in the groin, axilla or neck
• Swelling in the joint
• Inability to bear weight, walk or use the arm, leg or hand

The health care provider will perform a physical exam. Tests that may be done include:

• Alkaline phosphatase blood level
• Bone scan
• Chest x-ray
• CT scan of the chest
• MRI of the bone and surrounding tissue
• X-ray of bone and surrounding tissue
• PET scan

What is soft-tissue cancer?

Soft-tissue sarcoma (STS) is a cancer that forms in the soft tissue of the body. Soft tissue connects, supports, or surrounds other body parts. In adults, STS is rare.

There are many different types of soft tissue cancers. The type of sarcoma depends on the tissue it forms in:

• Muscles
• Tendons
• Fat
• Blood vessels
• Lymph vessels
• Nerves
• Tissues in and around joints

How is soft-tissue cancer diagnosed?

Your health care provider will ask you about your medical history and do a physical exam. Other tests may include:

• X-rays
• CT scan
• MRI
• PET scan

If your provider suspects cancer, you might have a biopsy to check for cancer. In a biopsy, your provider collects a tissue sample to examine in the lab.

The biopsy will show if cancer is present and help show how quickly it is growing. Your provider may ask for more tests to stage the cancer. Staging can tell how much cancer is present and whether it has spread.

What is metastatic bone cancer?

By far the most common type of "bone cancer" is cancer that started somewhere else and then travels or "metastasizes" to the skeleton. This is not really "bone cancer" as it is breast, kidney, prostate, lung or thyroid or other types of cancer that have spread to the bones. This type of cancer can cause serious problems for a patient due to pain and risk for fractures of bones weakened by the cancer. Indeed, sometimes the first sign a person has cancer is from a "pathologic fracture," a broken bone due to weakness caused by cancer from somewhere else.

This is why early detection of bone or joint pain in the setting of other cancers is so important. With the proper care, the damage to bones can be reversed without resorting to surgery, through treatment with medicines to halt the cancer and restore the bones or with radiation to kill the cancer affecting.