A picture showing the diagnosis of bone cancer and its various treatments

Diagnostics and treatment of bone cancer

Bone cancer treatment methods are complex procedures that require a specialized center and qualified staff. There are various procedures for treating different types of cancer and usually require continuous follow-up, starting with diagnosis, treatment and ending with recovery.

Bone cancer treatment

It is working to treat the disease and eradicate it from the body, and this process differs greatly between patients. There are treatments that focus on the complete eradication of the mass, including what works to relieve symptoms, and in the advanced stages, palliative treatment is provided to relieve pain.

Treatment decisions are made by an integrated team of multi-specialty doctors, therapists and consultants based on precise rules and protocols in which the patient is evaluated, the extent of the injury, the stage and severity of the cancer, and possible symptoms in order to finally determine the best appropriate treatment methods, taking into account the patient’s desire and involving him in the final decision.

Patients are advised to undergo all necessary medical examinations and can ask specialists about the available treatments and how to achieve the greatest benefit from them before starting them. It is necessary to create an interactive atmosphere in which the patient can be an integral part of the therapeutic decision-making process.

The most common methods of treating bone cancer include:

  • Surgery
  • chemotherapy
  • Immunotherapy
  • radiotherapy
  • Alternative therapies and herbal medicine

In general, the following are taken into account when applying the treatment:

  1. The grade and stage of the cancer
  2. the age
  3. The person's general health
  4. The location and size of the cancer.

An overview of bone cancer

Bone cancer can form when a mass or group of abnormal cells grows inside the bone, called osteosarcoma.

The tumor can be malignant, that is, it grows rapidly and spreads to other parts of the body, then the tumor is called cancer, or bone tumors may be benign, beginning in certain bones such as the pelvis and the long bones in the hands and legs.

A three-dimensional image of a metastatic bone cancer in the pelvis
pelvic bone cancer

Tumors that form early in the bone are rare but can also be highly malignant, so early detection will determine whether or not they will respond to treatment.

Orthopedic carcinomas can be simplified into two types:

  1. primary cancer: It forms from bone cells or surrounding tissues and is usually the most dangerous.
  2. secondary cancerOccurs when a tumor spreads and reaches the bone from other tissues such as the prostate, breast, and others. It is more common and its symptoms are less severe.

Some medical schools add a third type, which is blood malignancies, such as leukemia or leukemia, as they sometimes give bone symptoms and arise at the expense of cells in the bone marrow.

Bone cancer diagnosis

Cancer shows many signs that the doctor investigates during the examination, in addition to general symptoms such as pain, high fever, and others, which are a reason to seek medical advice at first.

The most important thing that is focused on before making the final diagnosis and determining the type of cancer and then choosing appropriate treatment methods for it is determining whether the bone cancer is primary or secondary, in addition to distinguishing benign cancer from malignant.

An accurate diagnosis of bone cancer depends on knowing which bone is affected and what its exact location in the bone, what it looks like on radiography, and what tumor cells are found when examined under a microscope biopsy.

The first step is the medically accurate clinical story that the medical team members write down as they need to ask the patient about the most prominent previous health problems he suffered, the reasons for his previous hospitalization, the medications he takes, and the surgeries he undertook.

Then comes the clinical examination, which is one of the important steps. Benign cancer can be determined, for example, by directly palpating the mass. The examination helps enhance trust between the doctor and the patient, which allows optimal medical assistance.

To determine the details of bone cancer, there are complementary tests that are usually used:


Modern imaging techniques today use X-rays, magnetic fields or radioactive materials to form a high-resolution image of the affected organ. The presence of many options has allowed the possibility of identifying and diagnosing the most rare and difficult cases correctly.


Magnetic resonance imaging (MRI) of bone cancer in the tibia of the leg.
Magnetic resonance imaging of bone cancer in the tibia of the leg.

Newer imaging methods used to diagnose bone cancer include:

  • X-ray: It is the first procedure where bone cancer appears clear with cancers that do not appear on the simple picture.
  • MRI: A safer technique in which patients are not exposed to radiation, it is possible to inject a substance that helps make the image more contrast, such as gadolinium.
  • CT scan: Not as effective as resonance imaging in bone cancer, but may be used when biopsy is taken.
  • bone scan: To check for bone metastases.
  • positron emission tomography: Using radioactive sugar, the spread of cancer is detected in the body.


The use of different imaging methods may guide us in detecting bone cancer and identifying the types of affected tissue, but the final diagnosis is always by biopsy, that is, removing a small amount of tissue from the suspicious area and examining it under a microscope.

There are several types of biopsy:

  • Needle biopsy: It is done either by a thick or thin needle and is of little use in bone cancer.
  • surgical castIt may be incisional for diagnosis or excision that removes all of the cancer.

lab tests

A bone cancer biopsy is sent to the histopathological laboratory for examination and to determine the degree and severity of the cancer. Oncologists may order blood tests such as:

  • Alkaline phosphatase
  • LDH
  • Blood count and formula
  • chemical examinations

Bone cancer treatment without surgery

Not all bone cancers require surgical treatment, as intravenous drugs can be given to eliminate the disease and this is called systemic treatment, or the treatment is to put the drug directly into the affected area and this is the local treatment, and bone cancer can be treated radiologically.


One of the most common ways to treat bone cancer, and is based on the use of more than one drug that prevents tumor cells from growing and dividing to give new cells.

Treatment is usually given according to doses controlled by a system or schedule and may include one or more drugs and it can be done in the clinic without the need to stay in the hospital.

Treatment is done before surgery, especially in fast-growing bone cancer, to stop its growth and reduce its size, which increases the success rate of the operation and reduces the incidence of recurrence after treatment. It is possible to apply chemotherapy after surgery to eliminate the remaining cancer.

Targeted Immunotherapy

When chemotherapy fails, tumor immunotherapy methods may be applied by targeting bone cancer genes, proteins or tissues that help it grow in order to stop the resulting damage and prevent it from spreading.

Not all types of bone cancer have the same genes and proteins, and therefore the benefit of targeted therapy is limited to patients who have undergone many necessary tests and analyzes and have the financial ability. This type of treatment, despite its high effectiveness, is expensive.


High-energy rays are applied to cancer cells to treat a tumor. These rays may come from an external device in external irradiation cancer treatment or from small pills implanted near the tumor in internal irradiation cancer treatment.

Irradiation is often used in bone cancer when it is not possible to remove the bone tumor or before and after the operation as a complement to the treatment.


An image showing a patient undergoing radiotherapy
Radiotherapy of bone cancer.

alternative treatment

One of the controversial methods of treating bone cancer includes taking vitamins, herbs such as saffron, and following a special diet.

Some patients resort to acupuncture or massage sessions and similar methods of treatment to improve their symptoms.

Surgical bone cancer treatment

One of the most widely applied methods of treating bone cancer. Surgical treatment is usually started after taking a biopsy and determining the type of cancer. It is very important that the biopsy and surgical excision be coordinated with each other and be performed by expert orthopedic surgeons.

The most common surgical method in the treatment of bone cancer depends on the complete or almost complete excision of the tumor, because malignant diseases relapse if a little of the cancer is left without excision, which explains why the surgeon removes a little healthy tissue around the tumor as a safety distance, as this procedure is called wide excision. .

After the surgery, the removed tissue is sent to the laboratory, which determines whether the edges of the excised cancer are healthy, negative, malignant or positive. In this case, the excision is repeated.

Surgical treatment in bone cancer varies according to its location. In limb tumors, there are two types of surgical procedures:

  1. Limb-conserving surgery: The majority of patients can do this operation, although it is difficult. The main goal is to remove all of the cancer in a way that preserves the limb effectively.
  2. limb amputationLarge and metastatic bone cancer may be the best option. Complementary prosthetic surgery is usually performed to help patients carry out their daily activities and to install prosthetic limbs. 

Among the surgeries performed to treat bone cancer in other locations are:

  • Hip surgeries: It is a difficult procedure and complementary chemotherapy is usually applied.
  • spine surgeriesIt may not be possible to remove the cancer with surgery only, so complementary treatments such as radiation are used.
  • Arthrodesis: Bone cancer sometimes affects the joints, and the joint and the flesh of the two bones together may be removed, and the result is a loss of movement ability that can be lived with by physical therapy.
  • bone curettage: It is used to treat bone cancers that do not usually degenerate and do not metastasize.
A picture showing the stages of bone cancer treatment using the bone cortage technique
Stages of treatment for bone cancer with bone curettage.

After the operation, bone cement is sometimes placed that hardens with time and blocks the areas of the wide excision of the bone.

Bone cancer treatment results

In the 1970s, the primary treatment for osteosarcoma was amputation, and the cure rate was only 20%. Fortunately, in the 1980s, a paradigm shift occurred in the treatment of bone cancer, as more successful surgical techniques were applied and chemotherapy was introduced.

Currently, 80-95% patients undergo limb-preserving surgery with complementary chemotherapy, and recurrence is rare unless the excision is not done correctly, as it may reach 25%, and here comes the importance of reaching an expert surgeon.

Bone cancer is treated by irradiation if surgery is not possible, but its success rates are lower.

The outcome of the treatment certainly depends on the choice of  Specialized Center He has high expertise and modern equipment.

Side effects of bone cancer treatment

Complications of treating bone cancer with surgery include:

  • short term complications: It is not common but may be dangerous when it occurs such as heavy bleeding, clot formation, inflammation and pain.
  • long-term complications: Such as inflammation of the skin at the place of the artificial limb or nerve damage at the site of the wound, leading to numbness and paralysis.

As for the non-surgical methods of treating bone cancer, it can cause:

  • Nausea, vomiting and loss of appetite
  • Hair loss, especially chemotherapy
  • Dry mouth and diarrhea
  • Skin burns and sensitivity after radiotherapy

Do not hesitate toContact us To seek medical advice or to inquire more about the treatment and diagnosis of bone cancer.


Common questions

Surgery with complementary chemotherapy is the best treatment option available.

There is no effective and successful way to completely prevent bone cancer, but work can be done to reduce the risk factors.

The cure rate for metastatic bone cancer ranges from 23% to 70%. Of course, early detection increases the rates of morbidity.

It is recommended to eat calcium-rich foods such as dairy products, green leafy vegetables such as broccoli and avoid undercooked or raw meats such as sushi.

Make an appointment with Dr. Çetin Işık
In Istanbul

Make an appointment with Dr. Çetin Işık
In Istanbul