Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Overview

Cancer that starts in the bone is called primary bone cancer. Cancer develops when normal cells change and grow uncontrollably. Over time, a growth (tumor) may develop, destroying healthy bone tissue and weakening the bone.

Cancer can occur in any bone in the body. Most often, it develops in the long bones of the legs and arms. 

Most primary bone cancers are called sarcomas. They include a number of diseases that form in the:

  • Bone
  • Muscle
  • Fat tissue
  • Fibrous tissue
  • Blood vessels
  • Lymph vessels

Some sarcomas don’t start in the bone (soft-tissue sarcomas).

To make the best decisions about your care, learn about bone cancer, what to expect, and the tools to help you cope.

Additional References:

Primary and Secondary Cancer

Primary bone cancer starts in the bone.

Secondary bone cancer spreads (metastasizes) to the bone from a different part of the body. For example, if you have breast cancer that spreads to the bone, it’s called breast cancer with bone metastases. The cancer cells in the bone are still breast cancer cells and are treated with therapies for breast cancer.

Bone is a common place for certain cancers (such as breast, lung, and prostate cancer) to spread. Cancer cells can break away from the original tumor and spread to the:

  • Spine
  • Hip
  • Shoulder
  • Thighbone 

Secondary bone cancer is more common than primary bone cancer. 

Cancers that affect the bone, but are not primary bone cancers, are:

  • Multiple myeloma
  • Leukemia 

They develop from cells in bone marrow. Bone marrow is the spongy material inside some bones where blood cells are made.

Additional References:

Types

The following are types of primary bone cancer. 

Osteosarcoma is the most common type of bone cancer. It develops in bone cells that normally make new bone tissue, such as the arms, legs, and hips. Most people diagnosed with this cancer are younger than age 20. 

Chondrosarcoma forms in cartilage. It’s the second most common type of bone cancer. It’s usually found in the pelvis, leg, or arm. It can also occur in the trachea, ribs, and shoulder blades. Most people with this cancer are older than age 40. 

Ewing sarcoma is the third most common primary bone cancer. It can also develop in soft tissues. When it starts in bone, it’s usually in the pelvis, ribs, shoulder blades, arms, or legs. 

Chordoma is a less common primary bone cancer. It typically forms in the lower part of the spine or base of the skull.

Risk Factors

Certain factors increase your risk of getting bone cancer.

Rare genetic disorders are linked to a small number of bone cancers. For example, the risk for chondrosarcoma is higher in people with a disorder that causes bumps on bones (multiple exostoses syndrome).

Previous radiation therapy increases the risk of bone cancer, particularly osteosarcoma. The cancer develops in a bone in the treatment area.

Paget disease of the bone is a noncancerous condition. Abnormal bone tissue forms in one or more bones. The condition mostly affects people older than 50. It rarely causes bone cancer (osteosarcoma).

Having one or more risk factors doesn’t mean you’ll develop the disease. Sometimes, people develop cancer even though they don’t have any risk factors.

Symptoms

As a tumor grows in the bone, it destroys bone tissue and presses on normal tissue. This can cause:

  • Bone pain that worsens with movement
  • Constant bone pain as the tumor grows
  • Swelling in the tumor area
  • Stiff or tender joints
  • Weak bones that may break (fracture)
  • A lump or mass felt under the skin, depending on the tumor location

These symptoms can also be caused by problems other than cancer. For example, bone pain and swelling often result from arthritis or an injury. It’s important that we assess your symptoms to determine the cause.

Diagnosis

To diagnose bone cancer, we learn about your medical history and perform a physical exam.

We may order one or more of the following tests:

  • Bone X-ray
  • Bone scan
  • CT scan
  • MRI
  • PET scan

We may remove a small sample of tissue or fluid (biopsy). The sample is evaluated for cancer cells.

If cancer cells are present, we determine whether the cancer is primary or secondary bone cancer. If the cancer started in the bone, we’ll identify the type of bone cancer. 

Other tests may be done to determine whether the cancer has spread to the lungs or other parts of the body.

Additional References:

Staging Cancer

Bone cancer may be:

  • Localized, or found only in one bone and possibly nearby muscles or tendons.
  • Metastatic, or has spread to other bones or parts of the body.

To stage bone cancer, we consider:

  • How likely the tumor will spread. High-grade tumors grow and spread more rapidly than low-grade tumors.
  • The size of the tumor.
  • If the tumor is found in one spot or several spots in the same bone.
  • If the cancer has already spread to lymph nodes or other parts of the body. 

The stages of bone cancer are:

  • Stage I, a small, low-grade tumor that hasn’t spread.
  • Stage II, a high-grade tumor that hasn’t spread.
  • Stage III, a high-grade tumor that hasn’t spread, but is found in more than one spot in the bone.
  • Stage IV, a tumor that has spread to the lungs or to lymph nodes and other organs.

Treatment

After your diagnosis of bone cancer, we can talk about your treatment options and develop a plan that’s right for you. Treatment options for bone cancer include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • A combination of these treatments
Additional References:

Follow-Up Care

After bone cancer treatment, you’ll have regular checkups so we can:

  • Monitor your recovery.
  • Immediately catch signs that the cancer is returning or getting worse. 

It’s important to attend all follow-up appointments. During these regular visits, we’ll:

  • Perform a physical exam
  • Check for symptoms related to cancer
  • Order bone scans and other tests, if needed
  • Ask about any continuing side effects of treatment

Although many treatment side effects go away once treatment ends, some can last for weeks, months, or even longer.

After extensive surgery, it’s possible you may need:

  • Physical therapy to regain mobility and independence
  • Rehabilitation to help you cope

Part of your survivorship plan is that you:

  • Eat a healthy diet
  • Do not smoke
  • Get regular exercise
  • Find support from a specially trained counselor or support group
Additional References:

Types

The following are types of primary bone cancer. 

Osteosarcoma is the most common type of bone cancer. It develops in bone cells that normally make new bone tissue, such as the arms, legs, and hips. Most people diagnosed with this cancer are younger than age 20. 

Chondrosarcoma forms in cartilage. It’s the second most common type of bone cancer. It’s usually found in the pelvis, leg, or arm. It can also occur in the trachea, ribs, and shoulder blades. Most people with this cancer are older than age 40. 

Ewing sarcoma is the third most common primary bone cancer. It can also develop in soft tissues. When it starts in bone, it’s usually in the pelvis, ribs, shoulder blades, arms, or legs. 

Chordoma is a less common primary bone cancer. It typically forms in the lower part of the spine or base of the skull.

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

For general medical advice, our Appointment and Advice line is available 24 hours per day, 7 days per week.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line. You will be connected with a nurse who can give you immediate advice.

If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.

Your Care with Me

If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.

If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options and develop a treatment plan that is right for you.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Related Health Tools:

Podcasts

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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