Primary Bone Cancer: Treatment Choices

There are many treatment choices for primary bone cancer (cancer that starts in the bones). Which may work best for you? It depends on a number of factors. These include the type, size, location, and stage of the cancer. Other factors include your age, overall health, your personal preferences, and what side effects you’ll find acceptable.

Learning about your treatment choices

You may have questions and concerns about your treatment choices. You may also want to know how you’ll feel, look, and how your body will work after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. Your provider can tell you what your treatment choices are, how well they’re expected to work, and what the risks and side effects are. A specific treatment might be recommended. Or you may be offered more than one choice, and asked to decide which one you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision for you.

Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to look at your choices. You may want to get another opinion before deciding on your treatment plan. You may also want to involve your family and friends in this process.

Understanding the goals of treatment for primary bone cancer

For many primary bone cancers, the goal of treatment is to cure the cancer. If cure is not possible, treatment may be used to shrink the cancer or keep it under control for as long as possible. Treatment can also improve your quality of life by helping to control symptoms caused by the tumor. The goals of bone cancer treatment can be one or more of the following:

• Removing the cancer in the bone

• Removing or destroying tumors in other parts of the body

• Killing or stopping the growth or spread of bone cancer cells

• Preventing or delaying the cancer's return

• Easing symptoms from the cancer, like pain or pressure on organs

Types of treatment for primary bone cancer

Most people with primary bone cancer will have more than one treatment. The treatments you have depend on your age, general health, and the type, grade, and stage of bone cancer. Here's an overview of each type of treatment:

Surgery

This is the main treatment for most bone cancers. Surgery is done to remove the tumor and some of the normal-looking tissue around it. This is done to make sure all of the cancer is removed. The surgeon will try to not change the way you look. If the tumor is in an arm or leg (limb), the surgeon will try not to affect the way your limb works. Depending on where the tumor is and its size, this can be hard to do. Sometimes, major reconstructive surgery using bone from another part of the body or metal plates is needed. Surgery to remove (amputate) an arm or leg is sometimes needed. 

Chemotherapy or other medicines

These treatments use strong medicines to kill cancer cells. Chemotherapy (chemo) might be used to treat some kinds of primary bone tumors. It can be used to shrink tumors before they're removed by surgery. It might also be given after surgery, to lower the chance the cancer will come back. Chemo may also be used to treat tumors that can’t be surgically removed. Or it can be used on tumors that have spread to other places in your body. Medicines called targeted therapies can also help treat certain types of bone tumors.

Radiation therapy

This treatment kills cancer cells using strong X-rays or other types of energy. In most cases, radiation therapy is not the main treatment for bone cancer. But sometimes it's used on tumors that can’t be removed. It may also be used after surgery to kill any cancer that may have been left behind. Radiation can also help ease the symptoms of bone cancer.

Supportive or palliative care

Your healthcare provider will use treatments that help ease your symptoms, but don’t treat the cancer. These are often used along with other treatments. For instance, pain medicine can be used to ease pain caused by the tumor. This doesn't treat the tumor, but it helps with the symptoms.

Clinical trials for new treatments

Researchers are always looking for new ways to treat cancer. These new methods are tested in clinical trials. Talk with your healthcare provider to find out if there are any clinical trials you should consider.

Talking with your healthcare provider

At first, thinking about treatment options may seem overwhelming. Talk with your healthcare providers, nurses, and loved ones. Make a list of questions. Ask where you can learn more about your choices. Consider the benefits and possible side effects of each choice. Discuss your concerns with your healthcare provider before making a decision. You may want to get a second opinion. Getting the input from another healthcare provider can help you feel more sure about the plan you choose.