Diagnosing bone cancer

To diagnose bone cancer you usually start by seeing your GP. You will then be referred to a bone surgeon for tests.

How bone cancer is diagnosed

If you have symptoms of bone cancer, you usually start by seeing your GP. They will check you and arrange any tests or x-rays you need. Your GP will refer you to a bone surgeon (orthopaedic surgeon) if:

  • they are not sure what the problem is
  • they think your symptoms could be caused by cancer that has started in the bones (primary bone cancer).

They may also refer you to a bone cancer specialist.

To help GPs, the National Institute for Health and Care Excellence (NICE) has produced referral guidelines. These are a list of risk factors, signs and symptoms that could suggest cancer. They help your GP decide what sort of tests you should have and how quickly you should see a specialist. The guidelines say the following:

  • Children, teenagers and young adults with unexplained bone swelling or pain should have an urgent x-ray within 2 days. If the x-ray suggests a possible bone cancer, your GP should refer you to a specialist within 2 days.
  • Adults should be seen by a specialist within 2 weeks if the results of an x-ray suggest a bone cancer.

You will see a specialist who will look at the affected area to check for any swelling or pain. They will ask you about your symptoms, your general health and any previous medical problems.

You will have a blood sample taken to check your general health and some of the tests below.

Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready.

We have more information about waiting for results that may help.

Bone x-ray

Bone x-rays may show if the cancer started in the bone (primary bone cancer). Or if the cancer spread to the bone from somewhere else in the body (secondary bone cancer).

Sometimes the way the bone looks on an x-ray can help the doctor tell which type of bone cancer it is. This is often true for osteosarcoma.

MRI scan

An MRI scan uses magnetism to build up a detailed picture of areas of your body. It can be used to look for abnormal areas of bone.

Bone biopsy

A biopsy means the doctor takes a sample of cells from the bone to be checked for cancer under the microscope. There are different ways of doing this.

If your doctor thinks you have bone cancer, you should have this test done at a specialist bone cancer centre.

We have more information about having a bone biopsy.

Further tests

If tests show that you have bone cancer, the cancer doctor may want to do further tests. These are to find out if the cancer has spread outside the bone. This is called staging.

Further tests will help you and your cancer doctor decide on the best treatment for you.

  • CT scan

    Most patients with bone cancer will have a CT scan of their lungs. They might also have a CT scan of the affected bone.

  • Bone scan

    A bone scan checks for abnormal areas of bone in the body. It uses a mildly radioactive injection.

  • Bone marrow sample

    When Ewing sarcoma is suspected or diagnosed, the doctor will take a small sample of bone marrow. The bone marrow is the spongy material inside the bones where our blood cells are made. They usually take the sample from 1 side of the hip bone (pelvis). Sometimes they may also take a sample from the other side. They give you a local anaesthetic first, to numb the area. But younger children may have a general anaesthetic.

  • PET-CT scan

    A PET-CT scan is a combination of a CT scan and PET scan. It gives more detailed information about the part of the body being scanned.

  • Chest x-ray

    The most common place for primary bone cancer to spread to is the lung. A chest x-ray can show if the lungs have been affected.