Primary bone cancer is not a common malignancy in North America.

It is estimated that anywhere from 2,000 to 3,000 Americans get diagnosed with primary bone caner each year. The condition primarily affects children and young teenagers.

The most common types of primary bone cancer are:

• Sterosarcoma: Chiefly occurs in growing bone tissues and generally has a poor prognosis.
• Chrondosarcoma: Predominantly occurs in the cartilage around the joints.
• Ewing’s Sarcoma: Occurs in the immature bone marrow of the long bones, such as the thigh and forearm bones.

The chief complaint of all individuals who have primary bone cancer is pain. Irrespective of where the bone cancer occurs, some degree of pain is common. The pain is usually mild in the beginning of the cancer’s development, but progresses with time. If left untreated, the pain will become constant, varying in intensity from moderate to severe. The majority of individuals are not able to sleep at night because of the pain and ambulation can become difficult. The pain is amenable to narcotic medications.

Besides pain, other symptoms of bone cancer include:

Weakness is a common presentation when bones in the extremities are involved. Some individuals may not be able to bear weight or be able to bend the joint in the affected arm or leg. The weakness in most cases is primarily due to the pain.
Fracture of the affected bone is often a common presentation in some individuals; the bone cancer simply destroys the bone and weakens it. The fracture can be an initial presenting sign of a bone tumor and is usually identified on an x ray.
Swelling of a primary bone cancer is quite common in the later stages. The swelling may be palpable and tender. Often, the swelling is a common feature of chondrosarcomas (a type of malignant cartilaginous growth).

Constitutional Symptoms

Many patients with bone cancer also develop constitutional symptoms like:

• Fever: Fever associated with bone cancer may be continuous or may occur at a set time each day. Initially the cause of the fever may be thought to be an infectious but in all cases the blood work up is negative.
• Fatigue: Most patients with bone cancer report feeling tired and/or having no energy or strength.
• Anorexia: Like all cancers, bone cancers may induce anorexia. Individuals with bone cancer do not feel hungry and start to lose weight. These features are generally more pronounced during the later stages of cancer.
• Anemia: Anemia is a common feature of bone cancers. Blood work usually reveals the presence of anemia.