Cancer that begins in the bones (primary bone cancer) is rare — accounting for less than 0.2% of annual cancer diagnoses. It occurs most commonly in the long bones of the arms and legs, usually in children and young adults. Cancer that has spread from other parts of the body to the bones (metastatic bone cancer) is more common and occurs most often in the hip, thighbone, shoulder and spine.

Types of Bone Cancer


About 35% of primary bone cancers are osteosarcomas, which usually affect patients between age 10 and 25. The most common site for this cancer is the knee.


This form of bone cancer accounts for 26% of cases. It is most often diagnosed in patients over age 50 and forms in the cartilage of the pelvis, shoulder, knee or upper thigh.

Ewing’s Sarcoma

Making up about 16% of bone cancer cases, Ewing’s sarcoma usually occurs in the hip, ribs, upper arm, and thigh. It affects primarily children and young adults.


Older patients may develop this very rare cancer after radiation therapy for other cancers. Fibrosarcomas usually occur in the knee or hip.

Giant cell tumors

are most frequently seen in young adults and in women more often than men.


usually occur in the shinbone.


are most often found in the sacrum (tailbone).

Pain that’s “bone deep” is the most common symptom of this cancer. Or the bone may break because it has been weakened by a tumor. Other symptoms such as fever, fatigue, swelling or stumbling may occur, but these may be caused by other non-cancerous conditions. For an accurate diagnosis, you must see a doctor.

Our interdisciplinary approach to cancer treatment means that we can be your single source for the diverse treatment options best suited to your situation. A single source ensures consistency and a continuum of care.


Surgically removing the cancerous bone is usually the primary treatment. The surgeon excises the diseased bone and some of the surrounding bone and muscle to ensure removal of as much cancer as possible. We may use healthy bone from elsewhere in the body to replace cancerous bone or implant a prosthesis.


In some cases, cryosurgery is included in the surgical procedure. The tumor is removed and liquid nitrogen is introduced into the cavity to kill microscopic tumor cells. This helps reduce the chance of the cancer coming back.

Adjuvant Therapy

Often it is advisable for bone cancer patients to have chemotherapy and/or radiation treatment as well as surgery. Such adjuvant therapy kills microscopic cancer cells to prevent them from growing later on.

Radiation Therapy

Radiation therapy is used to shrink tumors, kill remaining cancer cells after surgery or to treat cancer that can’t be surgically removed. It can also be used to relieve pain caused by bone tumors.

External-Beam Radiotherapy

External-beam radiotherapy is administered from outside the body, pinpointing the tumor area and surrounding tissues.


Intensity-modulated radiation therapy (IMRT) can be effective in treating sarcomas. This technology can be focused very precisely so that healthy tissue near the tumor is not injured.


Image-guided radiation therapy (IGRT) also called stereotactic radiosurgery, delivers extremely high doses of radiation to a very tightly circumscribed area. IGRT is often used to treat tumors in the spine.


Intraoperative Radiation Therapy (IORT) allows the radiologist to apply radiation directly to the exposed bone during surgery. This high-dose therapy is performed in a single session.


Chemotherapy (cancer drugs) with surgery can be a potent combination treatment for primary bone cancer. We use chemotherapy to shrink tumors before surgery (induction chemotherapy) and/or control it after surgery. These powerful drugs can also be used to kill any cancer cells remaining in surrounding tissue after the main tumor is removed.

Cancer research is being pursued all over the world, giving patients and physicians hope for new diagnostic techniques, improved treatments and cures.

Myeloablative therapy

This intense chemotherapy regimen, coupled with stem cell support, is a possible treatment option for Ewing’s sarcoma. Stem cells help the body recover from the effects of the powerful chemotherapy.

Targeted therapy

An innovative treatment targeting the cancer’s genes, proteins, or tissue environment that encourage tumor growth. Targeted therapy suppresses the growth and spread of malignant cells and limits damage to healthy cells.

Supportive care

Scientists are continually researching improved methods of relieving cancer symptoms and the side effects of treatment.

Oncology San Antonio - cancer information

Multidisciplinary Cancer Treatment