Bone Cancer Diagnosis & Detection

At Cancer Treatment Centers of America (CTCA), the first step to developing your personalized bone cancer treatment plan is to conduct a comprehensive evaluation of the disease.

Within the first few days of your arrival at a CTCA hospital, we will perform a complete array of state-of-the-art diagnostic tests. Our clinicians will also review your medical records and health history. This information helps us ensure that you have received an accurate bone cancer diagnosis and helps your team formulate treatment recommendations that are most appropriate for you.

Diagnostic Tools and Tests for Bone Cancer 

Throughout your treatment for bone cancer, we'll use imaging and laboratory tests to monitor your response to therapy and modify your treatment when needed. In addition to a review of your medical history and a physical examination, we may use other tests and tools when diagnosing bone cancer:

Imaging Tests 

Several types of imaging tests may be used to help visualize tissues inside the body to locate suspicious areas, determine the size and location of possible tumors, detect if the cancer has spread and monitor your response to treatment:

• X-Ray – Cancer can make the bone appear different from surrounding healthy bone on an X-ray. The bone may look ragged, or it may appear to have a hole in it. A chest X-ray can help to determine if cancer cells have spread to the lungs.
• Computed Tomography (CT) Scan – A CT scan is a special type of X-ray that generates three-dimensional, cross-sectional images throughout the body. Unlike a normal X-ray, CT scans can create detailed images of the internal organs, like the liver and lungs. It is usually used to help make the initial bone cancer diagnosis and to see if the cancer has spread to other areas of the body, but may sometimes be used to guide the biopsy needle.
• Magnetic Resonance Imaging (MRI) – MRI is also used to examine bone and soft tissues within the body, but unlike X-rays and CT scans, an MRI uses radiofrequency waves and powerful magnets to generate the images, so there is no radiation exposure. An MRI can be very effective for outlining a tumor in the bone, and can also help to determine if cancer cells have spread to the brain or spinal cord.
• Positron Emission Tomography (PET) Scan – This imaging technique is used to look at metabolic activity within different organs of the body. A radioactive dye, usually a form of glucose, is injected, and a special camera is used to take a picture of radioactive areas within the body. Because cancer cells are growing rapidly and are often more metabolically active compared to normal cells, they absorb more of the radioactive glucose. PET scans are very sensitive, but they do not show much detail, so they will often be performed in combination with a CT scan (called PET/CT).
• Radionuclide Bone Scan - This bone cancer detection tool can reveal if the primary tumor has spread to other places in the bone, and how much damage it has done. In a bone scan, a small dose of radioactive material is injected into a blood vessel, where it travels through the bloodstream. The material then gathers in the bones and is detected by a scanner through nuclear imaging. This test is very sensitive and can often find small metastases before they would appear on a regular X-ray. However, other conditions such as arthritis or infection look similar on the scan, so a confirmatory biopsy is often needed.

Biopsy

While imaging tests for bone cancer can be very helpful in determining if the disease is present, the only way to confirm a diagnosis is to examine a sample of the suspected tissue.

A biopsy allows us to get a sample of cells from the suspicious area of the bone so a pathologist can examine the cells under a microscope to determine if they are cancerous. The pathologist can also tell if the cells are from a primary bone cancer, or from a different kind of cancer that has spread to the bones.

Two biopsy techniques used for bone cancer detection include:

• Needle Biopsy – For this type of biopsy, your doctor will numb the area with a local anesthetic before inserting a needle into the suspected site to get a sample of cells. In some cases, a CT scan may be used to help guide the needle.
• Surgical Biopsy – This type of biopsy is generally performed under general anesthesia by a surgeon, who will remove a sample of the tissue (incisional biopsy) or the whole tumor (excisional biopsy).

Next Topic: Bone Cancer Staging