Further tests for bone cancer
This page tells you about further tests you may have if your doctor has just diagnosed cancer that started in your bones (primary bone cancer). If you have cancer that has spread to your bones from somewhere else, this is not the right page for you. We have information on secondary bone cancer that will be more suitable.
Further tests for bone cancer
If tests show that you have bone cancer, you will need more tests to see how big the cancer is and whether it has spread. This is called staging. It is important because the stage of the cancer affects the choice of treatment.
Bone scan, Chest X-ray and CT scan
Bone scans are very sensitive and can show if there is something wrong with the bones and how much of the bone is affected. If you have not already had a chest X-ray, you may have one to check whether the cancer has spread to the lungs. Most people also have a CT scan of their chest.
You may have blood tests to check your general health.
If you are diagnosed with bone cancer you may have other tests. For example, your doctor may measure your heart function and your hearing. This is because some of the chemotherapy drugs for bone cancer can affect your heart or hearing. This is not common, but your doctor may want to take baseline measurements. If you have any problems later, they will then have something to compare to.
After the tests
You will probably feel anxious while waiting for your test results. It might help to talk to a relative or friend about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience.
You can view and print the quick guides for all the pages in the Diagnosing bone cancer section.
The first tests you had were to find out if your symptoms were caused by a bone cancer. If your tests show that you definitely have bone cancer, you will need more tests to find the stage of the cancer. That means to see how big it is and if it has spread. This is important because the treatment for most types of cancer depends on their stage.
Bone scans are very sensitive and can show if there is something wrong with the bones and how much of the bone is affected. To have a bone scan, you first have a small injection of a radioactive substance. You wait 2 to 3 hours for the substance to collect in areas of damaged bone. Doctors call these areas hot spots. Then you have your scan. Hot spots may be due to bone cancer. But they can also show up if you have arthritis or other bone diseases.
The amount of radioactivity used in a bone scan is very small. It soon breaks down and goes away and is nothing to worry about. There is more information about having a bone scan in the cancer tests section.
A CT scan is a computerised scan using X-rays. You may have a CT scan of your chest to check whether the cancer has spread to your lungs. You may have an injection of dye called contrast before the scan. This helps to make the scan clearer to read. There is more about having a CT scan in the cancer tests section.
You may have general blood tests to check your overall health. These will include a full blood count and and tests to see how well your liver and kidneys are working.
If you have osteosarcoma, your doctor may measure your ALP level (alkaline phosphatase). This chemical is found in your blood and is a measure of bone activity. If you have a bone cancer, the levels of bone cell activity in the affected bone may be higher than normal. Not everyone with osteosarcoma has a raised ALP level.
Most people with Ewing's sarcoma will have a bone marrow biopsy to check whether the sarcoma cells are in the spongy marrow at the centre of the bone. The doctor pushes a needle through the bone and into the marrow to take a sample of the bone. Depending on which bone is affected, this test may be done using a local or a general anaesthetic.
Chemotherapy is often used to treat bone cancer. Some chemotherapy drugs can have effects on your body, such as making your heart or kidneys work less well, or stopping you from hearing high pitched noises. It is not very common for people to have long term side effects like these. If you are diagnosed with bone cancer and need to have chemotherapy, your doctor may want to take baseline measurements. You may have
- Tests of your heart function and hearing so that they have something to compare to later if you have any problems
- An echocardiogram (ECHO) to check your heart function
- Auditory tests to check your hearing
- A blood test to check how well your kidneys are working
Your specialist may give you an appointment to come back to the hospital when your test results have come through. Or you may have arranged with your specialist that they will contact you at home. The results will take a little time and you are likely to feel anxious, but try not to worry too much. It may help if you ask your specialist how long the results are likely to take so that you have some idea of how long you will have to wait.
While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience. If you want to find people to share experiences with online, you could use CancerChat, our online forum.
Look at the bone cancer organisations page for an organisation that can give you information about support groups or counselling services near you.
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