Stages and grades
The tests and scans you have to diagnose your cancer give some information about the stage.
In bone cancer, staging also takes into account how abnormal the cells look under the microscope (the grade).
Your doctors and surgeons might use one of 2 different systems to stage your bone cancer. These are:
TNM staging system
number staging system
They will explain which one they are using and what this means for you.
Staging and grading for bone cancer is complicated. The most common system doctors use is the TNM system.
The grade of bone cancer gives your doctor a guide to how the cancer may behave.
Low grade cancers have cells that look very much like normal cells. These cancers usually grow slowly and are less likely to spread.
High grade cancers have cells that look very abnormal. These cancers generally grow more quickly and are more likely to spread.
In the TNM system, bone cancer cells are graded from GX to G3:
grade X (GX) means the grade cannot be assessed
grade 1 (G1) means the cells look similar to normal bone cells (low grade)
grade 2 (G2) means the cells look quite different to normal bone cells (high grade)
grade 3 (G3) means the cells look very different to normal bone cells (high grade)
All Ewing sarcomas are high grade (G3).
TNM stands for Tumour, Node and Metastasis. The system describes:
the size of the cancer (tumour or T)
whether the cancer has spread to your (N)
whether the cancer has spread to a different part of your body (metastasis or M)
Read more about TNM staging for bone cancer
The tumour, node and metastasis results are put together with the grading to give the number stage. The following is a summary of the staging for bone cancer. There is no number staging for bone cancer that starts in the back (spine) and .
The cancer is 8 cm or less across. It has not spread to the lymph nodes or other parts of the body. The cancer is low grade or the grade can't be assessed.
The cancer is more than 8 cm across, or is in more than one place in the same bone. It has not spread to the lymph nodes or other parts of the body. The cancer is low grade or the grade can't be assessed.
The cancer is 8 cm or less across. It has not spread to the lymph nodes or other parts of the body. The cancer is high grade.
The cancer is more than 8 cm across. It has not spread to the lymph nodes or other parts of the body. The cancer is high grade.
The cancer is in more than one place in the same bone. It has not spread to the lymph nodes or other parts of the body. The cancer is high grade.
The cancer is any grade and is either:
any size
in more than one place in the same bone
There are no cancer cells in the lymph nodes and it has only spread to the lung.
This means the cancer has spread to the lymph nodes or to parts of the body such as the liver, other bones or the brain.
As well as the stage and grade of your bone cancer, your treatment will depend on other factors. These include:
the type of bone cancer
where the cancer is
your general health and level of fitness
The main treatment for bone cancer can include:
surgery
radiotherapy
chemotherapy
Some people might have a . You might have treatment as part of a .
Last reviewed: 11 Feb 2025
Next review due: 11 Feb 2028
The stage of a cancer tells you how big it is and whether it has spread. The grade means how abnormal the cells look under the microscope.
The main treatments for cancer that starts in your bone include surgery, chemotherapy and radiotherapy. You might have a combination of these treatments. Find out more.
We don’t know what causes most bone cancers. But there are some factors that may increase your risk of developing it. Find out what these may be.
Survival depends on many factors including the stage and type of your cancer. Find our the survival information for bone cancer.
Primary bone cancer is cancer that has started in any bone of your body.
Primary bone cancer is cancer that has started in any bone of your body.
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