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Radiotherapy treatment for bone cancer

Radiotherapy uses high energy x-rays to treat cancer. You don't routinely have radiotherapy for all types of bone cancer. But it can be an important part of treatment for Ewing sarcoma.

This page is about cancer that starts in your bone (primary bone cancer).

If your cancer has spread into bone from another part of the body, it is called secondary or metastatic bone cancer.

When you might have it

You don't routinely have radiotherapy for all types of bone cancer. But it can be an important part of treatment for Ewing sarcoma. You may have radiotherapy for:

  • Ewing sarcoma
  • osteosarcoma and chondrosarcoma if surgery is not possible
  • bone cancer that has spread or has come back after treatment
  • chordoma - sometimes after surgery
  • osteosarcoma - occasionally after surgery

Ewing sarcoma

If you have Ewing sarcoma, you might have radiotherapy in the following situations:

If surgery can't completely remove your cancer

It may not be possible to remove your tumour completely if the cancer is in a central area of your body. You might have a combination of surgery and radiotherapy. Or you might have radiotherapy instead of surgery. You usually have radiotherapy alongside chemotherapy.

Before or after surgery

Radiotherapy before surgery can make Ewing sarcoma easier to remove. You might be able to have a smaller operation.

Your doctors may think there is a risk that cancer cells have been left behind after your operation. So they may recommend radiotherapy to kill off any remaining cancer cells. 

If Ewing sarcoma spreads to the lungs

You might have radiotherapy to both of your lungs after chemotherapy if the cancer has spread to your lungs. This is sometimes called whole lung radiotherapy or a lung bath. You usually have a low dose of radiotherapy every day over a couple of weeks. 

Bone cancer that has spread or come back

You might have radiotherapy for all types of bone cancer that have spread or come back (advanced cancer). It might not be possible to get rid of advanced bone cancer. But radiotherapy and chemotherapy might control the growth of the cancer for a while.

This kind of radiotherapy is called palliative radiotherapy. Palliative radiotherapy can shrink advanced cancers and relieve symptoms. 

A growing cancer can cause symptoms by pressing on nerves and other body tissues. This can be painful. Radiotherapy can often shrink them which relieves the pressure.

Radiotherapy can also help to strengthen bones weakened by cancer. After the treatment has killed off the cancer cells, the holes in the bone caused by the cancer are repaired by the osteoblasts. These are the cells in bones that make the bone framework.

How you have it

You have external radiotherapy for bone cancer. External radiotherapy is the use of radiation to destroy cancer cells from outside of the body. Depending on your type of bone cancer and its stage, you might have one of the following types of external radiotherapy.

Conformal radiotherapy

Conformal radiotherapy shapes the radiation beams to closely fit the area of the cancer. It is also called 3D conformal radiotherapy or 3DCRT. It is a very common type of radiotherapy. 

Intensity modulated radiotherapy (IMRT)

You may have a type of radiotherapy called intensity modulated radiotherapy (IMRT) to treat primary bone cancer. IMRT shapes the radiotherapy beam to fit the shape of the tumour very accurately. This allows higher doses of radiation to treat the area, while the surrounding healthy tissues get less radiation.

Proton beam therapy

You might have a type of radiotherapy called proton beam therapy for chondrosarcomas or chordoma. This type of radiotherapy uses high energy or low energy proton beams to treat cancer.