Sarcomas, rare & complex cancers
Cancer types
Bone tumours
Osteosarcoma, Ewing sarcoma, chondrosarcoma and others.
Osteosarcoma, Ewing sarcoma, chondrosarcoma and others.
This map explains primary bone tumours step by step: what it is, the types, the tests, the stages, the treatment and its side effects.
Tap any topic on the map to read about it. Topics with an arrow open more topics.
Tap a type on the map.
Why this matters: each type has a very different treatment.
The most common bone cancer, usually in teenagers, often around the knee or shoulder. Treated with chemotherapy and surgery.
Children and young adults, often in the pelvis, ribs or long bones; can also start in soft tissue. Very sensitive to chemotherapy and radiotherapy.
Adults, often in the pelvis or shoulder. Starts in cartilage. Does not respond well to chemotherapy or radiotherapy, so surgery is the main treatment.
Usually not cancer, but grows locally and can come back. Treated with surgery, or denosumab injections when surgery would be disabling.
A slow-growing cancer of the skull base or lower spine (sacrum). Treated with surgery and high-dose radiotherapy (often proton therapy).
Tap a test on the map to see why it is done.
Please wait for all the reports. Why we wait
An X-ray often shows a typical pattern. MRI of the whole bone shows the extent into the bone and soft tissue.
A core needle biopsy, planned by the sarcoma surgeon so the track can be removed at surgery. Ewing sarcoma is confirmed by a gene test (EWSR1).
Check the lungs and other bones, the most common sites of spread.
Sperm or egg storage before chemotherapy, and a hearing test before cisplatin.
Before starting chemotherapy, immunotherapy or targeted therapy, these tests check that you are fit for treatment, and give a starting point to compare with later.
| Test | Why it is done |
|---|---|
| CBC (complete blood count) | Haemoglobin, white cells and platelets. Treatment can lower them. |
| RFT (kidney function) | Many medicines are cleared by the kidneys; the dose may need to change. |
| LFT (liver function) | Many medicines are processed by the liver. |
| Viral markers: HBsAg, anti-HCV, HIV | Hepatitis B can flare up during treatment. If positive, a tablet is given to prevent this. |
| Blood sugar (and HbA1c if diabetic) | Steroids given with chemotherapy can raise blood sugar. |
| ECG and 2D Echo | Check the heart rhythm and pumping before treatment, as some medicines affect the heart. |
Before immunotherapy, also:
| Test | Why it is done |
|---|---|
| Serum TSH (thyroid) | Immunotherapy can affect the thyroid gland. |
| Serum cortisol (morning sample) | Immunotherapy can affect the adrenal and pituitary glands. |
Sometimes needed, depending on your treatment:
Your doctor will choose the tests that apply to you. Some of them are repeated during treatment.
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Limited to the bone and nearby tissue. Most osteosarcoma and Ewing sarcoma patients with localised disease are cured.
Spread to the lungs or other bones. Still curable in some, especially with only a few lung deposits.
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Side effects: chemotherapy · surgery
Side effects: chemotherapy · surgery
Side effects: surgery
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Fever of 38°C or more during chemotherapy, pain, redness or swelling at the operation site or prosthesis, a sudden fracture, or breathlessness need urgent care.
This information is general. Your own treatment plan may be different. Please discuss it with your doctor.
Written and medically reviewed by Dr Prathyusha Eaga, MD, DM (Medical Oncology). Last reviewed: 12 October 2026. Based on NCCN and ESMO guidelines.
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