Page last updated: November 2025
The information on this webpage was adapted from Understanding Primary Bone Cancer - Information for people affected by cancer (2025 edition). This webpage was last updated in November 2025.
Expert content reviewers:
This information has been clinically reviewed by Prof Peter Choong AO, Orthopaedic Surgeon, and Sir Hugh Devine Professor, St Vincent’s Hospital, and Head of Department of Surgery, The University of Melbourne, VIC.
This edition is based on the previous edition, which was reviewed by the following panel:
- Prof Peter Choong AO
- Catherine Chapman, Adolescent and Young Adult and Sarcoma Cancer Specialist Nurse, Division of Cancer and Ambulatory Support, Canberra Hospital, ACT
- A/Prof Paul Craft AM, Medical Oncologist, Canberra Hospital and Australian National University, ACT
- Belinda Fowlie, Bone Tumour Nurse Practitioner Candidate, SA Bone and Soft Tissue Tumour Unit, Flinders Medical Centre, SA
- Prof Angela Hong, Radiation Oncologist, Chris O’Brien Lifehouse, and Clinical Professor, The University of Sydney, NSW
- Vicki Moss, Nurse Practitioner, SA Bone and Soft Tissue Tumour Unit, Flinders Medical Centre, SA
- A/Prof and Dr Marianne Phillips, Paediatric and Adolescent Oncologist and Palliative Care Physician, Perth Children’s Hospital, WA
- Chris Sibthorpe, 13 11 20 Consultant, Cancer Council Queensland
- Stephanie Webster, Consumer
The treatment of bone cancer is complex and requires specialist care. Research shows that having treatment at a specialist treatment centre means better recovery and longer survival. Treatment will depend on:
- the type of primary bone cancer
- the location and size of the tumour
- whether or not the cancer has spread
- your age, fitness and general health.
Primary bone cancer is usually treated by surgery, chemotherapy or radiation therapy, or a combination of those. The aim is to control the cancer and maintain the use of the affected area of the body.
Many people who are treated for bone cancer go into complete remission (when there is no evidence of active cancer).
Preparing for treatment
There are some key points to consider before treatment for primary bone cancer, including:
- Treatment may affect your ability to conceive a child. Before treatment starts, you may be able to store sperm, eggs, embryos or ovarian tissue.
- If your doctor thinks you may be at risk of a bone fracture, they may recommend you wear a splint to support the bone or use crutches.
- Your doctor may recommend you have some tests to check how well your heart and kidneys are working, as some types of chemotherapy and radiation therapy may affect these organs.
Specialist sarcoma treatment centres
You can find specialised sarcoma treatment centres at certain hospitals and cancer centres in major cities throughout Australia.
These specialist centres have multidisciplinary teams (MDTs) who regularly manage this cancer.
The team will include surgeons, medical oncologists, radiation oncologists, pathologists, radiologists and clinical nurse consultants.
It will also include allied health professionals such as physiotherapists, occupational therapists and social workers.
Some centres also have oncologists with experience in treating children and young people with bone cancer.
To find a specialised sarcoma team in your state or territory, visit the Australia and New Zealand Sarcoma Association. You might have to travel for treatment.
Surgery
The type of surgery you have will depend on where the cancer is in the body.
Limb-sparing surgery
Surgery to remove the cancer but save (salvage) the arm or leg (limb) can be done in most people. You will have a general anaesthetic, and the surgeon will remove the affected part of the bone.
The surgeon will also take out some surrounding normal-looking bone and muscle with a layer of surrounding normal tissue. This is called a wide local excision, and it reduces the chance of the cancer coming back.
A pathologist checks the tissue to see whether the edges are clear of cancer cells. The bone that is removed is usually replaced with a metal implant or a bone graft. A graft uses healthy bone from another part of your body or from a “bone bank”.
A bone bank is a facility that collects tissue for research and surgery. In some cases, the removed bone is treated with radiation therapy to destroy the cancer cells, then used to reconstruct the limb.
After surgery, you will be given medicine to manage pain and reduce the chance of getting an infection in the bone or metal implant. There are likely to be some changes in the way the limb looks, feels or works.
A physiotherapist can show you exercises to help you regain strength and improve how the limb works.
Surgery to remove the limb (amputation)
For about 1 in 10 people, the only way to remove the cancer completely is to remove the limb (amputation). This procedure is less common now because techniques used for limb-sparing surgery have improved.
However, amputation may be needed in certain situations. After surgery, you will be given medicine to manage the pain and taught how to care for the stump that remains (residual limb).
After the area has healed, you may be fitted for an artificial limb (prosthesis).
If you have an arm removed, an occupational therapist will teach you how to eat and dress yourself using one arm. If you receive a prosthetic arm, the occupational therapist will teach you exercises and techniques to control and use the prosthesis.
If you have a leg removed and receive a prosthesis, a physiotherapist will show you exercises and techniques to improve how you walk and move with your new limb. Some people choose to use a wheelchair instead of a prosthetic leg.
Surgery in other parts of the body
- Pelvis – When possible, the cancer is removed along with some healthy tissue around it (wide local excision). Some people may need to have a bone graft or a metal implant to rebuild the bone.
- Jaw or cheek bone (mandible or maxilla) – The surgeon will remove the affected bone. Bone from other parts of the body may be used to replace the affected bone. As the face is a delicate area, it may be difficult to remove the cancer with surgery, and some people may need to have chemotherapy or radiation therapy.
- Spine or skull – If surgery isn’t possible, a combination of radiation therapy and chemotherapy may be used. If you need one of these treatments, your doctor will explain what will happen.
Your guide to best cancer care
A lot can happen in a hurry when you’re diagnosed with cancer. The guide to best cancer care for sarcoma (bone and soft tissue tumours) can help you make sense of what should happen.
It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.
Please note: work is currently underway to refresh the guide to best cancer care for sarcoma.
Read the guide
Chemotherapy
Chemotherapy uses drugs to destroy or slow the growth of cancer cells, while causing the least possible damage to healthy cells. It may be given for high-grade osteosarcoma and Ewing sarcoma:
- before surgery, to shrink the size of the tumour and make it easier to remove
- after surgery or radiation therapy, to kill any cancer cells possibly left behind
- as palliative treatment, to help stop the growth of an advanced cancer or control the symptoms.
Chemotherapy drugs are usually injected into a vein. This may be as a day patient, or during a hospital stay.
You will need scans (MRI, CT or PET–CT) during treatment to see how well the cancer is responding to the chemotherapy.
Side effects
These depend on the drugs that are given and where the cancer is in your body.
Common side effects include fatigue (tiredness), nausea, vomiting, appetite loss, hair loss, constipation, diarrhoea, numbness or tingling in the hands and feet, effects on hearing and increased risk of infection.
Talk to your treatment team about ways to manage side effects. If your red blood cell count drops too low, you may need a transfusion to build them up again.
Radiation therapy
Radiation therapy uses targeted radiation (usually in the form of x-ray beams) to kill or damage cancer cells. It may be used for Ewing sarcoma:
- after surgery or chemotherapy, to kill any cancer cells possibly left behind
- as an alternative treatment to surgery if a wide local excision is not possible
- as palliative treatment, to help stop the growth of an advanced cancer or control the symptoms
Radiation therapy is usually given every weekday, with a rest over the weekend, for several weeks. Your specialist will provide details about your specific treatment plan.
Side effects
These will depend on the area being treated and the strength of the dose you have. Common side effects include fatigue (tiredness), skin redness or soreness, and hair loss in the treatment area.
Ask your treatment team for advice about dealing with any side effects.
Coping with primary bone cancer
Being diagnosed with a rare cancer can be distressing. The physical changes after treatment for bone cancer can affect how you feel about yourself (self-esteem) and make you feel selfconscious.
It will take time to get used to the differences in how you look and what you can do. Limb-sparing surgery is a major operation that can leave a scar and make the skin feel tight.
If you have an amputation or a lot of bone is removed, you may feel grief and loss. Many people find it helps to talk to a counsellor, psychologist, friend or family member.
Ask your treating team or call Cancer Council 13 11 20 to find out about support services in your area. You may also find Emotions and Cancer and Understanding Rare and Less Common Cancers helpful.
Get support
Follow-up appointments
After treatment, you will need regular check-ups for several years to confirm that the cancer hasn’t come back and to help you manage any treatment side effects.
How often you will need to see your doctor will vary depending on the type of bone cancer. Check-ups will become less frequent if you have no further problems. Let your doctor know immediately of any health concerns between appointments.
If the cancer comes back
For some people, bone cancer does come back (recur) after treatment. The risk that bone cancer will recur is greater within the first three years after treatment has finished.
Treatment options may include surgery, chemotherapy and radiation therapy. In some cases of advanced primary bone cancer, treatment will focus on managing your symptoms and improving your quality of life without trying to cure the disease.
Palliative treatment can relieve pain and help to manage other symptoms.
Question checklist
This checklist may be helpful when thinking about questions to ask your doctor.
- What type of bone cancer do I have?
- What treatment do you recommend and why?
- How can I find a specialist treatment centre?
- What is the prognosis?
- If I have surgery, what are the side effects?
- Do I need an amputation?
- If I have to travel for treatment, is there any government funding available to help with the cost?
- Are there any clinical trials I could join?
- If the cancer has spread outside the bone, what treatment options are available for me?
- How often will I need check-ups after treatment?
- If the cancer comes back, how will I know?
Bone cancer clinical trials
Cancer clinical trials are research studies that test whether a new approach to prevention, screening, diagnosis, or treatment works better than current methods and is safe.
There are clinical trials for bone cancer open to recruitment in Victoria. This list shows the most recently updated bone cancer studies on the Victorian Cancer Trials Link (VCTL).
Visit the VCTL to find more bone cancer clinical trials.
Understanding Primary Bone Cancer
Download our Understanding Primary Bone Cancer fact sheet to learn more.
Download now