Treatment for bone cancer

Treatments for bone cancer may include surgery, chemotherapy, radiotherapy or targeted therapy. Get information to help you make treatment decisions.

About bone cancer treatment

The treatment for primary bone cancer depends on:

  • where the cancer started in the body
  • the size of the tumour
  • if the cancer has spread
  • your general health
  • your preferences.

The results of your tests will help your doctors plan the best type of treatment for you. They will then talk about this with you. Most people need a combination of treatments.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

Surgery for bone cancer

Surgery is an important part of treatment. It is used to remove the cancer in the bone.

Sometimes it is not possible to remove a bone cancer using surgery. This is more likely to happen if the cancer is in a bone:

  • deep within the body, such as the pelvis
  • that cannot be removed without the risk of serious disability, such as a bone in the spine.

If this happens, chemotherapy and radiotherapy are used instead.

Chemotherapy for bone cancer

Most people with primary bone cancer will have chemotherapy.

Nearly everyone with Ewing sarcoma will have chemotherapy. It is also given to most people with osteosarcoma and spindle cell sarcoma.

It is not generally used for people with chordoma or chondrosarcoma.

Chemotherapy may be given:

  • before surgery to shrink the cancer, making it easier to remove – this is called neoadjuvant chemotherapy
  • after surgery to destroy any remaining cancer cells – this is called adjuvant chemotherapy
  • if the cancer comes back.

Radiotherapy for bone cancer

Radiotherapy is mainly only used to treat Ewing sarcoma. It is often given with chemotherapy and surgery. Radiotherapy can be given either before or after surgery. Radiotherapy may be used as the main treatment if it is not possible to have surgery to remove the cancer.

Other types of primary bone cancer are not as sensitive to radiation. But radiotherapy may sometimes be used:

  • if surgery is not suitable
  • if surgery has not completely removed the tumour
  • instead of surgery
  • as well as surgery.

Targeted therapy

Targeted therapy is sometimes used to treat osteosarcoma after surgery. But it is only suitable for some people.

Research is happening to find better treatments for primary bone cancer. You may be invited to take part in a clinical trial of a new drug or treatment.

Where treatment is given

Your treatment is usually planned and given in a sarcoma treatment centre. This is sometimes called a sarcoma unit. It could be based in just 1 hospital or across a group of nearby hospitals that work together.

Primary bone cancer is rare and there are only a small number of sarcoma treatment centres in the UK. This means you may need to travel a long distance.

It may be possible to have some of your treatment at a hospital close to home. The doctors at the sarcoma treatment centre will work with a specialist cancer doctor in your local hospital to plan your treatment. This is called shared care.

We have more information about cancer treatment for children and young people.

About our information

  • References

    Below is a sample of the sources used in our information about primary bone cancer. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    European Society for Medical Oncology, ESMO. 2021. Bone sarcomas: ESMOeEURACANeGENTURISeERN PaedCan Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology. S. J. Strauss1 et al. Available at: https://www.esmo.org/guidelines/guidelines-by-topic/sarcoma-and-gist/bone-sarcomas (accessed July 2023)

    UK guidelines for the management of bone sarcomas, Clinical Sarcoma Research (2016) 6:7. Gerrand C et al on behalf of the British Sarcoma Group. Available at: UK guidelines for the management of bone sarcomas - PMC (nih.gov)(accessed July 2023)

    British Medical Journal, BMJ Best Practice. Osteosarcoma. Last updated May 2022. Last reviewed 27 Jun 2023. Available at: Osteosarcoma - Symptoms, diagnosis and treatment | BMJ Best Practice (accessed July 2023)

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by senior medical editor Fiona Cowie, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 01 August 2022
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Next review: 01 August 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.