6. How is bone cancer diagnosed?

To diagnose bone cancer, the doctor asks about the patient's personal and family medical history and does a complete medical exam. The doctor may suggest a blood test to determine the level of an enzyme called alkaline phosphatase. A large amount of alkaline phosphatase can be found in the blood when the cells that form bone tissue are very active -- when children are growing, when a broken bone is mending, or when disease or a tumor causes production of abnormal bone tissue. Because high levels of this enzyme can normally be found in growing children and adolescents, this test is not a completely reliable indicator of bone cancer.

X-rays can show the location, size, and shape of a bone tumor. If x-rays suggest that a tumor may be cancer, the doctor may recommend special imaging tests such as a bone scan, a CT (or CAT) scan, an MRI, or an angiogram. However, a biopsy -- the removal of a sample of tissue from the bone tumor -- is needed to determine whether cancer is present.

The surgeon may perform a needle biopsy or an incisional biopsy. During a needle biopsy, the surgeon makes a small hole in the bone and removes a sample of tissue from the tumor with a needle-like instrument. In an incisional biopsy, the surgeon cuts into the tumor and removes a sample of tissue.

Biopsies are best done by orthopedic oncologists -- doctors experienced in the diagnosis of bone cancer. A pathologist -- a doctor who identifies disease by studying cells and tissues under a microscope -- examines the tissue to determine whether it is cancerous.

8. Are new treatments being studied?

To develop new, more effective treatments, the National Cancer Institute is sponsoring clinical trials (treatment studies with cancer patients) in many hospitals and cancer centers around the country. Clinical trials are a critical step in the development of new methods of treatment. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease. Various forms of cancer treatments using surgery, radiation therapy, and chemotherapy for bone cancer are being tested in clinical trials.

Patients who are interested in learning more about participating in clinical trials can call the Cancer Information Service or access the National Cancer Institute's database at http://cancertrials.nci.nih.gov on the World Wide Web.

You may want more information for yourself, your family, and your doctor. The following National Cancer Institute (NCI) services are available to help you.

Telephone...

Cancer Information Service (CIS)
Provides accurate, up-to-date information on cancer to patients and their families, health professionals, and the general public. Information specialists translate the latest scientific information into understandable language and respond in English, Spanish, or on TTY equipment.
Toll-free: 1-800-4-CANCER (1-800-422-6237)
TTY: 1-800-332-8615

Internet...

These web sites may be useful:

http://www.nci.nih.gov - NCI's primary web site; contains information about the Institute and its programs. Also includes news, upcoming events, educational materials, and publications for patients, the public, and the mass media on http://rex.nci.nih.gov.

http://cancernet.nci.nih.gov - CancerNet; contains material for health professionals, patients, and the public, including information from PDQ about cancer treatment, screening, prevention, supportive care, and clinical trials, and CANCERLIT, a bibliographic database.

http://cancertrials.nci.nih.gov - cancerTrials; NCI's comprehensive clinical trials information center for patients, health professionals, and the public. Includes information on understanding trials, deciding whether to participate in trials, finding specific trials, plus research news and other resources.

E-mail...

CancerMail
Includes NCI information about cancer treatment, screening, prevention, and supportive care. To obtain a contents list, send e-mail to [email protected] with the word "help" in the body of the message.

Fax...

CancerFax
Includes NCI information about cancer treatment, screening, prevention, and supportive care. To obtain a contents list, dial 301-402-5874 from a fax machine hand set and follow the recorded instructions.

National Cancer Institute Information Resource