If you're having symptoms of primary bone cancer, see your doctor. Your doctor is likely to ask you about the following:
Your medical history
Your family history of cancer
Your exposure to risk factors, such as radiation or chemotherapy treatments for other conditions
Your doctor may also do a physical examination to look for signs of primary bone cancer. And you may have one or more of these tests:
X-rays help your doctor determine whether you have a primary bone tumor. Most primary bone cancers will show up on X-rays. The tumor will give the bone a ragged look or may form a hole in the bone. X-rays can show the size, location, and shape of a primary bone tumor. A doctor who specializes in looking at X-rays is called a radiologist. He or she can often tell if a tumor is cancerous by the way it looks on the X-ray, but a biopsy is required to know for sure. If the tumor looks cancerous, the doctor may suggest other imaging tests, such as a bone scan, computed tomography, positron emission tomography scan, or magnetic resonance imaging.
The only way to know for sure if the tumor is cancerous is by taking a piece of tissue and looking at it under the microscope. This is called a biopsy. The type of biopsy done depends on what type of tumor the doctor thinks it is. For a needle biopsy, the doctor inserts a thin, hollow needle into the tumor to remove a tissue sample. For a surgical biopsy, the doctor cuts through the skin to remove a small piece of the tumor (incisional biopsy) or the entire tumor (excisional biopsy). Your doctor will determine which type of biopsy is most appropriate for you.
Your doctor may order blood tests to measure the levels of a substance called alkaline phosphatase in your body. Levels of this substance are high in people who have recently broken a bone and in children who are growing. This enzyme may also be high in people with bone cancer, because a tumor causes abnormal tissue production. This test may not be accurate in children and adolescents, whose bones are still growing. There are other blood tests that can also be done to help improve the accuracy of this test.