Bone Cancer Screening and Diagnosis

Arriving at a diagnosis of bone cancer is a multistep process that involves:

• Possible bone cancer symptoms, such as a complaint of a mass or pain, that leads your primary care physician to conduct a physical exam. He or she may also order X-rays.
  
  
• Your primary care physician refers you to an orthopedic surgeon or specialist, who reviews the X-rays and may refer you on to an orthopedic oncologist. The orthopedic oncologist will likely order a biopsy – by needle or through surgery – or other interventional studies to help reach a diagnosis.
  
  
• A fellowship-trained specialist in the pathology of sarcoma reviews the tissue specimen collected via the biopsy and helps determine the diagnosis. This process may require 5 days or more, as bone and soft-tissue tumors are rare and require complex testing to conclusively reach a diagnosis.

To detect and diagnose sarcomas, our doctors perform thorough exams. They ask questions about your past health and symptoms. They will evaluate you using the latest technology. Options include:

• Computed tomography scan: A CT or CAT scan uses X-rays to make a detailed image of the structures inside the body. A contrast liquid is often injected to make the structures easier to see.
  
  
• Magnetic resonance imaging: An MRI uses a magnetic field to visualize your anatomy in a 3D format and determine the quality of the tissue.
  
  
• High-definition MRI: The University of Kansas Cancer Center offers a sophisticated, high-definition MRI. This advanced technology produces clearer images faster for a more accurate and timely diagnosis. High-definition MRI is an excellent option for people with challenging or complex conditions.
  
  
• Bone scan: This scan uses nuclear medicine to evaluate the activity of a lesion in bone.
  
  
• Positron emission tomography scan: A PET scan uses a special camera that detects cancer through the use of an injected radioactive liquid. Because cancer cells consume sugar, the accumulation of the liquid at one or multiple sites indicates cancer.
  
  
• Image-guided biopsy: Assisted by scans from an MRI and CT, we remove cells from the tumor using a small, hollow needle or through a small incision. One of our fellowship-trained specialists in the pathology of sarcoma examines the cells under a microscope to determine if they are from a sarcoma, another type of cancer or a noncancerous disease.

These tests help your healthcare team:

• Detect the presence of a sarcoma
• Pinpoint its location
• Decide what kind of sarcoma it is
• Learn how far it has spread (also called staging)

Together, this information helps your care team develop a customized treatment plan.

The University of Kansas Cancer Center offers high-definition MRI to limit the need for repeated interventional radiology. In some cases, nonsurgical cancer treatments can be image-guided to deliver the treatment directly to the affected area rather than giving the treatment systemically.