When you’re learning about a bone cancer diagnosis for you or a loved one, the details surrounding the stages of bone cancer can seem complex and confusing at first.

But knowing the bone cancer stages, and all they entail will help you decide which alternative treatment for bone cancer is best for your body. 

At ITC, we’re here to help guide you through both the basics and the details, so you can be well-equipped with the knowledge needed to make your next decision. 

Bone Cancer Stages: The Basics

After a bone cancer diagnosis, bone cancer stages help doctors figure out how far and where the cancer has spread so that they can figure out the best treatment options for the disease. Cancer is staged 1-4 (I-IV) — the lower the number, the less the cancer has spread.

When it comes to the stages of bone cancer, it’s important to remember that each patient’s cancer is unique. Doctors will use stages to discuss a patient’s chance of survival, as the survival rate decreases as the stage increases. Later stage cancers have spread further, but this does not mean you should lose hope.

Let’s take a closer look at how bone cancer stages are evaluated, so we can answer the question of how is bone cancer diagnosed and become familiar with what treatment option might be best for you. 

TNM System 

The most typical method used by doctors to stage bone cancer is the TNM system. This particular staging system is based on 4 distinct things. 1

T: This refers to the extent or size of the primary tumor — how large the cancer is and whether or not it is in more than one spot in the bone.

N: The spread of the cancer to the nearby lymph nodes.

M: The spread — metastasis — of the primary cancer to distant sites. Has it spread to the lungs or to another distant site as well? (i.e. other bones or the liver)

G: The grade of the cancer and how abnormal the cancerous cells look under a microscope. 

Bone Cancer Grades

Bone cancer is graded on a scale from 1 to 3. G1 is applied to low-grade cancers that often grow and spread more slowly. High-grade cancers, like G2 or G3, spread faster. 1

G1: In grade 1, the cancer appears similar to normal bone tissue.

G2: In grade 2, the cancer is a mix of grade 1 and grade 3 (some bone tissue appears to be normal, while other soft tissue looks abnormal). 

G3: In grade 3, the cancer looks very abnormal.

AJCC Stage System

Effective January 2018, the AJCC system refers to cancers that affect the appendicular skeleton, like the arms, legs, skull, trunk, and facial bones. Keep in mind that bone cancers that affect the pelvis and spine use different T categories. With all the numbers and letters, this staging system can seem complex or overwhelming — so we’ve broken it down for our readers. If you’re curious about how fast does bone cancer spread; it bone metastasis happens quicker as the stages progress. Let’s break the stages down, to help you assess their differences and similarities. 1

IA

When bone cancer is staged IA, it’s further staged by T1, N0, M0, and G1 or GX. 

When cancer in stage IA is classified as T1, it means the cancer is about 3 inches or smaller across. N0 means that the cancer hasn’t reached the lymph nodes and M0 means that it is not yet metastatic and has not spread to distant sites. Either the cancer is low grade, G1, or its grade cannot be determined, GX.

IB

When bone cancer is staged IB, it’s further staged by T2, N0, M0, and G1 or GX. 

When cancer in stage IB is classified as T2, it means the cancer is larger than 3 inches across. N0 means that the cancer hasn’t reached the lymph nodes and M0 means that the primary cancer is not metastatic and has not spread to distant sites. Either the cancer is low grade, G1, or its grade cannot be determined, GX.

In stage IB, the cancer can also be further staged by T3, N0, M0, and G1 or GX. 

When cancer in stage IB is classified as T3, it means the cancer has spread to multiple locations on one bone. N0 means that the cancer hasn’t reached the lymph nodes and M0 means that it has not spread to distant sites. Either the cancer is low grade, G1, or its grade cannot be determined, GX.

IIA

When bone cancer is staged IIA, it’s further staged by T1, N0, M0, and G2 or G3. 

When cancer in stage IIA is classified as T1, it means the cancer is about 3 inches or smaller across. N0 means that it has not spread to nearby lymph nodes and M0 means that it has not spread to distant sites. The cancer is either G2 or G3, which is a high-grade classification. 

IIB

When bone cancer is staged IIB, it’s further staged by T2, N0, M0, and G2 or G3. 

When cancer in stage IIB is classified as T2, it means the cancer is larger than 3 inches across. N0 means that it has not spread to nearby lymph nodes and M0 means that it has not spread to distant sites. The cancer is either G2 or G3, which is a high-grade classification. 

III

When bone cancer is staged III, it’s further staged by T3, N0, M0, and G2 or G3. 

When stage 3 bone cancer is classified as T3, it means the cancer has spread to multiple locations on the same bone. N0 means that it has not spread to nearby lymph nodes and M0 means that it has not spread to distant sites. The cancer is either G2 or G3, which is a high-grade classification. 

IVA

When metastatic bone cancer is staged IVA, it’s further staged by Any T, N1, M1a, and Any G.

When stage 4 bone cancer (IVA) is classified as Any T, it means it could be any possible size and might also be in multiple locations on the bone. It also means it has reached the lymph nodes (referenced by N1). Any M means that may or may not have reached distant organs, including the lungs or different bones. The cancer is Any G, which refers to any grade classification. 

IVB

When bone cancer is staged IVB, it’s further staged by Any T, Any N, M1b, and Any G.

When stage 4 bone cancer (IVB) is classified as Any T, it means it could be any possible size and might also be in multiple locations on the bone. It also means it may or may have reached the lymph nodes. M1b means that the cancer has spread to distant sites, like the brain, liver, or other bones. The cancer is Any G, which refers to any grade classification. 

Other Staging Categories

These are some categories that are not listed above but may be used to describe the stage of the bone cancer. 

TX: This means that due to a lack of information, the primary tumor cannot be assessed.

T0: This means that there is no sign of a primary bone tumor. 

NX: This means that due to a lack of information, regional lymph nodes cannot be assessed.

Noticing the Symptoms of Bone Cancer

Finding cancer in the early stages when it is small and has not spread can often lead to more treatment options. Knowing what does bone cancer feel like, what are the symptoms of bone cancer, and what does bone cancer look like can all help in early diagnosis of the disease. 

The most common symptoms of bone cancer are pain, swelling, and tenderness in the affected area. The earliest sign is bone pain, which can come in increments and be more present during times when you’re active or at night. 2

Some people often ask how long can you have bone cancer without knowing — and that has to do with your recognition of the symptoms. Some people will experience bone pain for a few months, which is then followed by the onset of a sharp or prolonged pain that happens suddenly — at this time, they may decide to visit their doctor for further bone scan tests like MRIs (magnetic resonance imaging), x-rays, and a biopsy to diagnose the cancer. 

There are certain tests that can be used to find cancers early on before they cause symptoms, like lung cancer and breast cancer, but currently, that’s not the case with bone cancer. That’s why it’s crucial that you monitor your symptoms and become familiar with what to look for. 

If you have symptoms of bone cancer, you should then receive a bone scan test to determine which type of bone disease you have. Knowing what kind of bone cancer you have will help doctors decide the best treatment to target cancer cells. Types of bone cancer include:

  • Osteosarcoma
  • Ewing sarcoma
  • Giant cell tumor
  • Chondrosarcoma

Though it’s currently unknown as to what causes bone cancer, great strides have been made toward how to treat bone cancer naturally. If you’re wondering how long do you live after being diagnosed with bone cancer or have any additional questions about exactly what is bone cancer — reach out to us today. 

Traditional cancer treatment, such as radiation therapy, chemotherapy, and surgery, can leave patients feeling weaker than when they started. 

At Immunity Therapy Center, we believe there is a treatment for everyone. That’s why we put together a custom treatment plan that’s based on our patient’s current condition, their type of cancer, and past medical history.

Although a diagnosis can be scary — stay hopeful and remember, our team is here to help. Our alternative cancer treatments, combined with the warmth of our dedicated staff, will help guide you on your path to wellness.

Sources:

  1. cancer.org.  Bone Cancer Stages https://www.cancer.org/cancer/bone-cancer/detection-diagnosis-staging/staging.html 
  2. cancer.org.  Bone Cancer Early Detection, Diagnosis, and Staging https://www.cancer.org/content/dam/CRC/PDF/Public/8564.00.pdf