Chondrosarcoma: symptoms, types, treatment and outlook

Sarcoma UK says symptoms vary with the size and location of the tumour and can sometimes be mistaken for other conditions, like sports injuries. The NHS lists bone pain or tenderness that may be constant or come and go and may be worse at night, a lump or swelling (which may not always be easy to see or feel), and problems moving around. If the cancer is close to a joint, the joint may be difficult to move and you may walk with a limp.

• Bone pain, particularly at night.

• A lump or swelling in the affected area, which may be getting bigger.

• Weakness in a limb or difficulty moving a joint.

• Fracture of the affected bone, which Sarcoma UK says happens in rare cases and the NHS describes as a very rare symptom of bone cancer.

• Less commonly, tiredness, a high temperature with sweating, or weight loss without trying (NHS).

Chondrosarcoma is a type of bone cancer, also known as bone sarcoma. Cancer Research UK explains that cartilage is the shiny, smooth substance that normally covers the ends of bones in the joints but can also be found within the bone. Sarcoma UK adds that when we grow, our bones have areas called growth plates that contain cartilage-type cells; these should disappear when we finish growing, but if they do not, they can become a chondrosarcoma.

It can occur anywhere in the body. Sarcoma UK lists the most common sites as the thigh bone (femur), upper arm (humerus), pelvis, shoulder blade (scapula) and ribs, while Cancer Research UK says it is most commonly found in long bones such as the femur, tibia, fibula, humerus, radius and ulna. Primary bone cancer is different from secondary bone cancer, where cancer from another part of the body has spread to the bone, which Cancer Research UK says is much more common.

The UK sources we read do not describe a known cause or lifestyle trigger for chondrosarcoma, so this guide does not list risk factors.

Sarcoma UK describes conventional chondrosarcoma as the most common type. It can affect any bone and mostly grows inside the bone. It is usually slow-growing and low grade (grade 1 or 2), and some low-grade tumours may be called atypical cartilaginous tumours (ACT) depending on where they are in the body. The grade is worked out by a pathologist from the biopsy and means how fast the tumour is likely to grow. High-grade tumours (grade 3) are less common.

Sarcoma UK says the most effective treatment for chondrosarcoma is surgery, and the type depends on where the cancer is and how far it has spread. For arms and legs there are two main options. Limb-sparing surgery removes the affected bone and muscle and reconstructs the limb with a bone graft or prosthesis (metal artificial part). Amputation, the removal of the whole arm or leg or part of it, is used only if limb-sparing surgery is not possible. Surgery in the trunk (chest, abdomen or pelvis) is more complex because the tumour may be near organs.

Chemotherapy and radiotherapy may also be used in some cases, before or after surgery, according to Sarcoma UK. The NHS says that chemotherapy is very effective for some bone cancers, particularly Ewing sarcoma, and that radiotherapy may be needed for osteosarcoma or chondrosarcoma if surgery is not possible. It adds that the treatment depends on the type and size of bone cancer, where it is, general health and your preferences, and that a specialist team will discuss the benefits, side effects and chances of the cancer coming back.

After treatment, rehabilitation may include occupational therapy, physiotherapy, dietitian support and, after amputation, orthotics and prosthetics services. Sarcoma UK says you should be referred by your team and that, with bone sarcoma, it may help to start rehabilitation earlier.

The NHS says a GP who thinks you could have bone cancer will refer you to a bone specialist for tests, which may include an X-ray, a CT or MRI scan, a bone biopsy and blood tests. Sarcoma UK says that if your GP thinks you have chondrosarcoma they refer you to a bone sarcoma specialist centre, where tests may include blood tests, X-ray, MRI, CT and biopsy. A biopsy is described as a very safe procedure that takes a small sample of the tumour. A pathologist examines it under a microscope to confirm chondrosarcoma and work out the grade. Sometimes the diagnosis is made from scans alone.

The NHS says biopsy results should take about 2 weeks, but sometimes longer, and that a longer wait does not mean anything is wrong. The results show the stage (how big the cancer is and how far it has spread) and the grade, which help decide treatment.

Cancer Research UK, using national cancer registry data, reports that 90 out of 100 people (90%) with chondrosarcoma survive their cancer for 1 year or more after diagnosis, and around 80 out of 100 (around 80%) survive for 5 years or more. It says survival is better for people with chondrosarcoma starting in the arms or legs than for those with chondrosarcoma in the spine or hip bones.

These statistics are for everybody diagnosed with the cancer. Cancer Research UK stresses they do not take into account the stage and grade of your cancer, your age, where the cancer is, or how well treatment works, so your specialist can tell you more about your own outlook. Sarcoma UK notes that high-grade subtypes have a higher chance of coming back or spreading.

Sarcoma UK explains that chondrosarcoma can sometimes come back in the same place (local recurrence) or appear in other parts of the body, and that secondary cancer can appear in the lungs, which is why chest X-rays are part of follow-up. Follow-up may include a physical examination, blood tests, limb X-rays or MRI scans, and checks on any reconstruction. Your treatment team will tell you how many years of follow-up you need, and you should tell your doctor or clinical nurse specialist immediately about any symptoms between appointments.

The NHS advises seeing a GP if you have pain or tenderness in a bone, particularly if it is worse at night, if you notice a lump or swelling, or unexpected weight loss, or if bone or joint pain makes it hard to move around. Sarcoma UK specifically lists bone pain that does not go away or wakes you at night, a lump or swelling that is getting bigger, difficulty moving a joint and an unexplained fracture.

Most bone pain is not cancer. The NHS says you might not have bone cancer, but it is important to see a GP so they can check, and that an urgent referral does not definitely mean you have cancer. After a sudden injury with severe pain, a deformed limb or an inability to put weight on it, go to A&E or call 999.

Chondrosarcoma is rare, so diagnosis and treatment are concentrated in specialist bone sarcoma centres. The usual route is a GP referral, then assessment by a specialist team including a clinical nurse specialist, who the NHS says will be your main point of contact during and after treatment. A multidisciplinary team agrees the treatment plan.

Some people seek a private opinion or scan, for speed or choice of surgeon. Because the condition is rare and treatment is complex, the plan should still be agreed with a specialist sarcoma team, and the results shared with your GP. Sarcoma UK runs a free Support Line and local groups, and the Bone Cancer Research Trust, Maggie's, Macmillan and Shine Cancer Support also offer information or support.