Bone Cancer

Bone Cancer is very rare: it represents about <0.2 % of all malignant tumours (the numbers vary country by country). As the name implies, malignant bone tumours are found throughout the bones of the body.

Bone cancer, also known as bone sarcoma, can be classified as primary or secondary:

  • Primary bone cancer begins in the bone
  • Secondary bone cancer begins in another organ but the cancer cells spread to the bones (~ 90/ 100,000/ year)1

Primary bone cancer can occur in any bone in the body but is very rare (<0.2% of all malignant tumours, although the numbers vary by country).

Secondary bone cancer is becoming more common as the survival rates for many cancers improve, giving more time for the cancer to spread into the bone. 

primary bone cancer
Primary bone cancer mostly affects young people - the average age of bone cancer patients is 20 years and 50% of cases are diagnosed before the age of 59. 2
secondary bone cancer metastases
Bone metastases is the 3rd most frequent site of metastases (~ 90/ 100,000/ year)1


Tumour Subtype

Incidence (per 100,000 per year)


Use of CA

Bone Metastases


•Most commonly occurs in the spine, pelvis and thigh; associated with fracture and pain - Tx usually focused on slowing growth/ improving QoL, rather than cureB
•CA included in ESMO guidelines as a special consideration for relieving pain from spinal metastasesC
•Large multicentre studies also support use of CA for pain palliationD,E,F





•Usually arises in the metaphysis of a long bone, most commonly around the knee; occurs most frequently in adolescentsI
•Cryotherapy included in ESMO guidelines as alternative option for patients unfit for surgery who have recurrent osteosarcoma lung metastasesH

Ewing’s Sarcoma




•Mostly found in legs & arms (50%) and the pelvic bones (25%), followed by the ribs and spine; occurs most frequently in children and adolescentsI


(intermediate – locally aggressive, or malignant)


•Bone sarcoma that develops in the cartilage cells with the most common sites being the upper arm, pelvis and thigh bone; usually affects adults above the age of 40K
•Cryotherapy included in ESMO guidelines as a local adjuvant to curettage for Grade 1 atypical cartilaginous tumours (intermediate – locally aggressive)H




•Rare spinal tumours that usually develop around the neck or pelvis; most commonly affects adults in their 40’s and 50’sK
•CA included in ESMO guidelines as a pain palliation Tx for recurrent extracranial chordomasH

Giant Cell Tumours

(intermediate - locally aggressive, or intermediate - rarely metastasising, or malignant)


•Benign tumours that predominantly occur in the long bones of the arms and legs (always found at the end of the bone next to the joint); most frequent in young adultsK
•Retrospective studies support use of CA for Tx of benign/ intermediate bone tumoursL,M,N

Incidence of all benign bone tumour subtypes is ~ 2.6/ 100,000/year*

•Cryotherapy included in ESMO guidelines as a local adjuvant to surgery/ curettageH

Osteoid Osteoma



•Benign tumours that usually develop in the long bones and tend to be small (< 1.5 cm); typically occur in children/adolescentsS
•RFA already considered ‘gold-standard’ Tx
•Systemic review suggests CA may be a preferable option (improved safety near critical nerves and spinal chord, potential immunotherapy benefit)L

Osteoblastoma (intermediate - locally aggressive)

< 0.1Q,R

•Closely related to osteoid osteoma, however, they are larger (> 1.5-2 cm) and more likely to affect the axial skeleton; usually present in young adultsS

Aneurysmal Bone Cysts (intermediate - locally aggressive)


•Blood-filled, fibrous, tumour-like cysts which most commonly appear in the vertebrae and knee; generally occur in young adultsV
•Cryotherapy considered as a local adjuvant to curettageW,Y
* Osteochondroma has an incidence of 0.9/ 100,000 per year and is considered the most common benign bone tumour, accounting for 20-50% of all casesO,P ; assuming osteochondroma account for 35% of all benign tumours, total incidence of benign bone tumours is calculated as being ~2.6/ 100,000

Treatment options

Most of bone tumours are classified according to the presence of the disease in one area or in several areas, as this is one of the most important information in deciding what type of treatment to follow. Bone cancer is defined as2:
bone cancer treatment
Localised if the cancer cells are confined to the bone tissue where the tumour originated.
metastatic bone cancer
Metastatic if the cancer cells have reached other parts of the body. Metastases usually affect the lungs, but can also occur in other parts of the skeleton.
bone tumor treatments recurrence relapse
Relapsing if it recurs after treatment in the same location as the original tumour or in another organ.

The treatment strategy depends on different aspects: type of bone cancer, stage of disease and general health status of the patient. The most common treatments are:1, 3

  • External beam RT (EBRT)
  • Endocrine treatments
  • Surgery
  • Chemotherapy
  • Immunological therapies
  • Radiofrequency Ablation
  • Cryoablation

Clinical Results – Why Cryoablation?

Discover Cryoablation for Bone Metastases

“Bone tumour cryoablation is a safe procedure with a
very low rate of major complications.”

Auloge P et al. 2019. University Hospital of Strasbourg, France

Cryoablation is an effective treatment for palliating painful musculoskeletal metastases and achieving local tumour control. Recent studies have demonstrated that Cryoablation provides high efficiency in defeating malign metastatic bone tumours and a high percentage of survivals (5-year overall survival: 67.8%).4

Defeat the pain with Cryoablation!

“Pain, especially bone pain, is the most common
symptom in malignancy patients, which seriously
affects the life quality of patients with cancer.”

Zhu XC et al. 2015

Bone metastases have significant impact on quality of life and their prevalence is increasing as survival rates for cancer patients improve.5,6

A recent study (Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study)has demonstrated that Cryoablation of metastatic bone tumors provided rapid and durable pain palliation, improved quality of life7,8 and offered an alternative to opioids for pain control.8,9

Discover our IO Latest Evidence Page
  • MOTION is the first multicenter/prospective study on bone mets cryoablation.10
  • Worst pain: reduction of 2.61 points at week 8.10
  • Morphine Equivalent Dose: reduction of 14 mg (from 31.4 to 15.8mg) at week 24: reduction of 55%.8.10
  • Quality of Life: index changes from 5.5 to 3.2 (reduction of 42%).10

Our Solutions

Cryoablation is a minimally invasive treatment that uses extreme cold to freeze and destroy diseased tissue, including cancer cells. We offer a broad portfolio of Systems and Needles, that, thanks to the latest technology, provide an efficient treatment against tumours.

Learn more about our solutions



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