Unfortunately, bone cancer can go unnoticed as it may not present symptoms for quite some time. If there are symptoms, they depend on the location where the tumour is situated. Most often, patients experience the following symptoms:

• Pain or swelling where the tumour is located. The pain is not necessarily permanent. It may come and go at first and become more severe and steady later on. When moving, the pain might get worse and swelling of the nearby soft tissue is possible.
• Joint swelling and stiffness: A tumour near or in joints may cause the joint to swell and become tender or stiff. This limits movements and makes it painful.
• Limping: The bone with the tumour can break or fracture leading to emergency treatment. If a diagnosis is not made and simple fracture repair results this can lead to pronounced limping and further fractures.
• Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low red blood cell level.

Bone sarcomas are often difficult to recognize as malignant by clinicians, radiologists, and pathologists. A simple x-ray may not indicate a tumour to an inexperienced eye, although suspicion may be raised. Therefore, all patients with a suspected primary malignant bone tumour should be referred to a bone sarcoma reference center or an institution belonging to a specialized bone sarcoma network before biopsy. Biopsy should not be taken by a surgeon who does not normally treat these tumours.