For the patients who have bone cancer symptoms and have talked to a doctor, the first diagnostic test is an X-ray examination. Primary tumors of the bone provide a typical picture for rentgenogramme, which shows a dark spot in the affected area of bone or white spots in places where the tumors formed by the deposition of calcium in the formation of new bone (sclerosis). Bone scan is a more sensitive method than X-ray examination, which reveals a very small «hot spots», not visible on the rentgenogramme.

In the secondary cancer, when the place of primary tumor is known, biopsies are usually not required. If the primary lesion is not localized, biopsy is necessary for the production of a final diagnosis by examining the cells under a microscope. In such cases, usually resort to puncture biopsy under local anesthesia. Sometimes open-biopsy is required, which is an operation under general anesthesia.

Further examinations are conducted to determine whether the spread of cancer cells (in the case of primary tumor), or to detect the primary lesion (if the secondary and primary tumor is not localized). Such examinations include, as a rule, CT-scanning of chest (which often metastasised primary tumor lesion), ultrasound scanning of the liver.