Bone cancer is a rare malignancy, accounting for less than 0.2% of all cancer types. All primary bone tumors compromise the affected bone's ability to provide structural support and produce blood components required by the body. Pain in the affected area is the most common presenting symptom of all bone tumors, but in adults, symptoms might be confused with arthritic changes and dismissed. Primary bone lesions generally have a variety of presentations and behaviors and can be challenging to diagnose. This article discusses the types of primary bone tumors; testing, diagnostic, and treatment options; and the role of the radiation therapist when caring for patients with bone cancer.