Remembering Little Richard and Understanding Bone Cancer

What the record actually says

Little Richard was born Richard Wayne Penniman on December 5, 1932, in Macon, Georgia. Britannica records that he died on May 9, 2020, in Tullahoma, Tennessee, at the age of 87.

News coverage at the time described the cause as bone cancer. We were not able to confirm that description against a primary statement or a major news report we could verify, so this page will not characterize his diagnosis.

That gap is worth explaining rather than papering over, because "bone cancer" is one of the most misunderstood phrases in cancer coverage. It gets used for two conditions that are almost nothing alike.

Two different diseases, one phrase

The National Cancer Institute draws the line clearly. There are "primary bone tumors, which form from bone tissue," and there are "metastatic tumors (tumors that develop from cancer cells that formed elsewhere in the body and then spread to the bone)."

Primary bone cancer is genuinely rare. NCI says it "accounts for much less than 1% of all new cancers diagnosed." SEER, the National Cancer Institute's cancer surveillance program, lists 4,110 new cases of bone and joint cancer and 2,210 deaths in the United States for 2026, a projection the American Cancer Society makes, and measures the rate at 1.1 per 100,000 people per year. That is 0.2 percent of all new cancers.

Cancer that has spread to bone is far more common in adults. When a news report says an older adult had bone cancer, this is usually what is meant, though the report may not say so.

The naming rule is the part to remember. NCI states it directly: "Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer." Breast cancer in the bones is metastatic breast cancer. It is treated as breast cancer, with breast cancer drugs.

The primary bone cancers, and who gets them

NCI names four main types.

Osteosarcoma "arises from bone-forming cells called osteoblasts in osteoid tissue." It shows up mostly in adolescents and young adults, usually near the knee or shoulder. NCI reports a rate of 5.4 cases per million per year in people aged 0 to 19, and notes that about half of these tumors arise in the femur, most of those at its lower end near the knee.

Chondrosarcoma "begins in cartilaginous tissue." It usually develops slowly, and it typically affects adults over 40.

Ewing sarcoma "usually arises in bone but may also rarely arise in soft tissue." It is most common in children under 19.

Chordoma is "a very rare tumor that forms in bones of the spine," and it mostly affects older adults.

When to get checked

NCI is unambiguous about the leading sign: "Pain is the most common symptom of bone cancer." It also lists swelling, lumps, unexplained fever, and unexplained fractures. For cancer that has spread to bone, NCI names "pain and fractures."

Everyday aches do not qualify. These features do.

• Bone pain that wakes you at night or is present at rest, not only with activity
• Pain in one specific spot that has been getting worse for more than four weeks
• A firm lump or swelling over a bone, whether or not it hurts
• A bone that breaks after a minor stumble, or with no injury at all
• New back pain in someone who has had cancer before, which should be reported the same week
• Bone pain with fever, night sweats, or weight loss
• Any new weakness, numbness, or bladder or bowel changes with back pain, which needs emergency care

That last one matters most. Pressure on the spinal cord from a bone tumor is a medical emergency, and delay costs function that does not come back.

How a diagnosis is made

NCI lists imaging first: X-rays, CT, MRI, and PET scans. Then comes "biopsy (removal of a tissue sample from the bone tumor)."

Where that biopsy is done is not a small logistical detail. NCI's guidance on osteosarcoma recommends that "the biopsy be performed by a surgeon skilled in the techniques of limb sparing," because badly placed biopsy tracks "can render subsequent limb-preserving reconstructive surgery impossible."

That is worth reading twice. In suspected primary bone cancer, going to a sarcoma center before the biopsy, not after it, can change whether a limb is saved.

What treatment involves

For primary bone cancer, NCI lists surgery, chemotherapy, radiation therapy, cryosurgery, and targeted therapy, with surgery as the standard approach. In osteosarcoma, most protocols use "an initial period of systemic chemotherapy before definitive resection of the primary tumor." Giving drugs first shrinks the tumor and makes limb-sparing surgery more feasible.

For cancer that has spread to bone, the plan follows the original cancer. NCI notes that "often, the goal of treating metastatic cancer is to control it by stopping or slowing its growth," and that treatment depends on the primary type, where it has spread, what has already been given, and overall health.

What the survival figures show

SEER puts five-year relative survival for bone and joint cancer at 68.7 percent, using cases from 2016 through 2022. Median age at diagnosis is 48, and 22.4 percent of cases occur in people under 20.

Osteosarcoma figures are more specific. NCI reports that five-year survival for localized disease rose from 40 percent to 72 percent in children under 15, and from 56 percent to about 71 percent in adolescents aged 15 to 19. For metastatic osteosarcoma, event-free survival remains about 20 to 30 percent.

Those numbers describe cohorts of patients, not individuals, and they lump together tumor types with very different behavior. NCI also makes a point that applies to metastatic disease broadly: "Some people can live for years with metastatic cancer that is well controlled."

Sources

• https://www.britannica.com/biography/Little-Richard
• https://www.cancer.gov/types/bone/bone-fact-sheet
• https://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq
• https://www.cancer.gov/types/metastatic-cancer
• https://seer.cancer.gov/statfacts/html/bones.html
• https://www.cancer.org/research/cancer-facts-statistics.html