Osteosarcoma
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OVERVIEW
What is osteosarcoma?
Osteosarcoma is a kind of bone cancer that most often affects children, teenagers, and young adults between the ages of 10 and 20. It usually begins in a leg bone (either the femur or the tibia) near the knee or in the upper arm bone (the humerus) near the shoulder. Osteosarcoma can metastasize (spread) to other parts of the body, most often to the lungs or to other bones.
SYMPTOMS
What are the symptoms of osteosarcoma?
Most people who have osteosarcoma do not feel or look sick. An osteosarcoma tumor may cause a dull aching pain in the bone or joint around the tumor. Often, there is a firm swelling or lump in the area of the pain. This swelling is caused by the tumor growing inside the bone.
If the cancer is in a leg bone, the person may limp. Also, the muscles in the arm or leg that has the osteosarcoma may look smaller than the muscles in the opposite arm or leg. Sometimes, the bone can break in the area of the tumor, because the tumor weakens the bone.
CAUSES & RISK FACTORS
What causes osteosarcoma?
Osteosarcoma has no known cause. Some researchers believe that genetics may play a role. In some cases, osteosarcoma can develop as a result of radiation therapy.
DIAGNOSIS & TESTS
How is osteosarcoma diagnosed?
There are several tests your healthcare provider may use to determine if your child has osteosarcoma:
- Physical exam: Your healthcare provider will check for general signs of health as well as examine the place around the swelling, lump or break. Your healthcare provider will also ask about any previous health conditions or medical treatments.
- X-ray: An X-ray is usually the first imaging test your healthcare provider will order. If there is a tumor, it will usually show up on the Xray.
- Scans: Your healthcare provider may also order various scans such as an MRI scan, a CT scan (also called a CAT scan), a PET scan, or combinations of scans. MRI scans take pictures that help your healthcare provider see in detail if the tumor has spread or involved nearby portions of the bone. A CT scan can look at the bone but is also used to look at the chest or abdomen for signs of spread to internal organs. Similarly, a PET (positron emission tomography) scan can also help to show if the tumor has spread to other bones or other parts of the body.
- Biopsy: A biopsy is important because other malignant (cancerous) tumors and some infections can look like osteosarcoma on an X-ray. For the biopsy, a healthcare provider with training in the treatment of bone cancer takes a piece of the tumor from the bone They can sometimes do the biopsy with a needle. Other times, they will need to make an incision (a cut in the skin). The piece of tissue that is taken is looked at under a microscope to see if the tumor is an osteosarcoma.
- Other tests: Your healthcare provider may recommend other tests to see if the cancer has spread to the lungs or other organs. For example, a bone scan will help your healthcare provider see if the cancer has spread to other bones. Other tests may also be needed.
PREVENTION
Can osteosarcoma be prevented or avoided?
There are no known ways to prevent osteosarcoma.
TREATMENT
How is osteosarcoma treated?
Osteosarcoma is treated with a combination of chemotherapy, surgery, and/or radiation therapy. For chemotherapy, your child or teenager will be given medicines that kill the main tumor. These medicines will also kill any tumor cells that have moved to other parts of the body. This treatment is usually started before surgery to kill the tumor or make it smaller.
Surgery is performed to remove the tumor. Almost everyone who has this type of cancer can have “limb-sparing” surgery. In this surgery, the tumor is removed along with the area of bone that it grew in. Then the healthcare provider replaces the missing bone so that, after rehabilitation, the joint will still work normally. In some cases, the healthcare provider may recommend amputation (removal of the limb) as the best way to remove the tumor.
After the surgery, your healthcare provider may recommend more chemotherapy and/or radiation therapy. Chemotherapy and radiation therapy help to kill any remaining cancer cells in the body that might be left after surgery.
Living with osteosarcoma
Today, about 3 out of 4 of people who have osteosarcoma can be cured if the cancer has not spread to other parts of the body. Almost everyone who is treated with limb-sparing surgery ends up with that arm or leg working well.
Many people who have osteosarcoma will need physical therapy for several months after the surgery. If amputation is necessary, rehabilitation may last for much longer. There are many new prosthetic treatments now available to help people who have had amputations regain movement and independence.
After the treatment is over, you or your loved one will:
- Need to see the bone cancer specialist regularly for several years
- Have frequent scans to see if the tumor comes back or travels to the lungs or other parts of the body
- Have X-rays to check for problems with any replaced pieces of bone
FOR MORE INFORMATION
Canadian Cancer Society website:
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