Description

Osteosarcoma is a type of cancer that begins in the cells that form bones. Osteosarcoma tends to occur more frequently in teens and young adults. But it can also occur in young children and older adults.

Osteosarcoma can begin in any bone. It is most often found in the long bones of the legs and sometimes the arms. Very rarely, it occurs in soft tissue outside the bone.

Advances in the treatment of osteosarcoma have improved the prognosis of this cancer. After treatment of osteosarcoma, people sometimes face the end of the effects of strong treatments that are used to control the cancer. Health professionals often suggest a permanent monitoring of the side effects after the treatment.

Symptoms

Osteosarcoma signs and symptoms most often begin in a bone. The cancer most often affects the long bones of the legs and sometimes the arms. The most common symptoms include:

  • Bone or joint pain. The pain may come and go the first time. It can be confused with growing pains.
  • The pain associated with a bone that breaks for no clear reason.
  • Swelling near a bone.

When to see a doctor

Make an appointment with a health professional if you or your child has ongoing symptoms that worry you. Osteosarcoma symptoms are similar to many more common conditions, such as sports injuries. The health care professional can check the causes first.

Causes

It is not clear what causes osteosarcoma.

Osteosarcoma occurs when bone cells develop changes in their DNA. A cell's DNA contains the instructions, called genes, which tell a cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time.

In cancer cells, changes in DNA to give different instructions. The changes, to tell the cancer cells to make many more cells quickly. Cancer cells can continue living when healthy cells would die. This makes too many cells.

The cancer cells may form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. At the time, cancer cells can break off and spread to other parts of the body. When cancer spreads, it is called metastatic cancer.

Risk factors

The majority of people with osteosarcoma have no known risk factors for cancer. But these factors can increase the risk of osteosarcoma:

  • Certain conditions that run in families. These include hereditary retinoblastoma, the Bloom syndrome, Li-Fraumeni syndrome, Rothmund-Thomson syndrome and Werner syndrome.
  • Other diseases of the bones. These include Paget's disease of bone and fibrous dysplasia.
  • Prior treatment with radiation therapy or chemotherapy.

There is no way to prevent osteosarcoma.

Complications

Complications of osteosarcoma and its treatment include the following.

Cancer that spreads, also called metastasis

Osteosarcoma may spread from where it began to other areas. This makes treatment and recovery more difficult. Osteosarcoma most often spreads to the lungs, the same bone or other bone.

Coping after surgery to remove an arm or a leg

Surgeons aim to remove the cancer and spare the arm or leg when you can. But sometimes, surgeons need to remove part of the affected limb to remove all the cancer. The learning of the use of an artificial limb, called a prosthesis, which requires time, practice and patience. The experts can help.

Long-term side effects of treatment

The fort of necessary treatments for the control of osteosarcoma may cause major side effects, both in the short and long term. Your health care team can help you or your child handle the side effects that occur during treatment. The team can also give you a list of side effects to watch out for in the years after treatment.

Diagnosis

The diagnosis of Osteosarcoma may begin with a physical examination. Based on the findings of the examination, other tests and procedures.

Imaging tests

Imaging tests create pictures of the body. You can show the location and size of an osteosarcoma. Tests may include:

  • X-ray.
  • The magnetic resonance imaging .
  • CT .
  • Bone scan.
  • The positron emission tomography scan, also called a PET.

The removal of a sample of cells for testing, called a biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. The tissue can be removed through a needle placed through the skin and the cancer. Sometimes surgery is necessary to obtain a tissue sample. The sample is analyzed in a laboratory to see if it is cancer. Other special tests to give more details on the cancer cells. Your health care team uses this information to make a treatment plan.

Determine the type of biopsy you need and how you should do requires a lot of careful planning by the team doctor. The biopsy must be done to not get in the way of the future of the surgery to remove the cancer. Before you undergo a biopsy, ask your health professional to refer you to a team of experts that have experience in the treatment of osteosarcoma.

Treatment

Osteosarcoma treatment most often involves surgery and chemotherapy. Rarely, radiation therapy may also be an option if the cancer cannot be treated with surgery.

Surgery

The goal of surgery is to remove all the cancer cells. In the planning of the surgery, the health care team keeps in mind the way in which the surgery is going to affect your child's daily life. The extent of surgery for osteosarcoma depends on several factors, such as the size of the cancer and where it is.

Operations is used for the treatment of osteosarcoma include:

  • The surgery to remove the cancer only, also called limb-sparing surgery.The majority of osteosarcoma of the operations can be done in a way that removes all of the cancer and spare parts in the arm or leg. If this type of surgery is an option that depends, in part, on the extent of the cancer and how much muscle and the tissue has to be removed. If a section of bone is removed, the surgeon of the reconstruction of the bone. How the bone is regenerated depends on the situation. Options include a metal implants or bone grafts.
  • The surgery to remove the affected arm or leg, also called the amputation. Rarely, a surgeon may remove the affected leg or arm to get all of the cancer. After the surgery, an artificial arm or leg can be used. This is called a prosthesis.
  • The surgery to remove the lower part of the leg, which is also called rotationplasty.Rotationplasty may be an option for osteosarcoma in and around the knee joint. In this surgery, the surgeon removes the cancer and the surrounding area, including the knee joint. The foot and ankle are, then, turn and place it back upon the part of the leg that stays on top of the knee. The ankle, then it works as a knee. It uses a prosthetic leg and foot. This surgery is sometimes a good option for children who are still growing. It allows them to take part in physical activities and sports.

The surgery to remove the cancer only, also called limb-sparing surgery. The majority of osteosarcoma of the operations can be done in a way that removes all of the cancer and spare parts in the arm or leg. If this type of surgery is an option that depends, in part, on the extent of the cancer and how much muscle and the tissue has to be removed.

If a section of bone is removed, the surgeon of the reconstruction of the bone. How the bone is regenerated depends on the situation. Options include a metal implants or bone grafts.

The surgery to remove the lower part of the leg, which is also called rotationplasty. Rotationplasty may be an option for osteosarcoma in and around the knee joint. In this surgery, the surgeon removes the cancer and the surrounding area, including the knee joint. The foot and ankle are, then, turn and place it back upon the part of the leg that stays on top of the knee. The ankle, then it works as a knee.

It uses a prosthetic leg and foot. This surgery is sometimes a good option for children who are still growing. It allows them to take part in physical activities and sports.

Chemotherapy

Chemotherapy treats the cancer with strong medications.

For osteosarcoma, chemotherapy is often used before surgery. You can reduce the cancer and make it easier to remove.

After the surgery, the chemotherapy treatments can be used to kill cancer cells that may remain.

For osteosarcoma that returns after surgery or extends to other areas of the body, chemotherapy may help relieve the pain and decrease the growth of cancer.

Radiation therapy

Radiation therapy treats cancer with powerful rays of energy. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around your body. The machine directs radiation to precise points on your body.

Radiation is not often used for the treatment of osteosarcoma. The radiation therapy may be suggested in place of the surgery if the surgery cannot remove all of the cancer.

Clinical trials

Clinical trials are studies of new treatments. These studies provide an opportunity to test the latest treatments. The risk of side effects may not be known. Ask your health care team if you or your child may be able to be in a clinical trial.

Coping and support

A diagnosis of osteosarcoma can be overwhelming. With the time you're going to find ways to cope with the distress and uncertainty of cancer. Until then, you may find the following useful:

Learn enough about osteosarcoma to make decisions about the care

Ask your son or health care professional about osteosarcoma, including treatment options. As you learn more, you can feel better about the decision making about treatment options. If your child has cancer, please consult with the health care team to guide you in talking with your child about the cancer in a loving way that your child can understand.

Keep friends and family close

Keep your close relationships strong will help you deal with osteosarcoma. Friends and family can help with daily tasks, such as helping to take care of your home if your child is in the hospital. And that you can serve as emotional support when you feel like you're dealing with more than you can handle.

Ask about mental health support

Speak with a counselor, medical social worker, psychologist or other mental health professional can also help. Ask your health care team for options for professional mental health support for you and your child. You also can search online for a cancer of the organization, such as the American Cancer Society, which lists the support services.

Preparing for your appointment

If there are signs and symptoms that worry you, start by making an appointment with a health care professional. If the healthcare provider suspects osteosarcoma, ask to be referred to a trained specialist.

Osteosarcoma typically needs to be treated by a team of specialists, which may include, for example:

  • The orthopedic surgeons who specialize in the operation of the cancers that affect the bones, called orthopedic oncologists.
  • Other surgeons, such as pediatric surgeons. The type of board depends on the site of the cancer and the age of the person with osteosarcoma.
  • Doctors who specialize in the treatment of cancer with chemotherapy or other systemic medications. These may include medical oncologists, or, for children, pediatric oncologists.
  • Doctors who study tissue to diagnose the specific type of cancer, called pathologists.
  • Rehabilitation specialists who can assist in the recovery after the surgery.

What you can do

Before the appointment, make a list of:

  • The signs and symptoms, including any that seem unrelated to the reason for the appointment, and when they began.
  • Any medication that you or your child are taking, including vitamins and herbs, and their doses.
  • Key personal information, including any major stresses or recent life changes.

Also:

  • To bring to, or x-rays, both in the images and reports, and any other medical records that are linked to this condition.
  • Make a list of questions to ask the health care professional to ensure that you get the information you need.
  • Tak to a family member or friend to the appointment, if you can, to help you remember the information that is obtained.

For you or for your child, the questions may include:

  • What kind of cancer is this?
  • Has the cancer spread?
  • More proof do you need?
  • What are the treatment options?
  • What are the odds that the treatment is going to cure this type of cancer?
  • What are the side effects and risks of each treatment option?
  • Which is the treatment that you think is better?
  • It influences the treatment to be able to have children? If so, does it offer ways to preserve that ability?
  • Are there brochures or other printed material I can have? What websites do you suggest?

What to expect from your doctor

Your healthcare provider is likely to ask you questions, such as:

  • What are the signs and symptoms that concern you?
  • When did you notice these symptoms?
  • Do you always have symptoms, or come and go?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • There is a personal or family history of cancer?
Symptoms and treatment of Osteosarcoma