A child or teen with osteosarcoma is given the chemotherapy drugs intravenously through a vein. The drugs enter the bloodstream and work to kill cancer in parts of the body where the disease has spread, such as the lungs or other organs. Amputation carries its own short-term and long-term side effects. It usually takes at least 3 to 6 months until a young person learns to use a prosthetic artificial leg or arm, and this is just the beginning of long-term psychological and social rehabilitation.
With limb salvage surgery, a person usually starts bending the knee or the affected body part almost immediately. A continuous passive motion CPM machine that continuously bends and straightens the knee may be used to improve motion for children with tumors around the knee. Physical therapy and rehabilitation for 6 to 12 months after surgery helps a child walk, initially with a walker or crutches, then without any assistive devices.
Early complications after surgery include infection and slow healing of the surgical wound. Also, the metal prosthetic device or the bank bone may need to be replaced as the body grows, although some prosthetics can be adjusted to fit as a child grows. Other late problems might include fracture of the bank bone or failure of the bank bone to heal to the child's bone, which might require more surgery.
Many of the medicines used in chemotherapy also carry the risk of both short-term and long-term problems. Short-term effects include anemia, abnormal bleeding, and increased risk of infection due to destruction of the bone marrow, as well as kidney damage and menstrual irregularities.
Some drugs carry a risk of bladder inflammation and bleeding into the urine, hearing loss, and liver damage. Others may cause heart and skin problems. Years after chemo for osteosarcoma, patients have an increased risk of developing other cancers. Osteosarcoma that has spread cannot always be treated as successfully. Also, a child whose osteosarcoma is in an arm or leg generally has a better prognosis than one whose disease involves the ribs, shoulder blades, spine, or pelvic bones.
Treatments are being developed and researched with new chemotherapy drugs. Other research is focused on the role certain growth factors might play in the development of osteosarcoma. This research may be used to develop new medicines to slow these growth factors as a way to treat the cancer. For osteosarcomas that cannot be removed surgically, studies are underway on treatments that use new combinations of chemotherapy and localized radiation that focuses more specifically on the tumor cells.
Reviewed by: Eric S. Osteosarcoma most often starts in a leg bone around the knee joint, either at the femur, which is the lower end of the thigh bone, or the tibia, which is the upper end of the shin bone.
The next most common place osteosarcoma begins is in the humerus. This is the upper arm bone close to the shoulder. However, osteosarcoma can develop in any bone in the body. Each type of osteosarcoma has different subtypes. The type and subtype of osteosarcoma is determined by looking at the tumor cells through a microscope.
Conventional central osteosarcoma, such as osteoblastic, chondroblastic, fibroblastic, and mixed types. The most common subtype of osteosarcoma is conventional central osteosarcoma. The other subtypes are much less common. Grade is the most important factor in treatment decision-making.
This is because low-grade tumors only recur in the same area, called locally. High-grade tumors metastasize, or spread, to other parts of the body and can recur anywhere in the body. Most osteosarcoma in children are high grade. This guide covers osteosarcoma that is diagnosed during childhood and adolescence, also called pediatric osteosarcoma.
Visit the bone cancer and soft-tissue sarcoma sections on Cancer. Net to learn more about other types of sarcoma. If you would like more of an introduction, explore these related items. Please note that these links take you to other sections on Cancer. This free fact sheet is available as a PDF, so it is easy to print. Osteosarcoma most commonly happens in the long bones around the knee.
Other sites for osteosarcoma include the upper leg, or thighbone, the lower leg, upper arm bone, or any bone in the body, including those in the pelvis, shoulder, and skull. Osteosarcoma may grow into nearby tissues, such as tendons or muscles. It may also spread, or metastasize, through the bloodstream to other organs or bones in the body. The exact cause of osteosarcoma is not known, but it is believed to be due to DNA mutations inside bone cells—either inherited or acquired after birth.
Previous treatment with radiation for another cancer, especially at a young age or with high doses of radiation. Li-Fraumeni syndrome. A rare family predisposition to multiple types of cancers such as soft tissue sarcomas, breast cancer, brain tumors, osteosarcoma, and others caused by a mutation in a gene—the p53 tumor-suppressor gene—that normally curbs cancer.
Rothmund-Thompson syndrome. A rare inherited syndrome that includes skeletal problems, rashes, short stature, and an increased risk of developing osteosarcoma. It is caused by an abnormality in the REQL4 gene. Hereditary retinoblastoma. A cancer of the eye that usually happens in children younger than 4 years old.
The following are the most common symptoms of osteosarcoma. However, each individual may experience symptoms differently. Symptoms may include:. The symptoms of osteosarcoma may resemble other medical conditions. Always talk with your healthcare provider for a diagnosis. In addition to a complete medical history and physical examination, diagnostic procedures for osteosarcoma may include the following:. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
Bone scans.
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