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Osteosarcoma

The Causes, Symptoms, and Treatment of Osteosarcoma

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Updated July 01, 2014

Osteosarcoma is a common type of bone cancer that affects mostly children and teens between the ages of 10 to 19. It occurs during periods of rapid bone growth and is more common boys than in girls. Osteosarcoma cab diagnosed in adults, but it extremely rare.

Symptoms of Osteosarcoma

The shin, thigh, and upper arm are common tumor sites in children and adolescents with osteosarcoma. It is in these areas that pain and swelling occur with the disease. Osteosarcoma can develop in other bones, but it is much less common.

Bone pain is a common symptom of osteosarcoma that may become worse during exercise or at night. Bone pain is more often related to a benign condition, like an injury, than it is to cancer. Keep in mind that not all bone tumors are cancerous as some are benign.

Other symptoms of osteosarcoma include:

  • joint tenderness or inflammation
  • fractures due to bone weakness
  • limited range of motion
Non-specific symptoms like fever, unintentional weight loss, fatigue, and anemia can also be symptoms of osteosarcoma. But they are also indicators of other less severe conditions.

Diagnosing Osteosarcomar

Symptoms combined with other findings during a physical exam may suggest the presence of osteosarcoma, but additional tests are needed to confirm any suspicion.

Imaging tests, like x-rays, MRIs, and CT scans help identify any bone abnormalities. Other tests may include a bone scan, a specialized nuclear imaging test that allows doctors to see the metabolic activity of the bone. Bone scans identify areas in the bone that have new growth or have broken down -- excellent indicators of conditions.

Ultimately, it is a bone biopsy that will rule out or confirm the presence of cancer. A bone biopsy involves the removal of a small amount of bone tissue to be examined under a microscope. It usually takes less than an hour and can be done as an outpatient or surgical procedure.

Doing a biopsy on someone with primary bone cancer can be complex because there is a risk of spreading the cancer during the procedure. The procedure should be done by a surgeon who has experience performing bone biopsies on those with suspected bone cancer. Note that biopsies a common way to worsen these cancers and potentially spread into other tissues.

If cancer is detected, it is then graded and staged by a pathologist. Grading and staging classifications vary based on the type of bone cancer. Ideally, the pathologist examining the sample will be experienced in diagnosing bone cancer.

Treatment of Bone Cancer

The key to successful treatment is having a treatment team that is experienced in bone cancer. Many types of bone cancer are very rare, and having a team that is highly experienced in managing bone cancer is a necessity. Several types of doctors make up these unique treatment teams and include medical oncologists, radiation oncologists, radiologists, surgical oncologists, orthopedic oncologists, and specialized pathologists. There are three standard forms of treatment for osteosarcoma: surgery, radiation therapy, and chemotherapy. Many times, more than one treatment method is required, such as surgery along with radiation therapy. Treatment varies based on type of bone cancer, if it has spread (metastasized), and other general health factors.

Surgery: Osteosarcoma is most commonly treated with surgery. Surgical treatment for bone cancer that has not spread involves removing the cancerous tissue and a small margin of healthy bone tissue surrounding it. Some tumors may require chemotherapy or radiation therapy in addition to surgical treatment.

Radiation Therapy: Radiation therapy uses specific types high energy beams of radiation to shrink tumors or eliminate cancer cells. Radiation therapy works by damaging a cancer cell's DNA, making it unable to multiply. Although radiation therapy can damage nearby healthy cells, cancer cells are highly sensitive to radiation and typically die when treated. Healthy cells that are damaged during radiation are resilient and are often able to fully recover.

Chemotherapy: Chemotherapy is often prescribed to treat osteosarcoma. Chemotherapy drugs work by eliminating rapidly multiplying cancer cells. However, other healthy cells in the body multiply just as quickly, such as hair follicle cells. Unfortunately, many chemotherapy drugs may not be able to discern the two, attacking healthy cells and causing side effects like hair loss.

Note that most teams offer neoadjuvant therapy for the sarcomas and there is adjuvant therapy, too.

Sources:

American Cancer Society. Detailed Guide: Bone Cancer What Is Bone Cancer? July 07, 2008.
http://www.cancer.org/Cancer/BoneCancer/DetailedGuide/bone-cancer-what-is-bone-cancer

National Cancer Institute. Bone Cancer.
http://www.cancer.gov/cancertopics/types/bone

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