Osteosarcoma

Osteosarcoma

(also known as osteogenic sarcoma)

Osteosarcoma is the most common type of bone cancer in children (the second being Ewing’s sarcoma), and accounts for about 3% of pediatric cancer cases. Most other types of cancer start elsewhere in the body and then spread to the skeleton, however osteosarcoma is one of the few types of cancer that begin in the bones.

Osteosarcoma is a type of bone cancer that begins in the cells that form the bones. Our bones can be separated into two main types: “flat” and “long.” Flat bones protect the brain and other organs, and long bones support the legs and arms. Osteosarcoma can occur all over the body, but typically develops in the growing ends of long bones (called the “metaphysis”), and mostly occurs in the areas that form the knees. The second most common site of osteosarcoma is at the ends of the upper arms around the shoulders.

What are the symptoms of osteosarcoma?

Signs and symptoms of osteosarcoma vary from case-to-case, depending on the size and location of the tumor and the patient’s age and health prior to diagnosis.

Symptoms can include:

  • Pain, especially in the site of the tumor
  • Swelling around affected areas
  • Decreased motion in the joints
  • Weak bones (which, in rare cases, can lead to fractures)
  • General fatigue
  • Weight loss
  • Anemia

Are there any known risk factors?

A risk factor is anything that affects your chance of developing a disease such as cancer. Different diseases have different risk factors.

Lifestyle-related factors such as body weight, physical health, diet, and tobacco usage are well-known to contribute heavily to adult cancers. However, these factors usually take many years to influence cancer risks and are not thought to play as significant of a role in pediatric cancer.

Known risk factors for osteosarcoma include:

  • Age – the risk of osteosarcoma is highest for those between the ages of 10 and 30, especially during a growth spurt, suggestion a potential link between rapid bone growth and tumor formation
  • Height – children with osteosarcoma are often tall for their age
  • Gender – osteosarcoma is more common in males than in females. However, females tend to develop it earlier, possibly to due to generally having growth spurts earlier
  • Race/ethnicity – Osteosarcoma is more common in African-Americans and Hispanic/Latinos than in whites
  • Radiation to bones – Previous encounters with radiation therapy for another cancer might have a higher risk of later developing osteosarcoma in the treated area. Two things can lead to a higher risk of Osteosarcoma; radiation treatment at a young age and being treated with higher doses of radiation
  • Bone disease – People with certain non-cancerous bone diseases (such as Paget’s disease or osteochondromas) have an increases risk of developing osteosarcoma
  • Inherited cancer syndromes – Though it is rare, people with certain inherited genes may have an increased risk of osteosarcoma. Some diseases with recorded links to risk include retinoblastoma, Li-Fraumeni syndrome, Rothmund-Thomson syndrome, Bloom syndrome, Werner syndrome, and Diamond-Blackfan anemia

How is osteosarcoma diagnosed?

There are currently no widely recommended screening tests for osteosarcoma. However, most cases of osteosarcoma are found at an early stage due to symptoms often prompting quick visits to the doctor.

Your health care provider may perform one or more of the following to determine a diagnosis:

  • Complete medical history
  • Physical exams
  • A blood test to measure alkaline phosphatase, an enzyme found in the blood when children are growing, when a broken bone is healing, or when a disease or tumor causes production of abnormal bone tissue
  • Imaging tests (x-rays, bone tests, CT scans, MRI, or angiogram)
  • Needle or surgical biopsy of the tumor

What is the survival rate for osteosarcoma?

If the disease has not spread to other areas of the body, the long-term survival rate is about 70-75%. However, if the disease has already spread to the lungs or other bones at the time of diagnosis, the long-term survival rate is about 30%.

What treatments are available for osteosarcoma?

Osteosarcoma is usually treated with surgery (to remove affected areas) and chemotherapy (to shrink/slow down growth).

Surgical treatments for osteosarcoma include amputation or limb-salvage surgery.

Chemotherapy is typically given to patients both before and after surgery.

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