What is osteosarcoma?
Osteosarcoma is a disease in which cancer (tumor) cells arise in the bone. It is the most common type of primary bone cancer in children and young adults. It often develops during the growth spurt period in the ends of long bones of the leg or arm. Most patients have pain and swelling that may have been present for several weeks. They usually do not have other major symptoms such as weight loss or fever. Typically an x-ray is taken of the affected region which will show an abnormality in the bone. Patients are usually then referred to an orthopedic surgeon to biopsy the lesion. Ideally, this surgeon should be an oncologic orthopedic surgeon who is familiar with osteosarcoma, and s/he should be the one who performs the definitive surgery to remove the tumor. The biopsy should also be read and interpreted by a pathologist who is familiar with bone tumors.
Stages of Osteosarcoma
Once the diagnosis is made from the biopsy, studies need to be performed to determine whether the cancer cells have spread beyond the bone where it started. This is called staging. The most common places for osteosarcoma to spread are to the lungs and to other bones. If the cancer is not detected anywhere except the bone where it started, this is called Localized osteosarcoma. If it has spread to any other place, then it is called Metastatic osteosarcoma. These are the two main stages of osteosarcoma.
Treatment option overview
Patients with osteosarcoma generally require treatment consisting of a combination of surgery and chemotherapy.
Surgery is an important component of treatment to remove any sites of detectable disease. The oncologic orthopedic surgeon may remove the tumor and some of the healthy bone around the tumor and replace them with a prosthesis or bone graft. This is called Limb-sparing surgery. Sometimes, all or part of an arm or leg may have to be removed to make sure that all of the tumor is removed. This is called an amputation. Which type of surgery is performed will depend on the size and extent of the osteosarcoma tumor in the bone.
Chemotherapy is also an important component of treatment used to kill cancer cells, particularly those cells that cannot be seen by x-rays, CT scans or other imaging studies. Typically chemotherapy is given prior to surgery for several weeks, and then continued after surgery for several months to make sure that all the cancer cells are killed.
Radiation therapy is another treatment that is used for many types of cancer. However, osteosarcoma cells are not very sensitive to radiation; therefore, radiation is not typically used as initial therapy for this tumor.
Recurrent disease means that the cancer has come back after it has been treated. The cancer may come back in the same place it started, or in another part of the body. If your child’s cancer comes back, treatment depends on the kind of treatment he or she received before, how much time has passed since the first cancer was treated, and where the cancer came back. Treatment may include surgery, chemotherapy and/or radiation therapy.
The National Cancer Institute at the National Institutes of Health provides more information about this disease: