What is Osteosarcoma?Osteosarcoma is the most common form of bone cancer in children, teenagers and young adults. It is a form of cancer that can occur at any age but usually develops in growing bones. This makes it more common in younger people. There are approximately 750-1,000 individuals diagnosed with osteosarcoma each year in the United States. About 450 of those are children or teenagers under the age of 20. This classifies it as a rare cancer. Osteosarcoma commonly occurs in the legs, knees and upper arms. However, it can form in any bone throughout the body, including the pelvis, jaw bones and shoulders. Osteosarcoma can also spread (metastasize) to other areas of the body, most likely the lungs. Osteosarcoma occurs in different types (or grades). The grade of the cancer determines how quickly it will spread and what type of treatment is necessary.
- High-grade osteosarcomas occur most commonly in children. They are easy to spot as they do not look like normal bone cells. High-grade osteosarcomas spread the quickest and require the most prompt treatment.
- Intermediate grade osteosarcomas are usually treated in the same way as low-grade cases. They most commonly affect the periosteum, which is a membrane that covers the outer surface of your bones.
- Low-grade osteosarcomas are slow-growing but less obvious to detect. The tumors look more like normal bone and have few dividing cells when seen with a microscope.
Causes and risk factors of Osteosarcoma:A risk factor is something that increases the likelihood of Osteosarcoma occurring. If you exhibit several different risk factors, it is not guaranteed that Osteosarcoma will occur. Similarly, cancer can still occur in people with no known risk factors. Common risk factors include:
- Previous radiation therapy – People who have been previously treated with radiation are at a higher risk of developing Osteosarcoma in the area that was targeted.
- Age – Osteosarcoma occurs most frequently in people under the age of 20.
- Height – Children with osteosarcoma are usually of above-average height. This suggests that osteosarcoma may be related to growth spurts or and increased bone growth.
- Existing bone conditions – People who suffer from Paget disease (forming of abnormal bone tissue) or osteochondromas (non-cancerous bone tumours) are more prone to developing Osteosarcoma.
Symptoms of Osteosarcoma:Below are some of the most common symptoms associated with Osteosarcoma. Early detection is key to preventing the spread of cancer. For this reason, it is important to see a doctor if you are worried or notice any of the following symptoms:
- Pain in the affected area – The most common symptom of Osteosarcoma is bone pain. This pain may increase with activity such as exercise and may become more noticeable at night. Since Osteosarcoma occurs most commonly in the knees and upper arms, pain in these areas should be an extra reason for concern.
- Swelling – As a tumour develops, it can begin to swell. Depending on the location of the tumour, it may be possible to feel a lump of mass through your skin.
- Weakened bones – Osteosarcoma can weaken the bone it develops in, increasing the likelihood of fractures occurring. In fact, many cases of bone cancer are diagnosed due to a broken bone.
Treatment for Osteosarcoma:There are several available treatments for osteosarcoma. However, the type of treatment that your doctor recommends may depend on the type and stage of a patient’s cancer. Most forms of osteosarcoma are treated with a combination of therapies which include surgery, radiation therapy and chemotherapy. Each treatment comes with its own risks and side effects. For this reason, it is important to thoroughly consider all options and discuss them with your doctor. Below are some of the most common treatments associated with osteosarcoma:
SurgeryThe goal of surgery is to remove all traces of cancer and prevent it from growing back over time. During surgery, surgeons will attempt to remove the tumour, as well as a margin of healthy tissue around the tumour. In some cases, a bone will have to be removed in order to prevent the spread of cancer. When this happens, a surgeon may replace the bone with a metal implant. These implants are designed to mimic the function of the missing bone, allowing for little to no difference. Occasionally due to a tumour’s size, an amputation will be necessary to prevent cancer from spreading to other parts of the body. This is only done in severe cases where cancer poses a life-threatening risk to the patient.
Chemotherapy:Chemotherapy is the use of drugs to target and destroy cancer cells. Chemotherapy may be used prior to surgery to weaken and destroy cancer cells. This will make it easier for a surgeon to remove what is left. Chemotherapy may also be used post-surgery to reduce the likelihood of cancer reoccurring. Chemotherapy is usually conducted in “sessions”. During each session, a cancer-fighting drug will be administered either orally or intravenously (via a drip). The time between sessions gives your body time to recover from each dose. Chemotherapy does cause side effects. These include:
- Tiredness and fatigue
- Loss of hair
- Increased risk of infection
- Nausea and vomiting
Radiation therapy:During radiation therapy, a radiation oncologist will use external radiation to target cancer cells. Although radiation therapy is not commonly recommended for osteosarcoma, it can be great for removing remaining cancer cells following surgery, or for weakening a tumour prior to surgery. Common side effects of radiation therapy include:
- Irritated, red or itchy skin around the area of treatment
- Loss of hair around the area of treatment.