Osteosarcoma

Osteosarcoma (otherwise known as osteogenic sarcoma) is the cancerous malignant tumor that starts in the bone tissue. Osteosarcoma produces immature osteoids from malignant tumor cells making the bones weak and brittle. It usually develops in the period of youth mostly in adolescence. It peak incidence and diagnosis is at the age of 15 and affects both boys and girls. It could affect the youth as early as 10 years of age until about 25.

Its cause remains to be unknown but studies have shown that it usually runs in the family. It has a marked association with type of eye cancer in children known as retinoblastoma. This cancer normally affects the long bones especially in the area where bone growth is at its fastest. It tends to occur in the bones in the shin near the knee, thigh near the knee, and upper arm near the shoulder. However, it can occur in any bone of the body too.

It is the eighth most common malignancy in pediatric patients and comprises about 20% of all cancers involving the bone.

Signs and Symptoms

Malignant tumors are rarely found that most of the times Osteosarcoma is misdiagnosed as a muscle problem or cyst and the patient will be sent to physical therapy without an x-ray. However, once x-ray is indicated, further diagnostic procedures such as CT scans and Pet scans will be done. Consequently, to make sure, bone biopsy may also be prescribed.

A few of the most common symptoms associated with Osteosarcoma are:

  • Bone fracture that occurs even after normal and routine movement
  • Bone pain
  • Limit in motion
  • Limping if tumor affects a foot
  • Redness, swelling , tenderness of the affected area
  • Pain when lifting for arm tumors

Prevention

The cause of this type of cancer has not been established yet. There are no known means of preventing this malignancy.

Treatment

Chemotherapy

These are medications taken orally or injected intravenously in order to halt the spread of the cancer cells to other parts of the body, reduce the size of the tumor to a more manageable size or kill the cancer cells. This is normally done before the surgery to reduce the accompanying risks of the operation and ensure its relative success. After surgery, most of the times, chemotherapy is resumed in order to fight the remaining cancer cells not seen in the imaging diagnostic procedures. The most common chemotherapeutic drugs used in Osteosarcoma are cisplatin, carboplatin, methotrexate and leucovorin, ifosphamide and cyclophosphamide.

Surgery

Surgery involves the techniques such as tumor removal, rebuilding of the damaged bone tissue, placement of an implant, leg sparing or amputation or leg rotation. The most common is tumor removal for the purposes of saving the limb known as limb-sparing technique. A few of the known limb-sparing techniques are as follows:

  • Autograft – a tissue from your own bone is implanted at the site where the cancerous tissues are removed.
  • Allograft – a tissue from a bank or a donor is used to rebuild the affected site of tumor.
  • Rotationplasty – The surgeon will cut above and below the knee in order to remove the affected part then rotate the leg and reattach the ankle as the knee. A prosthetic leg and ankle is then attached allowing almost normal functioning of the foot.
  • Prosthetic implant – Normally only done when age of the patient suggests that he will have no more expected bone growth. In this procedure, parts of the leg are attached with artificial and expandable implants.

Amputation is normally the last option and only done when tumors are large or very complex in nature involving several parts of the limb. It is considered as the most radical form of surgery.

Radiation Therapy

This is normally done when surgery is not a viable option. It is highly dependent on several factors including location of the tumor.