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What To Know About Osteosarcoma

Osteosarcoma is a bone cancer that’s mostly common in young adults and adolescents, but can occur in people of any age. It’s a rare disease, but the most common bone cancer in teenagers. But what is it? How does it develop? Can it be treated? This article aims to answer all of those questions, and more.


What is osteosarcoma?

It’s a cancer that starts in bone cells, which are what help bone tissue form. The tumours, or cancerous cells, cause the tissue to develop abnormally, causing complications in the body, especially in younger teenagers and children, whose bones are still growing and developing. It generally occurs in longer bones, like those in the arms and legs, but can affect almost any bone in the body, and, rarely, the soft tissue outside the bone. Most tumours occur near the knee joint or the shoulder. The cancer can sometimes also metasize, or spread to other parts of the body – most commonly the lungs – and affect other organs.


What causes it?

There is no determined cause for osteosarcoma, but there are certain risk factors that may mean you have a higher chance of developing the disease, such as:

  • Age. Osteosarcoma is most common in those between the ages of 10 and 30, with the risk decreasing in adults. It becomes more common in those above the age of 60.
  • Height. Children and teenagers tall for their age go through rapid bone growth, which may involve cancerous cells developing.
  • Gender. The cancer is most common in boys, though girls tend to develop it at a younger age.
  • Inherited cancer syndromes. Those with retinoblastoma, the LiFraumeni syndrome, and the Rothmund-Thomson syndrome are at a higher risk of developing osteosarcoma.
  • Bone diseases. Some bone diseases, though non-cancerous, can increase chances of developing this disease. This includes the Paget disease, osteochondromas, and fibrous dysplasia.
  • Radiation exposure. Being exposed to radiation, such as through prior radiotherapy, may be linked to the risk of developing osteosarcoma.


What are the symptoms?

The primary symptom of osteosarcoma is pain: pain often occurs in the joints, accompanied by swelling, redness, and weakness. Bones may fracture repeatedly, and injury may be frequent. The pain or swelling may also limit joint motion. Very rarely do symptoms occur as a product of metastasis.

If there is a large or painful swelling or mass in any bone in your body, see a doctor immediately. It’s important to get it examined, even if it may not be osteosarcoma. Cancers are more easily treated when detected early, so if you see fractures occurring often, or feel your bones weakening, let your GP know.


How can I get diagnosed?

The initial test will likely be an X-ray. Some X-rays can indicate abnormalities, such as cloud-like lesions or unusual new bone growth, which can be further investigated. Your doctor might also do some simple physical tests, observing a noticeable lump, if one is present.

Sometimes, it is clear that the diagnosis is a bone cancer, but you might have to go through further imaging tests, like MRI scans, CT scans, and PET scans so your diagnosis can be confirmed. These scans can also help determine where else – if anywhere – the cancer has spread.

Finally, the doctor may carry out a biopsy, taking a sample of cells from the located tumour and observing them under a microscope. A biopsy will be carried out by an experienced surgeon, and there are two types: needle and surgical; the type used depends on the location of the tumour and the results of previous scans. A biopsy can help confirm whether or not the cells are cancerous, and if so, then with determining the type, grading, and staging of the cancer, making it easier to design a treatment plan.

If cancer is confirmed, you might also undergo blood tests, which can provide more detailed information. Certain chemicals are markers of cancer stages; high levels of LDH might mean more advanced osteosarcoma is present. Checking your vitals and other chemical levels in the blood can also help form a better overall image of your general health.


Is there treatment available?

There are multiple methods of treatment available, and, most probably, many of them will be combined to treat you based on factors like your age, cancer grade and stage, tumour location, and overall health.


For small tumours and localised cancers, surgery is the ideal option. As much of the tumour as possible is removed – often all of it, if possible – and remaining cancerous cels are treated using chemotherapy and radiation therapy. Removing the tumour decreases the chance of cancer recurring, though it’s not guaranteed, and symptoms should continue to be monitored.

Certain complications, like large tumours, metastasis, or health conditions make surgery difficult, or impractical. Combination therapies like chemotherapy, radiotherapy, and targeted therapies can be used to shrink the tumour before surgery, or combined with cryotherapy, immunotherapy, and more as an overall treatment procedure. Talk to your doctor about what treatment methods best suit you and your condition.


You may be recommended chemotherapy, which is a process where certain effective chemicals are either injected into your body, or taken through pills, depending on your health condition, the location and size of the tumour(s), and other treatments you may be receiving. These chemicals target cancerous cells and can also help shrink tumours before surgery. Another option is radiotherapy, which uses high-energy beams of radiation targeted at certain tumour locations to shrink them, or get rid of them. Again, this can be used in combination with other treatment methods or as a reduction before surgery. Chemotherapy and radiotherapy are often both used to get rid of a tumour, and while the cancer may recur, both treatments are generally very effective at treating it.

Other treatments also include cryotherapy, in which extremely cold temperatures are used to freeze the tumour and kill malignant cells, as well as immunotherapy. Immunotherapy works on building up your own immune system to strengthen it against the cancer and help your body fight back against it. Immunotherapy is also important since other treatments like chemotherapy, radiotherapy, and cryotherapy can weaken your body’s defences. The treatment, or combination of treatments, is based upon the stage and grade of your cancer, and what your doctor sees fit to treat it.


What’s next?

As with all cancers, it’s important to monitor, even after surgery or other treatments, for symptoms that may indicate recurrence. If you have recently been diagnosed with osteosarcoma, make sure to stay connected with your healthcare team and a support system of friends and family, and remember that, during this pandemic, it’s especially important to take care of your immune system, stay at home, and get vaccinated if possible. July, upcoming, is Sarcoma Awareness Month, and you can wear a yellow ribbon to show your support for sarcoma patients and survivors.

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