Osteosarcoma

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KEY POINTS

• Osteosarcoma is the most common form of bone cancer in children. It usually starts at the ends of the long bones in the arms and legs.
• Treatment may include chemotherapy, radiation therapy, or surgery, along with medicine for pain and other symptoms.
• Ask your child’s healthcare provider how to take care of your child at home, what symptoms or problems you should watch for, and what to do if your child has them.

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What is osteosarcoma?

Osteosarcoma is a growth of abnormal cells that form tumors in the bones. The tumor usually starts at the ends of the long bones in the arms and legs.

Osteosarcoma is the most common form of bone cancer in children. The sooner cancer is found and treated, the better your child's chances for recovery. However, even advanced cancer can usually be treated. Treatment may slow or stop the growth of the cancer and ease symptoms for a time. Ask your healthcare provider what you can expect with the type of cancer that your child has.

What is the cause?

The exact cause is not known. The risk is higher if your child has other diseases of the bone. High doses of X-rays may also increase the risk of osteosarcoma. In some cases, osteosarcoma runs in families.

Bone tumors usually develop during times of rapid growth. It is most often seen in children between the ages of 10 and 20, but it can occur in younger children and adults. Osteosarcoma is more common in boys than girls.

What are the symptoms?

Symptoms may include:

• Pain and swelling in the bones or joints that often gets worse at night
• Fragile, weakened, or broken bones

Tumors in the legs may cause limping, while those in the arms cause pain when lifting.

How is it diagnosed?

Your child's healthcare provider will do a physical exam and ask about the history of pain and swelling in your child's bones or joints. Tests might include:

• Blood and urine tests
• X-rays of the bones
• A bone biopsy, which uses a needle passed through the skin to take a small sample of bone tissue for testing
• CT scan, which uses X-rays and a computer to show detailed pictures of the bones
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the bones
• PET scan, which is a kind of X-ray that uses a radioactive chemical injected into a vein to show detailed pictures of the cancer

How is it treated?

You and your healthcare provider will discuss possible treatments for your child. You may also talk with a surgeon and a cancer specialist. Some things to think about when making treatment decisions are:

• Your child's age
• Your child's overall health
• The stage of the cancer (how advanced the cancer is)
• Whether the cancer has spread to other parts of your child's body

Possible treatments include:

• Radiation therapy, which uses high-energy X-rays to kill cancer cells
• Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
• Medicine to slow bone damage and strengthen bones
• Surgery to remove areas of bone affected by cancer
• A metal piece put into a weakened bone to strengthen it
• Limb-salvage surgery, which replaces the damaged bone and tissue with artificial material or bone from another part of your child's body may be possible
• Amputation of the limb

Your child's treatment will also include:

• Preventing infections
• Controlling pain or other symptoms
• Preventing and controlling the side effects from treatments
• Helping your child and your family cope with cancer

After surgery, sometimes more chemotherapy is needed. Osteosarcoma may spread to the lungs. Your child will have chest CT scans to check for tumors in the lungs. Often, more than 1 treatment is used. Your child will need to have regular follow-up visits with his or her healthcare provider.

Ask your healthcare provider about clinical trials that might be available to your child. Clinical trials are research studies to find new cancer treatments. It’s always your choice whether your child takes part in one or not.

How can I take care of my child?

If your child has been diagnosed with osteosarcoma:

• Talk about your child’s cancer and treatment options with your healthcare provider. Make sure you understand your choices.
• Follow the full course of treatment prescribed by your healthcare provider.
• Ask your healthcare provider:
  • How and when you will get your child’s test results
  • How long it will take your child to recover
  • If there are activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them
• Make sure you know when your child should come back for a checkup.

It may also help if your child:

• Eats a healthy diet and gets regular exercise as recommended by your healthcare provider
• Gets plenty of rest
• Takes time for activities that your child enjoys. It may help your child to talk with a counselor about his illness.
• Tells you or your provider if treatment causes discomfort. Usually there are ways to help your child be more comfortable.

For more information, contact:

• American Childhood Cancer Organization
  855-858-2226
  http://www.acco.org/
• American Cancer Society
  800-227-2345
  https://www.cancer.org/
• National Cancer Institute
  800-422-6237
  https://www.cancer.gov/