Osteosarcoma is a type of cancerous tumor found in the bones of the body. It is the third most common type of bone cancer and the eighth most common type of cancer found in children and young adults between the ages of 10 through 25 years. Osteosarcoma is a fast-advancing neoplasm created by mutated mesenchymal cells, which in return produce cancerous osteoid cells which congregate over time. Over 90% of osteosarcomas are known to attach themselves to the ends of bones, also known as the metaphysis of the bones and sometimes it is found in the tubular, long bones of the body, such the femur or tibia, although they can appear on any bone in the body.
The exact origin of osteosarcoma is yet unknown to scientists and doctors since it is affiliated to the mutation of the mesenchymal cells, or osteoblasts. Nevertheless, there are some conditions which may increase the risk factors for this disease, such as a family history of Paget’s disease, retinoblastoma, Li Fraumeni syndrome, Rothmund-Thomson syndrome, or previous exposure to radiation, as part of an environmental-type of risk factor. Like other sarcoma-type cancers, even if a neoplasm small in size is found in the body, there may be undetectable spread on a microscopic level to other parts of the body. Osteosarcoma is characterized by pain and swelling, limping (if found in the legs), shortness of breath or bone fractures after a minor fall or bump due to extensive weakness of the bone.
Osteosarcoma can be easily diagnosed by routine imaging studies, such as X-rays, MRI and CT exams and a pathological biopsy as a final form diagnosis, in order to determine the cancer stage of the disease. Therapy for osteosarcoma has greatly progressed in the last decades, and today’s conventional therapies such as chemotherapy are one of the most recommended option’s for treating osteosarcoma in combination with a total, or sub-total removal of the tumor. Depending on the size of the tumor, the type of bone involved and the stage of the tumor, some of the surgical treatments include: Limb salvage, rotationplasty, or a limb amputation. Ninety percent of those who undergo limb salvage may encounter one of more of these symptoms: infection, prosthetic loosening, or local tumor recurrence. In these cases, chemotherapy/radiation therapy may be recommended line of treatment, before and after surgery.
As chemotherapy may be administered prior to or after surgical removal of the tumor, the oncologic team of doctors will have to decide upon differentiating factors involved in treating the disease. Sometimes a combination of radioactive agents such as chemotherapy, radiation or a combination of both is recommended, even before surgical removal of the tumor, resulting in a decompression of the tumor, in turn, facilitating the surgical removal and recovery of the patient. Although chemotherapy may be sometimes recommended before surgery, it will most likely be administered also after surgery in order to completely eliminate any microscopic evidence left in the body.
Osteosarcoma patients do require a close follow-up after surgery, and may be requested to perform of imaging and bone density exams, as well as follow-up blood work during the recovery period which may extend to months and even years after surgery. Proper combination of chemotherapy/surgical treatments along with today’s medical prosthetics advancements in patients without detectable metastases of the cancer, have a long term survival rate of up to 70%.