Osteosarcoma is a rare malignant bone tumor that primarily affects adolescents and young adults. In the United States, there are approximately 800 to 900 new cases each year. Although it is a rare cancer, it is the most common primary bone tumor in children and adolescents. Osteosarcoma most frequently occurs in young people between the ages of 10 and 30, particularly during the growth spurt of adolescence. It most commonly occurs at the ends of long bones, such as the femur (thigh bone), tibia (shin bone), and humerus (upper arm bone). About 60% of cases occur near the knee joint.The data mainly comes from the National Cancer Institute (NCI) in the United States.
Osteosarcoma symptoms
The symptoms can vary, but some of the most common signs and symptoms include:
- Pain: The most common symptom is pain at the site of the tumor. The pain may be intermittent or constant, and it may worsen with activity.
- Swelling: A noticeable lump or swelling may be present at the site of the tumor.
- Fractures: Osteosarcoma can weaken the bone, making it more prone to fractures.
- Fatigue: General feelings of tiredness and weakness may occur.
- Weight loss: Unintentional weight loss may occur in some cases.
- Limb length discrepancy: If the tumor is located near a joint, it may cause the affected limb to become longer than the opposite limb.
- Limited range of motion: The tumor may impede the normal range of motion of a joint.
- Systemic symptoms: In advanced cases, osteosarcoma may cause systemic symptoms such as fever, night sweats, and an overall feeling of malaise.
Cause
The exact cause of osteosarcoma is not fully understood, but there are several factors that may increase the risk of developing this type of bone cancer. These factors include:
- Genetic Mutations: Most cases of osteosarcoma are thought to result from random mutations during cell growth. These mutations can cause the cells to multiply rapidly and form a tumor.
- Hereditary Conditions: Certain genetic conditions can increase the risk of developing osteosarcoma. These include:
- Hereditary retinoblastoma, a rare eye cancer that can lead to osteosarcoma later in life.
- Li-Fraumeni syndrome, a rare inherited syndrome that increases the risk of several types of cancer, including osteosarcoma.
- Werner syndrome, a rare genetic disorder that leads to premature aging and an increased risk of cancer.
- Rothmund-Thomson syndrome, a rare genetic disorder characterized by a skin rash at birth and an increased risk of cancer.
- Previous Radiation Therapy: Exposure to high-dose radiation, such as radiation therapy for cancer treatment, increases the risk of developing osteosarcoma.
- Family History: Having a family history of osteosarcoma or other bone cancers may increase the risk.
- Bone Disorders: Certain bone disorders, such as Paget’s disease of bone, increase the risk of osteosarcoma.
- Growth Disorders: Children with rapid bone growth or very tall stature may have a slightly higher risk of developing osteosarcoma.
Most people with known risk factors do not develop osteosarcoma, and many people with osteosarcoma have no known risk factors. Research is ongoing to better understand the causes of this disease and to develop new ways to prevent and treat it.
The survival rate
When osteosarcoma is diagnosed and treated before it has spread to other parts of the body (localized disease), the outlook is generally better. The five-year survival rate for localized osteosarcoma is typically between 70% and 80%. However, if the cancer has already spread to the lungs or other bones at the time of diagnosis (metastatic disease), the five-year survival rate drops to around 30%.
Survival rates are statistical estimates and can vary based on the specific circumstances of each individual. Additionally, advances in treatment have improved outcomes over the years, and these statistics may not reflect the most current data.
Treatment plan
The best treatment plan for osteosarcoma depends on several factors, including the stage of the cancer, its location, the extent of the tumor, and whether the cancer has spread to other parts of the body. Treatment typically involves a combination of surgery, chemotherapy, and sometimes radiation therapy. Here is an overview of the standard treatments:
- Surgery: The primary treatment for osteosarcoma is surgery to remove the tumor. The goal is to remove all of the cancerous cells while sparing as much healthy tissue as possible. Depending on the size and location of the tumor, this may involve procedures such as limb-sparing surgery, where the tumor is removed without amputating the limb, or bone transplantation.
- Chemotherapy: Chemotherapy is often used before surgery to shrink the tumor and kill any cancer cells that may have spread to other parts of the body. It may also be used after surgery to eliminate any remaining cancer cells and reduce the risk of recurrence.
- Radiation Therapy: Radiation therapy is less commonly used in the treatment of osteosarcoma than surgery and chemotherapy. However, it may be used in certain cases, such as when the tumor cannot be completely removed with surgery or to treat a recurrence of the cancer.
- Targeted Therapy: Targeted therapy is a type of treatment that targets the specific genes, proteins, or tissue environment that contribute to cancer growth and survival. While targeted therapies are not yet a standard part of osteosarcoma treatment, they are being studied in clinical trials and may become part of treatment plans in the future.
- Clinical Trials: For some patients, participation in clinical trials may be an option. These trials can provide access to experimental treatments that are not yet widely available.
The treatment plan is usually determined by a team of specialists, including an orthopedic oncologist, a medical oncologist, and a radiation oncologist. The team will consider the individual characteristics of the patient and the cancer to recommend the most appropriate treatment approach.
