As the name implies, osteosarcoma occurs in bone cells. It usually affects bones in the legs, arms, or pelvis, though it can occur in any bone. Among children and young adults, osteosarcoma is the most common form of bone cancer. Depending on the stage, location, and subtype of the tumor, osteosarcoma can be treated with surgery, chemotherapy, radiation therapy, or targeted therapy. Depending on the pain, swelling, deformity, or reduced motion of the affected bone or joint, osteosarcoma may require surgery, chemotherapy, radiation therapy, or targeted therapy. Radiation, chemicals, or viruses that damage the bone cells can cause osteosarcoma.
Causes
Although osteosarcoma is not known for sure, genetic mutations or bone cell defects are believed to contribute to the disease. It is possible for these mutations or defects to affect bone cell growth, division, or repair, leading to abnormal cell growth and the formation of tumors. As well as invading the surrounding bone tissue, the tumor can also spread to other parts of the body by means of the blood or lymph system. This is known as metastasis.
Osteosarcoma may be caused by a number of factors, including:
-
The most common age group for osteosarcoma is children and young adults, especially during puberty when bones grow rapidly.
-
Osteosarcoma is more common in males than females, with a ratio of 1.5:1.
-
Osteosarcoma is more common in tall people than in short people, possibly because tall people grow their bones faster.
-
Osteosarcoma can run in families, especially if there is a history of genetic syndromes affecting bone cells, such as Li-Fraumeni syndrome, Rothmund-Thomson syndrome, or Paget's disease.
-
Radiation therapy for another cancer can cause osteosarcoma in the bones, especially if the radiation dose was high or the exposure was early.
-
Osteosarcoma can develop in bones that have been treated with certain chemotherapy drugs for another cancer, such as alkylating agents or anthracyclines.
-
Osteosarcoma can develop in bones that have been injured or fractured, especially if the injury did not heal or was infected.
Symptoms
There are many symptoms associated with osteosarcoma depending on its size, location, and stage. The most common symptom is bone pain, which can be mild or severe, and worsen with activity, pressure, or weight-bearing.
-
Visible or palpable swelling or lump on the bone
-
An abnormal shape or curvature of the bone that affects the limb's appearance or function
-
An inability to perform certain movements or activities due to a reduced range of motion or stiffness of the joint
-
The fracture of a bone may occur easily or spontaneously, even after minor trauma or stress
-
A fever, weight loss, fatigue, or anemia may indicate a systemic infection or inflammation
Diagnosis
Medical history, physical examination, imaging, and laboratory tests are used to diagnose osteosarcoma. The doctor will ask about the symptoms, the onset and duration of the symptoms, the medical history, and the family history of the patient. In addition to the physical examination, the doctor will also ask about:
-
Examining the affected bone or joint for swelling, lumps, or deformities
-
Feeling the tumor's size, shape, and consistency by palpating the affected bone or joint
-
Checking for stiffness, pain, or range of motion in the affected bone or joint
-
Assessing the nerve and vascular function of the affected limb for signs of compression or obstruction
Some imaging and laboratory tests may also be ordered by the doctor, such as:
-
An X-ray can provide information about the bone structure as well as the tumor's size, location, and location
-
An MRI can show the soft tissues and blood vessels surrounding the tumor, as well as rule out any malignant transformation or complications
-
A CT scan can provide cross-sectional images of the bone and tumor, as well as detect any calcification or fragmentation
-
A bone scan can reveal the metabolic activity of the bone and the tumor, and detect any multiple or hidden tumors.
-
PET scans show the tumor's glucose uptake and indicate its aggressiveness or metastasis
-
Using a biopsy, a small sample of tumor tissue can be examined under a microscope and the diagnosis and subtype of the tumor can be confirmed
-
Tests of blood cells, calcium, alkaline phosphatase, and lactate dehydrogenase can indicate bone health and tumor activity.
Treatment
The treatment of osteosarcoma depends on the stage, location, and subtype of the tumor, as well as the patient's age, health, and preferences. In order to prevent or delay the recurrence or metastasis of the tumor, treatment options include:
-
The procedure involves removing the tumor and some of the surrounding healthy bone tissue, as well as repairing any defects or damage to the bones or joints.
-
An operation that preserves the limb and its function by replacing the removed bone with a graft, a prosthesis, or a rotationplasty
-
An artificial limb or prosthesis is used to restore function to the limb after amputation, which involves removing the entire limb or part of it
-
A metastasectomy removes tumors that have spread to other parts of the body, such as the lungs or the liver
-
-
It is given before or after surgery or both, and uses drugs that kill or stop cancer cells from growing. During or after surgery, chemotherapy can shrink the tumor, make it easier for it to be removed, or kill any remaining or hidden cancer cells. It can also be used to prevent or treat tumor metastasis.
-
An alternative to surgery is radiation therapy, which uses high-energy rays or particles to kill or damage cancer cells. Radiation therapy can also shrink and make the tumor easier to remove, or kill any remaining or hidden cancer cells after surgery. Radiation therapy can also prevent or treat tumor metastasis.
-
Alternatively, targeted therapy can be combined with chemotherapy or radiation therapy, as it uses drugs that target specific molecules or pathways involved in the growth or survival of cancer cells. In targeted therapy, the immune system is triggered to attack the tumor or the blood supply to the tumor is blocked.
Prevention
Although osteosarcoma cannot always be prevented, some measures can be taken to reduce the risk or severity of the disease, including:
-
Radiation, chemicals, and viruses that can damage bones or cause genetic mutations should be avoided
-
Whenever there is any sign of bone pain, swelling, or deformity, seek medical attention immediately
-
Osteosarcoma treatment and follow-up should follow the doctor's instructions
-
To support bone health and growth, eat a balanced diet rich in calcium and vitamin D
-
Regular exercise strengthens bones and muscles and improves joint function
