Osteosarcoma

What is osteosarcoma?

• Osteosarcoma is a kind of cancer. Cancer is a condition where cells grow and divide without control or order, often making a tumor (lump). Osteosarcoma is a tumor made of cells that produce bone. Osteosarcoma is commonly found inside the long bones of your body, such as your arm and leg bones. It may also grow on the surface of your bones or in your soft tissue, such as muscles. Osteosarcoma can occur in people of all ages. The cancer more commonly occurs when a person's bones are still growing, such as with children and young adults.
  
  
• Cancer cells may spread to other areas of your body. Once cancer cells spread, the cancer becomes harder to treat. Having your osteosarcoma treated may help relieve your symptoms, such as pain and swelling. Osteosarcomas that are found and treated early have a higher chance of being cured.

What causes osteosarcoma?

The exact cause of osteosarcoma is unclear. Caregivers believe any of the following conditions may increase your risk of having osteosarcoma:

• Bone diseases: Bone diseases, such as Paget's disease and fibrous dysplasia, may increase your risk of having osteosarcoma. Ask your caregiver for more information about these bone diseases.
  
  
• Chemicals: Being around certain chemicals, such as beryllium oxide, may increase your chances of getting osteosarcoma. Ask your caregiver for more information about these chemicals.
  
  
• Genetic diseases: Genes are little pieces of information that tell your body what to do or make. You may be at an increased risk for osteosarcoma if you have damaged genes.
  
  
• Other cancers: Cancer in other areas of your body, such as a retinoblastoma, also increases your risk for osteosarcoma. Retinoblastoma is a cancer of your retina. Your retina is the part of your eye that captures light and sends information to your brain.
  
  
• Radiation: Past exposure to radiation may increase your risk for osteosarcoma. You may have had radiation in the past to treat another cancer

What are the signs and symptoms of osteosarcoma?

At first, you may have no signs and symptoms of osteosarcoma. As your tumor grows, you may have any of the following:

• Early stage:
  
  
  • Pain with movement of the area where your tumor is growing.
    
    
  • Fever (high body temperature).
    
    
  • Feeling tired most of the time.
  
  
• Late stage:
  
  
  • Pain with movement, and at rest in the area where your tumor is growing. Your pain may worsen and begin to wake you from sleep.
    
    
  • Trouble moving or using your arm or leg (limb) where your tumor is. Your limb may lose strength and feel limp (floppy).
    
    
  • A lump in your involved limb that you can see or feel.
    
    
  • Red and warm skin around the area of your tumor.
    
    
  • Swelling of your involved limb or area of your tumor.
    
    
  • Swollen blood vessels that may cause bulges under your skin.
    
    
  • Weak or damaged bones. Your tumor may cause a fracture (break) in your involved bone.

How is osteosarcoma diagnosed?

Your caregiver will do a complete physical exam. If your tumor forms a mass that can be seen, your caregiver will measure its size. The location and shape of your tumor, and your skin temperature will also be noted. Your caregiver may move your involved limb to see if your mass changes with the movement. He may feel your tumor to check if it is hard or soft, and painful when touched. He will check your muscles near your tumor to see if they have become smaller. He will feel for any masses that may have spread to other areas. You may also need any of the following tests:

• Biopsy: This procedure is needed to see if you actually have cancer. Your caregiver will remove a part of your mass using a needle. He may also cut out a small piece of your bone. The bone or tissue sample is then sent to a lab for tests. Your biopsy will be done after the following imaging tests:
  
  
  • Bone scan: This is a test to look at your bones. You are given a special dye as a shot into your vein (blood vessel). Pictures are then taken of your bones. Caregivers can look at the pictures to check for cancer in your bones and for any broken bones. Your caregiver may also use these pictures to see if your cancer has spread.
    
    
  • Computerized tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your body. Your caregiver may take pictures of your involved bone to check for a tumor or other problem. This test will also show your nerves and the blood flow around your tumor. Your caregiver may also take pictures of your chest to see if cancer has spread to your lungs.
    
    
  • Magnetic resonance imaging: This test is also called an MRI. During the MRI, 3-D (three-dimensional) pictures are taken of your body. If you have a tumor, your caregiver will use these pictures to check its size. The pictures will also show if your tumor is affecting the blood vessels, nerves, and tissues around it. Your caregiver may also be able to see if your tumor has spread to other bones and nearby joints. MRI pictures may also help your caregiver plan your biopsy and treatment.
    
    
  • X-ray: Your caregiver will take a picture of your involved bone. The picture may show if your bone has a tumor, a fracture (break), or other problem. X-rays may also show if there are changes in your bone where your tumor is growing. The X-ray may also be used to take a picture of your lungs to see if your cancer has spread.
  
  

How is osteosarcoma treated?

The goal of treatment is to remove the cancer from your body. You may need one or more of the following:

• Chemotherapy: This medicine, often called chemo, works by killing cancer cells. It is normally given through a vein (blood vessel). Your caregiver may use this medicine to make your tumor smaller before surgery. Chemo may also be needed after your surgery. Chemo after your surgery may help to kill any cancer cells that have spread to other areas.
  
  
• Surgery: Surgery may be needed to remove your tumor. The bones and tissues around your tumor may also need to be removed. A bone graft may be used to replace any bone that was removed. A bone graft is a piece of bone that may be taken from another area of your body. The bone graft may also come from a donor (another person). A prosthesis (man-made part) may also be used to replace the bone that was removed. In some cases, your caregiver may have to amputate (remove) your limb to remove your cancer.
  
  
• Radiation therapy: Radiation is a treatment using x-rays or gamma rays to treat your cancer. Radiation works to kill cancer cells and prevent it from spreading. You may need this treatment if your tumor cannot be removed through surgery. You may also need radiation along with chemo or surgery to treat your cancer.

Where can I find support and more information?

Osteosarcoma is a life-changing condition for you and your family. Accepting that you have cancer is hard. You and those close to you may feel scared, sad, or angry. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Learning about your cancer may help you and your family cope with your condition. You may also want to join a support group for people who have osteosarcoma. Contact the following for more information:

• American Cancer Society
  250 Williams Street
  Atlanta , GA 30303
  Phone: 1- 800 - 227-2345
  Web Address: http://www.cancer.org
  

• Cancer Information Service
  Cancer Information Service
  Phone: 1- 800 - 422-6237
  Web Address: http://www.nci.nih.gov
  

When should I call my caregiver?

Call your caregiver if:

• Your pain and swelling worsen.
  
  
• You see or feel new lumps under your skin.
  
  
• You have a lump that is getting bigger.
  
  
• You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You have no feeling in or near the area where your osteosarcoma is.
  
  
• You are unable to move your limb where your tumor is.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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