Though rare, osteosarcoma is the most common type of bone cancer, which begins in cells that form bones. In very rare instances, it occurs in soft tissue outside the bone. Osteosarcoma is most often found in the long bones — more often the legs, but sometimes the arms — but it can start in any bone.
Osteosarcoma tends to occur in teenagers and young adults, but it can also occur in younger children and older adults. Treatment usually involves chemotherapy and surgery. Typically radiation therapy is not effective in treating osteosarcoma, though the use of new improved radiation techniques, such as proton beam therapy, is being studied.
Treatment for osteosarcoma has greatly improved over the years. The outlook (prognosis) and treatment decisions depend on where the osteosarcoma starts, tumor size, the type and grade of osteosarcoma, and whether the cancer has spread. After completion of treatment, people need lifelong monitoring for potential late effects of intense chemotherapy.
Signs and symptoms of osteosarcoma may include, among others:
- Swelling near a bone
- Bone or joint pain
- Bone injury or bone break for no clear reason
Because these symptoms can be mistaken for other health issues, such as a sports injury, sometimes there is a delay in seeking medical help.
The cause of osteosarcoma is not clear and most cases appear to occur sporadically, but some factors may increase the risk.
These factors increase the risk of osteosarcoma:
- Previous treatment with radiation therapy
- Certain inherited or genetic conditions, including hereditary retinoblastoma, Bloom syndrome, Li-Fraumeni syndrome, Rothmund-Thomson syndrome, Diamond-Blackfan anemia, Paget's disease and Werner syndrome
Osteosarcoma can spread from where it started to other areas, making treatment and recovery more difficult. Surgery that removes the tumor and spares the limb is most often the norm. But certain patients may require amputation of the affected part of the limb and then need to learn to use an artificial limb (prosthesis).
As with other types of serious cancer, aggressive chemotherapy for osteosarcoma can cause substantial side effects, both in the short and long term. The health care team takes steps to treat and manage these effects as best as possible. And it's important for you to learn what to watch for and contact your team with any concerns.
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