If you or a loved one has been diagnosed with osteosarcoma, you may have several questions and concerns, and to help navigate this diagnosis, you’ll want a team of experts by your side. Sarcoma experts at the OSUCCC – James specialize in treating rare cancers like osteosarcoma. Our experts will work with you or your loved one to determine a customized treatment approach to address your specific needs.
What is osteosarcoma?
Osteosarcoma is a rare type of bone cancer that is classified as a type of sarcoma. It is the most common form of bone cancer. Sarcomas occur in the soft tissues, such as muscles or fat, or in the bone; there are over 80 types of sarcomas.
When osteosarcomas occur, they usually form in children and young adults; most cases occur before 25 years of age. Less commonly, older adults may develop the disease. A second peak of occurrence also happens in older individuals (over 50), which is referred to as secondary osteosarcoma. These are associated with previous radiation therapy, Paget’s disease, and potentially genetic disorders such as Li-Fraumeni syndrome. Osteosarcomas usually occur in the arms and legs (also referred to as the extremities). However, it can occur in other bones, especially in adults.
Because these cancers are rare, it’s important to understand how complex they can be, no matter the age of diagnosis. That’s why it’s important to seek treatment at a specialized facility with dedicated full-time sarcoma experts like our team at the OSUCCC – James.
View our video series on sarcoma
Symptoms of osteosarcoma
Symptoms of osteosarcoma will vary based on the size and location of the suspected tumor. It’s important to remember that just because you have some symptoms, it doesn’t mean you have osteosarcoma. Symptoms may include:
- A bump or lump under the skin
- Unexplained bone or joint pain, stiffness or swelling
- Constant dull pain in a bone or joint
- Pain that awakens you from sleep
- Limited activity or mobility
There are different causes for these symptoms, so if you are experiencing any unusual symptoms, it’s important to talk to your doctor to rule out a cause.
What causes osteosarcoma?
At this time, the exact cause of osteosarcoma is not fully understood. In normal healthy bone tissue, cells that make up our bones grow and replicate normally. Cells contain instructions, also called DNA, that tell cells how to reproduce. Sometimes, those instructions might change and give cells bad instructions. When this happens, cells grow out of control and can invade surrounding tissue, resulting in a cancerous tumor. When this occurs within bones, osteosarcomas form. However, why this happens in some people and not in others may somehow be related to risk factors.
Osteosarcoma risk factors
Risk factors are anything that could increase the chance that you may or may not develop a condition. When it comes to risk factors, there are some things you can influence and other things you can’t. It’s important to keep in mind that just because you may be at risk for osteosarcoma doesn’t mean you’ll get it.
Some risk factors for osteosarcoma include:
- Age: Children and young adults 25 years and younger are at the greatest risk of developing sarcoma.
- Sex: Males assigned at birth are more likely to develop osteosarcoma.
- Genetics: Those with inherited genetic conditions (passed down from parent to child) may be at greater risk. If you or a loved one have hereditary retinoblastoma, Li-Fraumeni syndrome, Rothmund-Thomson syndrome, Bloom syndrome or Werner syndrome, you may be more likely to develop osteosarcoma.
- Radiation therapy: Previous exposure to radiation therapy for other cancers may increase the risk of osteosarcoma.
Just because you may be at risk doesn’t mean you’ll develop an osteosarcoma. It’s important to talk to your doctor to understand your specific risk factors.
Osteosarcoma types
Despite being a rare cancer, osteosarcomas can be further classified into different types.
Some subtypes of osteosarcomas include:
- Osteoblastic
- Chondroblastic
- Fibroblastic
- Small cell
- Telangiectatic
- High-grade surface
- Extra-skeletal
- Post-radiation
If your doctor suspects that you might have osteosarcoma, they will order specific diagnostic tests to help determine which type you may have.
How is osteosarcoma diagnosed?
To determine the exact type of osteosarcoma you may have, a doctor may order a series of imaging tests, such as computed tomography (CT) scans or magnetic resonance imaging (MRI) scans. These scans will help your treatment team understand the exact size and location of your tumor.
To identify the specific subtype, a biopsy will be ordered. A specially trained pathologist will take the tissue collected by the doctor and will examine the cell structure of the tumor. From there, they can determine what osteosarcoma you may have.
Osteosarcoma treatment
Osteosarcoma can be treated several ways. The most common approach is chemotherapy combined with surgery.
Surgery
Osteosarcoma is usually treated with surgery. Depending on the type and size of the tumor, your doctor will determine the best surgical treatment approach. The goal for most osteosarcomas is to only remove the tumor and enough surrounding tissue to decrease the risk of tumor recurrence. This occurs in most cases; surgical oncologists at the OSUCCC – James want to ensure that they preserve as much function of your limbs as possible. There are some rare cases where this isn’t possible, but advanced surgical techniques are reducing this possibility. Your doctor will determine what will work best for your specific situation.
Some surgical treatments may include:
- Distal femoral/proximal tibia replacement (oncologic total knee replacement)
- Intercalary allograft reconstruction using patient-specific 3D-printed models
- Vascularized fibula reconstruction
- Reverse oncologic total shoulder replacement
- Rotationplasty
- Internal hemipelvectomy with or without custom megaprosthetic reconstruction
Nonsurgical treatment options
The most common nonsurgical treatment option for osteosarcoma is chemotherapy. Chemotherapy uses special medications that are given in an IV (intravenously) along with other supportive therapies to help offset some of the medications’ side effects. The drugs your doctor chooses to use will be based on the size and location of the tumor. Chemotherapy is given to help shrink the size of the tumor, and in some cases, shrink the tumor so that surgery can be performed to remove it.
If you’ve been diagnosed with osteosarcoma, would like a second opinion or would like to speak with an osteosarcoma specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.
Additional Resources
Types of Sarcoma
Bone and Spine Sarcoma
Screening and Diagnosis
Clinical Trials