Osteosarcoma: Symptoms, Causes, Diagnosis and Treatment

Bone cancer continues to be a daunting challenge in developing countries due to limited diagnostic facilities and a lack of clarity regarding the disease. Among different types of bone cancer, osteosarcoma is the most common one in children and adolescents, accounting for nearly 36% of cases.

Wondering when you should see a doctor? Scroll down to learn about osteosarcoma signs and symptoms first!

Osteosarcoma, also known as osteogenic sarcoma, develops in connective tissue like cartilage, bone or muscle. It generally occurs at the ends of long bones where the fastest growth takes place, and if diagnosed at the localised stage, the osteosarcoma survival rate stands at 70%.

Even though anyone can be diagnosed with osteosarcoma, the disease is most common in children and teens, including people above 60 years of age.

It has also been observed that the incidence of osteosarcoma is relatively higher in males (around 5.2 per million every year) than females (around 4.5 per million per year).

The most common osteosarcoma symptoms include -

• Joint pain or soreness, which keeps increasing with time
• A mass or lump (tumour) around bones or towards the ends of bones
• Broken bone, even due to simple movement
• Swelling and redness near the tumour
• Limping
• Pain every time you work out
• Fever

Look out for these warning signs and immediately visit a doctor to avoid the spread of this disease.

If you are curious to know how osteosarcoma actually develops in human bodies, go through the following section.

The exact reason behind this disease is still unknown. However, it is predicted that osteosarcoma occurs due to an error in the DNA or your genetic code. 

If the cell starts making new bone when it is not required, it leads to a mass of poorly formed bone cells that eventually hamper healthy body tissue. 

Following are the risk factors associated with different types of osteosarcomas -

• Previous treatment with radiation therapy (the higher the dose of radiation, the higher are the chances of developing osteosarcoma)
• Having a history of noncancerous bone disease like osteochondroma or Paget disease
• While going through a phase of rapid growth, which is mainly common among teenagers
• Having an inherited syndrome, for instance, Bloom syndrome, Rithmund-Thompson syndrome, hereditary retinoblastoma, etc.

Note that the risk factors often vary depending on the type of osteosarcoma a person is suffering from. Here, have a look at the types of this disease:

1. High-grade Osteosarcoma

Generally, children and teenagers suffer from high-grade osteosarcoma, which is the fastest-growing type among all. Following are the 9 subtypes of this variant:

• Osteoblastic
• Telangiectatic
• Fibroblastic
• Chondroblastic
• Post-radiation
• Small cell.
• Pagetoid
• High-grade surface (juxtacortical high-grade)
• Extraskeletal

2. Low-grade Osteosarcoma

This one grows slower than the high-grade, and the cells usually look like a regular bone under a microscope. Scientists have discovered only two types of low-grade osteosarcoma until now;

• Intramedullary or intraosseous well-differentiated
• Parosteal (juxtacortial low grade)

3. Intermediate-grade Osteosarcoma

This particular type is in between low-grade and high-grade osteosarcoma and quite uncommon. Its main type is known as periosteal or juxtacortical.

As mentioned earlier, among all the histological types of osteosarcoma, the high-grade one is more prone to spreading quickly, even to other parts of your body. Therefore, in case you notice persistent signs and symptoms mentioned in the previous section, opt for a thorough physical examination.

Just the details of your symptoms are not enough to start a radiation treatment as the repercussions are unavoidable and can be dangerous if misdiagnosed. Therefore, the doctor will conduct a few osteosarcoma diagnostic tests before starting the treatment -

• Blood Tests: This generally helps in collecting information about blood counts and if the organs are in proper condition. However, blood tests will not be able to detect the presence of a bone tumour.
• Computed Tomography (CT): This particular test helps check if there are tumours in your lungs.
• Bone Scan: Doctors will inject a small amount of radioactive material into your body in order to look for any bone disorders.
• Biopsy: This process involves collecting a small tissue sample from the affected area of your body, which the medical examiners will study for cancer cells. Generally, a needle or surgical biopsy is used for this procedure.

Other than these, some general tests like X-ray, ET scan, magnetic resonance imaging (MRI), etc., are carried out before starting the treatments for osteosarcoma.

Based on the condition of the tumour or how fast it is growing, how far it has spread, the patient’s age and health condition, doctors begin the treatment process. Here are some common osteosarcoma treatment options -

Surgery

Surgery is helpful in removing the cancerous cells. Any residual cell makes the recovery become difficult. In fact, they further grow into a new tumour. Usually, there are three kinds of surgery, such as limb-sparing surgery, amputation and rotationplasty. The first one is generally used on people whose cancer has not spread that much, and if the tumour is large and affecting the blood vessels, that part has to be amputated. In such cases, the bone is removed during surgery and can be replaced by an artificial limb afterwards.

Chemotherapy

The process involves shrinking the tumour and destroying the cancer cells that are floating around in the blood. Osteosarcoma chemotherapy is usually done before surgery and takes about 10 weeks. However, in some cases, it is also necessary after the surgery to kill any remaining cancer cells. In that case, patients have to undergo adjuvant chemotherapy for another 18 weeks after his/her surgery.

Radiation therapy

Sometimes doctors use external beam radiation therapy to kill the cancer cells that they were unable to take out through surgery. However, this type of therapy is usually applicable if the tumour is in the hip, jawbone or areas where surgery is not possible.

Apart from these, patients suffering from osteosarcoma are also opt for targeted therapy that involves blocking certain proteins important to cancer cells with drugs.

Note that early detection along with an effective treatment by a paediatric oncologist can cure this disease. The emergence of new treatments for osteosarcoma is also increasing the long-term survival rates; however, it is only possible if the tumour has not spread to the lungs.

So, if you are experiencing constant bone pain or swelling, contact your doctor right away!