Bones are an important part as they provide the skeletal structure to the human body. Healthy bones are necessary for a healthy body, especially in children and teenagers, where the growth is ongoing. Any cancerous growth in the bone in this age group may adversely affect their growth and development. One such cancerous condition is osteosarcoma.
About osteosarcoma
Osteosarcoma is a combination of two words “Osteon”, which in Greek means “bone” and the word “sarcoma” refers to “cancer”. Now combine both the words – Osteosarcoma, it is a cancerous condition where the cancer growth is seen in bone. Osteosarcoma is usually formed in the cells called osteoblast, which forms a growing bone. It is a common type of bone cancer found affecting children and teenagers between the age group 10-25 years who are experiencing rapid bone growth. It is also called as osteogenic sarcoma meaning bone forming cancer. In many people, it grows around the bones near the knee region. Osteosarcoma is common in boys than in girls. Osteosarcoma cells exhibit metastasis (spreads), moving to other parts of the body, especially to other bones and lungs.
Causes
As the case with cancer so is with osteosarcoma, the exact cause of osteosarcoma is unknown. It is found that children who are suffering from a rare form of hereditary eye tumor called retinoblastoma are at high risk of developing osteosarcoma. Children with previous history of radiation and chemotherapy are also shown to develop osteosarcoma. The development of tumor is also related to the period of rapid bone growth in children and teenagers. This relationship should also explain why it is more common in boys than girls. The development of cancer during bone growth is attributed to the fact that newly growing bone cells are more vulnerable to damage that is caused by chance or by yet unknown factors. Any pre-existing bone disease may rarely result in osteosarcoma. Other diseases that increase the risk of osteosarcoma are Ollier’s disease (cartilage tumor of bone), osteogenesis imperfect (fragile bone from birth), polyostotic fibrous dysplasia (thinning of more than one bone), and Paget’s disease (bone deformity).
Symptoms
The signs and symptoms of osteosarcoma vary from child to child depending on the location of cancer and the severity of the tumor. There may be pain, swelling and tenderness in the area where the cancer is developing and the pain tends to increase overtime, and worsens during exercise and during nights. A lump can be felt in the affected region with the cancer growth interfering with the movement of bone. The bones may weaken and may result in fractures. Other symptoms include tiredness, fever, rapid and sudden weight loss, and anemia.
The above mentioned symptoms are not sure only for cancer it might be due to other reasons also; therefore if your child complains any pain in the bone, especially in nights, it should be reported to doctor immediately.
Diagnosis
If the symptoms make your physician suspect a bone tumor he would recommend few medical examinations for your child. A general physical examination will be done to check for general signs and symptoms of health. A detailed examination of the area around swelling or lump will be done. He would also ask you about the previous medical history and previous treatments undergone
Physical examination is followed by an X-ray study of the site where the symptoms are present. An X-ray will show the bone condition and if there is a tumor it will usually show up in the X-ray. If your child’s X-ray shows the presence of tumor then your physician will follow up with a magnetic resonance imaging (MRI) or a Computer Tomography (CT) scanning. MRI scanning is useful to check the level of damage occurred to the bones. A CT scanning will show whether the cancerous cells have spread to other parts of the body. Along with this bone scanning of the entire body will be done to see whether the cancer has spread to other bones and to locate the regions where the cancer cells have spread.
Finally, a biopsy will be done using a small sample of tumor cells, which is collected either through a needle or through a small incision. This test is used for perfect diagnosis of osteosarcoma.
After diagnosis of osteosarcoma, doctor (oncologist- cancer specialist) will study the reports to confirm the stage of your cancer. Staging depends on the progress of your tumor. Low-grade or initial cancer are categorized as stage-I, high grade tumor as stage-II, metastatic tumor (spreading) as stage-III. Depending on the stage of cancer treatment procedure for your child will be decided.
Treatment
Before starting treatment for your child your physician might consider many things like size, position, and stage of cancer. The treatment procedure for osteosarcoma consists of combination of chemotherapy and surgery and rarely radiation therapy.
Your child will be given chemotherapy drug intravenously or orally. The drug enters the blood stream and kills the cancerous cells in various part of the body and in circulating blood. It is usually a combination of different drugs. Chemotherapy is suggested before and after surgery to control the spread of tumor to other parts
To obtain permanent cure, a surgical removal of the tumor in any region should be attempted. Usually surgery is done after chemotherapy. Surgery will also be done depending on the location of tumor and your child’s health condition. Sometime surgery involves the complete removal of the arm or a part of arm or leg to avoid spreading of cancer. Most of the patient with osteosarcoma has a limb sparing surgery where the tumor is removed along with the bone where it grew, then the removed bone is replaced with a metal bone called endoprosthesis.
Radiation therapy uses high energy radiations from a machine that is focused on the affected area to shrink the tumor by killing the cancerous cells.
Prognosis
The outcome of treatment procedure depends on various factors like the size and location of tumor, the stage of disease, response to therapy, the age and overall health of the child, and the child’s tolerance to certain medicine or therapy.
The overall success rate of osteosarcoma treatment rate has increased with the development of advanced treatment procedure. If your child has been treated with limb sparing surgery he/she has to regularly follow few simple exercises so that the arms become strong and works well again. After chemotherapy is over, remember to take your child for regular visit to hospital to check his condition. The survival rate of osteosarcoma is about 70%.
Conclusion
As a parent, the fact that your child has cancer can be really the toughest one for you to live with. You may find yourself emotionally weak but it is very important that you try to keep your feeling aside and start positively towards supporting your child in all possible ways. Osteosarcoma can be treated effectively in almost about 80% of children. But the reason for failure of treatment in many is recurrence of osteosarcoma. Researches are going on to find the exact cause of osteosarcoma so that a very effective curable treatment procedure can be found.
