The most common type of bone cancer is Osteosarcoma, also known as childhood bone cancer. Osteosarcoma is also the 6th most common type of cancer found in children. Since osteosarcoma develops from osteoblasts (the cells responsible for making bones grow), osteosarcoma symptoms are seen predominantly in teenagers who are experiencing a growth spurt, especially during puberty. Although medical science has seen great advancements, it’s always overwhelming when the cancer is diagnosed. So, understanding more about this childhood bone cancer may help parents to cope with the situation. Therefore, this article aims at educating the people about osteosarcoma symptoms, osteosarcoma causes and treatments.

Signs, Symptoms, Causes & Treatments for Osteosarcoma (Childhood Bone Cancers)

Childhood Bone Cancers

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In today’s era, more kids than ever are the victims of childhood bone cancer. These kids suffering from childhood bone cancer experience common osteosarcoma symptoms such as pain in arms and legs, lump formation and limping. Osteosarcoma is most commonly seen in teenagers and is very rare in kids under the age of five. Also, as boy tend to grow taller more quickly than girls, they are at greater risk of having Osteosarcoma symptoms than girls. Therefore, the earlier one recognizes the osteosarcoma symptoms, the faster and more efficient will be the prognosis and treatment for Osteosarcoma.

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Osteosarcoma Causes and Risk

Osteosarcoma causes are not yet known, however, Osteosarcoma is generally seen in teenage boys and evidence suggests that teenagers who are taller than children of average heights are at an added risk of developing the disease. This childhood bone cancer develops at the ends of the long bones which are the origin of the formation of new bone tissue as the body grows. Bones of arms and legs, especially near knee and shoulder joints are most affected. The bone tumor could also develop in pelvis or jaw. Though a definite cause for the Osteosarcoma is unknown, there are few risk factors that are associated with this disease.

Most of the risk factors of Osteosarcoma cannot be changed. Mentioned below are some of the common risk factors or (Childhood Bone Cancers) Osteosarcoma Causes:

  • Height: A child who’s unusually tall or whose bones are growing at an unusual rate
  • Genetic syndromes: If a genetic syndrome is passed on to the child, then the risk of developing Osteosarcoma is high in that child. A genetic syndrome is caused by the mutation of genes. Familial retinoblastoma, Li-Fraumeni syndrome, Werner syndrome and Bloom syndrome are such genetic syndrome which increases the risks of bone cancer at the very early age.
  • Previous cancer treatment: Since radiation is a trigger for DNA mutations, children who have previously received treatments like radiation therapy and chemotherapy for some other type of cancer are also at risk for Osteosarcoma.
  • Injury of bone: Though any damage or injury to bones is not accountable for this bone cancer, they increase the chances of developing it.

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Osteosarcoma Symptoms

Although, osteosarcoma causes may not be known. What is known to medical science is that, osteosarcoma usually begins from places where bones are growing quickly such as around the long bones of arms and legs like shins, thighs or knees. So, the signs and Osteosarcoma symptoms of this bone cancer of children vary depending on the area of bone or the kind of bone from where it originates. Unlike other cancers,  Osteosarcoma symptoms are visible months before the diagnosis of the disease. If your child shows following Osteosarcoma symptoms, consult with the good orthopaedist:

  • Pain: The most common osteosarcoma symptoms include pain in your child’s arms or legs. It is usually felt in the joint or a bone close to the tumor. This pain often looks like a sports injury but gradually worsen which cannot be relieved by mild pain medications. The pain can be worse during nights or when exerting your body.
  • Limp: This is one of the osteosarcoma symptoms, wherein, unexplained limp in the leg of your child, is also the strong osteosarcoma symptoms.
  • Swelling or lump: Swelling or a soft lump is also another type of osteosarcoma symptoms, that may also be developed around the affected area. Due to a lump, it becomes easier to feel a tumor but in the chest or pelvis, it becomes hard to notice until it grows.

Other Osteosarcoma Symptoms include:

  • Stiffness and tenderness at the origin of the tumor
  • Limited movement or motor skills
  • Weak and brittle bones causing frequent fractures
  • Anemia
  • Fatigue
  • Weight Loss

Osteosarcoma developed around the spinal cord may cause severe back pain which radiates outwards to arms or legs. In other cases, the first sign of this disease can be a broken arm or leg, due to the fact that cancer weakened the bones, making them vulnerable to injuries. So, the earlier this cancer is diagnosed, the higher the chances of a successful treatment.

Osteosarcoma Diagnosis

After successful detection of Osteosarcoma symptoms, doctors can undertake an appropriate action for osteosarcoma treatment. Doctors, to diagnose bone cancer perform a physical exam and ask for a detailed medical history of the patient. They will also order X-rays to help detect changes in the bone structure, and sometimes an MRI scan of the bones helps understand the best area for the biopsy while also showing whether the disease has spread from the bones to surrounding muscles and fat.

  • Bone biopsy: A bone biopsy might also be required to get a sample of a tumor for further examination in the lab. The biopsy is the only definitive diagnostic test.

If the correct detection of osteosarcoma symptoms and diagnosis is made, CT chest scans and bone scans are ordered to show whether cancer has spread to more parts of the body. These tests will be repeated after treatment starts to determine how well it is working and whether the bone cancer is continuing to spread or not.

  • Grading: This is done under the microscope to determine the rate at which cancer cells are developing. Low-grade cancer cells increase very slowly, thus are less likely to spread to other parts of the body whereas high-grade tumor cells are rapidly-growing cancer cells which spread to lungs and other parts of the body at a much quicker rate.

Osteosarcoma Stages

Once the grading and all diagnostic tests are finished, staging of a tumor is carried out to know the origin of the tumor, its size, growth and if it’s affecting other parts of the body. Different stages of Osteosarcoma show different Osteosarcoma symptoms.  Following are the osteosarcoma’s stages:

  • Localized: In this stage, the tumor is low-grade and not yet spread, it is still in the origin site and tissue around it.
  • Metastatic: This is the second stage in which the tumor has spread from the origin site to other parts, most likely lungs, and other bones.
  • Recurrent: This is the stage where the tumor has come back or relapsed during or after treatment. Mostly, it comes back in lungs and bones and in the case of recurring, the staging needs to be done again, called re-staging.

Knowing the Osteosarcoma symptoms and stages help the doctors to decide the best osteosarcoma treatment plan for the patient and it can also be used to predict the prognosis of the disease, the chance of recovery.

Treatments For Osteosarcoma

Treatment of the osteosarcoma depends mainly on the size, location and the stage of the tumor cells. Depending on the child’s needs, the doctor may suggest a combination of different treatments to treat your child. The paediatric oncologist may suggest the following treatment depending on the needs of the child:

  • Chemotherapy: This is the most common treatment for childhood bone cancer given to the kids before or after surgery to remove the bone tumor. This is used to target the primary tumor as well as cancerous cells that are already spread to other parts but not has been detected yet. Chemotherapy is installed through an implantable venous port in the chest which remains there during the duration of the therapy.
  • Surgery: Surgery is used to remove the tumor as well as to restore the function of the part of the body where the tumor is located. This may include the removal of the whole limb called amputation or part of the damaged bone called limb-sparing surgery. The removed part is replaced by false limb called prosthesis. Amputation of the limb is carried out when cancer has spread to the surrounding blood vessels as well as nerves. After the surgery, a false limb or prosthesis is fitted which helps your child to carry out his normal routine and even sports activities.
    • In limb-sparing surgery also, a prosthesis is fitted but in some cases, a bone-grafting can also be done. In bone-grafting, the part of the affected bone is replaced by the bone taken from another part of the body.
  • Radiotherapy: In this, high energy rays are used to destroy the cancer cells while doing very little damage to the healthy cells.

Side effects or complications of Osteosarcoma Treatment

Treatment of cancer often leads to various side effects and complications, so it’s best to discuss it with the doctor before the treatment starts. If one is aware of the various Osteosarcoma symptoms, one can undergo the following osteosarcoma treatment options given below.

  • Chemotherapy side effects:
    • Nausea
    • Hair loss
    • High-risk of infection
    • Bruising
    • Bleeding
    • Tiredness
  • Radiotherapy side effects:
    • Irritation
    • Soreness
    • Tiredness
  • Surgery Side Effects:
    • Slow healing of the wound
    • Prosthesis or bank bone needs to be replaced as the body grows
    • Fracture of the bank bone
    • Failure of the bank bone

Bone Cancer in Children – Osteosarcoma New Treatment Options

Medical scientists have researched a new type of biological therapy treatment called Mifamurtide or Mepact which is given to the patient who has undergone a surgical resection to remove the bone tumor. It will be injected along with the chemotherapy to stop the recurrence of the bone cancer. As it is a new drug, more research needs to be done before bringing it in action.
For tumors, which cannot be removed surgically, researchers are doing a study on combinations of treatments like chemotherapy and localized radiation that targets only on tumor cells.

  • Survival Rate
    Chances for cure are 60%-80% for cancer which has not spread to other parts. Also, the bone cancer in arm or leg has a better prognosis than the tumor present in ribs, spine, shoulder blades or pelvic bones.
  • Follow-up Care
    After the treatment, your child may need to visit the doctor for regular check-ups and x-rays. The follow-up care is required to ensure cancer has not recurred, manage side effects and complications and also monitor the patient’s overall health. The follow-up care may include regular medical tests, physical examinations for keeping the track of the child’s recovery. Also, he/she may need a surgery to lengthen the affected bone or limb as they grow.

If you found any symptoms of Osteosarcoma then you may consult in Narayana Hospital Raipur

  • Supportive Care
    This plays an important part in the rehabilitation of the child as it helps both the family and the patient to meet the physical and emotional challenges of cancer. Supportive care focuses on improving the quality of life of children and encourages them to cope up with cancer, treatment and mainly the side effects of the treatment. There are many centres and programs available to help the children and their loved ones to come out of the life of cancer.

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