Osteosarcoma is cancer of the bone. The cancer (malignant) cells make immature bone cells (osteoid). Osteosarcoma is very rare, but it is the most common type of bone cancer in children and teens. It is most common in teens and young adults.
The cancer most often grows in the ends of long bones, especially the bottom of the thigh bone (femur) and the top of the larger shin bone (tibia). The top of the upper arm bone (humerus) is another common place it grows.
The types of osteosarcoma include:
A child with one of certain rare genetic cancer syndromes may be at higher risk of osteosarcoma. Having radiation or chemotherapy treatment for other cancers also increases the risk.
Other risk factors for osteosarcoma include:
Symptoms can occur a bit differently in each child. They can include:
The symptoms of osteosarcoma can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.
Your child's healthcare provider will ask about your child's health history and symptoms. He or she will examine your child. Your child may be referred to a specialist. This may be a bone specialist (orthopedic surgeon) or a bone cancer specialist (orthopedic oncologist). Your child may have tests such as:
After a diagnosis of osteosarcoma, other tests will be done. These help your child's healthcare providers learn more about the cancer. They will show how much and how far the cancer has spread (metastasized) in your child's body. A stage grouping is then assigned.
The most commonly used system uses stage groupings with a value of 1 to 3. They are written as Roman numerals I, II, and III. Some staging systems add a stage 4 (IV). The higher the number, the more advanced the cancer is. Letters and numbers can be used after the Roman numeral to give more details.
Staging for osteosarcoma also takes into account the grade of the cancer. This is a measure of how much the cancer cells look like normal cells. A 1 or 2 is used. In grade 1 tumors, the cancer cells look a lot like normal cells and tend to grow and spread slower than grade 2. This may also be called a low-grade tumor. Grade 2 may be called high grade, and the cells look very different from normal cells.
The stage of a cancer is one of the most important things to know when deciding how to treat the cancer. Be sure to ask your child's healthcare provider to explain the stage of your child's cancer to you in a way you can understand.
Treatment will depend on the stage and other factors. The cancer can be treated with any of the below:
With any cancer, how well a child is expected to recover (prognosis) varies. Keep in mind:
A child may have complications from the osteosarcoma or from treatment, such as:
A child with osteosarcoma needs ongoing care. Your child will be seen by oncologists and other healthcare providers to treat any late effects of treatment and to watch for signs or symptoms of the tumor returning. Your child will be checked with imaging tests and other tests. And your child may see other healthcare providers for problems from the tumor or from treatment. Your child may need therapy to help with movement and muscle strength. This may be done by physical and occupational therapists.
You can help your child manage his or her treatment in many ways. For example:
Call the healthcare provider if your child has:
Tips to help you get the most from a visit to your child’s healthcare provider: