In this blog, we delve into the symptoms, meaning, treatments, and more surrounding this condition. Osteosarcoma, often referred to simply as bone cancer, is a rare but severe form of cancer that originates in the bones, typically in the long bones of the arms and legs. It develops when abnormal cells in the bone tissue multiply uncontrollably, forming a tumor. While osteosarcoma can occur at any age, it most commonly affects teenagers and young adults during periods of rapid bone growth. While osteosarcoma is relatively uncommon, it is essential to understand its nature, symptoms, and available treatment options for those affected by it or seeking knowledge about it.
Osteosarcoma represents a complex and challenging condition that requires careful evaluation and management by healthcare providers. By understanding its symptoms, meaning, and available treatment modalities, individuals affected by osteosarcoma, as well as their families & caregivers, can make informed decisions and access appropriate care. Stay tuned as we dig into each aspect of osteosarcoma in greater detail, providing valuable insights and resources for those navigating this complete guide.
Table of Contents
Osteosarcoma Symptoms
The symptoms of osteosarcoma can differ depending on the location & size of the tumor, but some common signs and symptoms may include:
1. Pain: Persistent or worsening pain in the affected bone is one of the most common symptoms of osteosarcoma. The pain may initially be mild & intermittent but can become more severe over time, especially at night or with activity.
2. Swelling: Swelling or a noticeable lump may develop near the site of the tumor. This swelling may be tender to the touch and can sometimes feel warm.
3. Limited Range of Motion: As the tumor grows, it can interfere with the normal movement of nearby joints, leading to stiffness or a limited range of motion.
4. Fractures: Osteosarcoma weakens the bone, making it more susceptible to fractures or breaks. A fracture may occur suddenly, even with minimal trauma or stress on the bone.
5. Limping: If osteosarcoma affects a bone in the leg, such as the femur or tibia, it can cause limping or difficulty walking due to pain and structural changes in the bone.
6. Unexplained Weight Loss: In some cases, osteosarcoma can cause unexplained weight loss, fatigue, or a general feeling of being unwell. This is more common in advanced or metastatic instances in which the cancer has spread to other parts of the body.
It’s vital to remember that these symptoms can also be caused by conditions other than osteosarcoma. However, if you or someone you know is experiencing persistent bone pain, swelling, or other concerning symptoms, it’s better to consult a healthcare professional for further evaluation and diagnosis.
Osteosarcoma Meaning
Osteosarcoma is a type of cancer that starts in the bone cells. It is also known as osteogenic sarcoma. It is the most common type of bone cancer in children, teens, and young adults, but it can also affect older adults. Osteosarcoma usually affects the long bones of the legs and arms, especially near the joints where the bones grow rapidly. However, it can also occur in any other bone, such as the pelvis, shoulder, or jaw. Osteosarcoma is a serious and life-threatening disease that requires prompt diagnosis and treatment.
Osteosarcoma Treatment
1) Surgery is the main treatment for osteosarcoma. Surgery aims to remove the tumor & any cancer cells that may have metastasized to surrounding tissues. There are two types of surgery for osteosarcoma:
– Limb-sparing surgery: This is a surgery that preserves the affected limb and its function. The surgeon removes the tumor & some surrounding healthy tissue and then reconstructs the bone with a metal implant, a bone graft from another part of the body, or a combination of both. Limb-sparing surgery is possible in most cases of osteosarcoma, especially if the tumor is detected early and has not spread to other parts of the body.
– Amputation: This is a surgery that removes the entire limb or part of it that contains the tumor. Amputation is done when limb-sparing surgery is not possible or safe, such as when the cancer is very large, involves major blood vessels or nerves, or has not responded to chemotherapy. Amputation may also be done if there are complications after limb-sparing surgery, such as infection, poor healing, or implant failure.
The cost of limb-sparing surgery ranges from 3 lakh to 10 lakh rupees (about 4000 to 13000 USD), depending on the type of implant or graft used. The cost of amputation ranges from 1 lakh to 3 lakh rupees (about 1300 to 4000 USD), depending on the level of amputation and the type of prosthesis used.
2) Chemotherapy is a treatment that uses drugs to kill cancer tumors or stop them from growing. Chemotherapy is usually given before and after surgery for osteosarcoma. Chemotherapy before surgery (called neoadjuvant chemotherapy) can shrink the tumor & make it easier to remove with limb-sparing surgery. Chemotherapy after surgery (called adjuvant chemotherapy) can kill any remaining cancer cells & reduce the possibility of recurrence. Chemotherapy for osteosarcoma usually involves a combination of drugs, such as doxorubicin, cisplatin, methotrexate, and ifosfamide.
The cost of chemotherapy ranges from 50,000 to 2 lakh rupees (about 700 to 2600 USD) per cycle, depending on the drugs and doses used. Depending on the response to treatment, the total number of cycles may vary from 6 to 18.
3) Radiation therapy is a treatment that uses high-energy rays or particles to kill cancer tumors or slow their growth. Radiation therapy is not commonly used for osteosarcoma because osteosarcoma cells are not very sensitive to radiation. However, radiation therapy may be used in some situations, such as when surgery is not possible or complete, when there are small areas of cancer spread to the lungs or other organs, or when there are painful bone metastases.
The cost of radiation therapy ranges from 75 thousand to 1.5 lakh rupees (about 1000 to 2000 USD) per session, depending on the type and dose of radiation used. The total number of sessions may vary from 10 to 30, depending on the indication for treatment.
The cost of osteosarcoma treatment in India depends on various factors, such as the type and stage of the cancer, the type and extent of surgery, the number and duration of chemotherapy cycles, the need for radiation therapy, and the choice of hospital and doctor. The approximate cost of osteosarcoma treatment in India may range from 5 lakh to 25 lakh rupees (about 6500 to 33000 USD), which is much lower than the cost in other countries like the USA or UK. However, these are only approximate figures and may vary depending on individual cases and circumstances.
India also has some of the best doctors and hospitals for osteosarcoma treatment in the world. Some of the top hospitals for osteosarcoma treatment in India are:
– Tata Memorial Hospital in Mumbai
– Apollo Hospitals in Chennai
– BLK Super Speciality Hospital in Delhi
– Fortis Hospital in Gurgaon
– Gleneagles Global Hospitals in Chennai
These hospitals have state-of-the-art facilities, advanced technology, experienced surgeons, oncologists, radiologists, pathologists, nurses, and support staff. They also have international accreditations and certifications from reputed organizations such as JCI, NABH, ISO, etc.
Types Of Osteosarcoma
There are several types of osteosarcoma, categorized based on various factors such as location, appearance under the microscope, and genetic characteristics. The main types of osteosarcoma include:
1. Conventional osteosarcoma: This is the most common type of osteosarcoma, accounting for about 80% of cases. It typically occurs in the long bones of the arms and legs, particularly around the knee. Conventional osteosarcoma is further divided into subtypes based on the look of the cancer cells under the microscope, such as osteoblastic, chondroblastic, and fibroblastic subtypes.
2. Telangiectatic osteosarcoma: This type of osteosarcoma has a unique appearance under the microscope, characterized by large cavities filled with blood. Telangiectatic osteosarcoma tends to occur in the long bones, often in the area around the knee.
3. Small cell osteosarcoma: Small cell osteosarcoma is a rare subtype characterized by small, round cancer cells. It tends to occur in the bones of the hands and feet, although it can also affect other bones.
4. Periosteal osteosarcoma: This type of osteosarcoma develops on the surface of the bone, underneath the periosteum (the thin coating of connective tissue that shelters bones). It generally affects the long bones of the arms and legs.
5. High-grade surface osteosarcoma: This subtype is similar to periosteal osteosarcoma but tends to be more aggressive. It develops on the surface of the bone and can spread to nearby tissues.
6. Secondary osteosarcoma: Secondary osteosarcoma refers to osteosarcoma that develops as a complication of a pre-existing condition, such as Paget’s disease of the bone, radiation therapy, or bone infarcts. It is less common than primary osteosarcoma.
Each type of osteosarcoma may have distinct clinical features, treatment approaches, and prognoses. Treatment typically involves a mixture of surgery, chemotherapy, & sometimes radiation therapy tailored to the individual characteristics of the tumor and the patient.
Ewing Sarcoma Vs. Osteosarcoma
Ewing sarcoma and osteosarcoma are both types of bone cancer, but they have distinct characteristics:
1. Ewing Sarcoma:
– Origin: Ewing sarcoma originates in bone or soft tissue, usually in the long bones of the body, like the femur, tibia, or humerus.
– Age of Onset: It primarily affects children and young adults, with most cases diagnosed between the ages of 10 and 20.
– Genetic Mutation: Ewing sarcoma is associated with a specific genetic mutation involving the fusion of the EWSR1 gene with another gene, most commonly the FLI1 gene.
– Symptoms: Common symptoms include localized pain, swelling, and sometimes fever.
– Metastasis: It tends to metastasize to other parts of the body, particularly the lungs and bones.
– Treatment: Treatment typically involves a combination of chemotherapy, surgery to remove the tumor, & radiation therapy. Targeted therapies and immunotherapies may also be used in some cases.
2. Osteosarcoma:
– Origin: Osteosarcoma also originates in the bone, typically in the areas where new bone tissue forms, such as near the ends of the long bones.
– Age of Onset: It most commonly occurs in children, adolescents, and young adults, with a peak incidence during the teenage growth spurt.
– Genetic Factors: While some cases of osteosarcoma may be associated with genetic factors, specific genetic mutations are not as well-defined as in Ewing sarcoma.
– Symptoms: Symptoms may include pain, swelling, and sometimes a noticeable lump in the affected area.
– Metastasis: Osteosarcoma also has the potential to metastasize, typically to the lungs.
– Treatment: Treatment often involves a combination of chemotherapy and surgery to remove the tumor. Radiation therapy may be used in some cases, but it is less common than for Ewing sarcoma.
In summary, while both Ewing sarcoma and osteosarcoma are types of bone cancer that primarily affect children and adolescents, they differ in their genetic characteristics, age of onset, and specific treatment approaches.
Osteosarcoma Causes & Risk Factors
Osteosarcoma is a type of bone cancer that primarily affects the cells that form bones. While the exact causes of osteosarcoma are not fully understood, several risk factors have been recognized:
1. Genetic factors: Some cases of osteosarcoma have been linked to genetic syndromes such as Li-Fraumeni syndrome and hereditary retinoblastoma. These conditions increase the risk of developing osteosarcoma.
2. Radiation exposure: Exposure to increased levels of radiation, whether due to radiation therapy for other cancers or exposure to radioactive materials, can increase the risk of developing osteosarcoma.
3. Bone diseases: Certain bone diseases, such as Paget’s disease, may increase the risk of developing osteosarcoma.
4. Age: Osteosarcoma most commonly occurs in children, teenagers, and young adults, particularly during periods of rapid bone growth. However, it can occur at any age.
5. Gender: Osteosarcoma occurs slightly more frequently in males than in females.
6. Previous cancer treatment: Previous treatment with certain chemotherapy drugs, particularly those called alkylating agents, may increase the risk of developing osteosarcoma.
7. Bone trauma: While rare, some cases of osteosarcoma have been associated with previous bone injuries or trauma.
It’s important to note that having 1 or more risk factors does not mean that an individual will certainly acquire osteosarcoma. Many people with one or more risk factors never develop this cancer, while others with no known risk factors do. Osteosarcoma remains a relatively rare form of cancer, and most cases occur sporadically without a clear cause.
Osteosarcoma Prognosis
The prognosis of osteosarcoma depends on many factors, such as the stage of cancer, the location and size of the tumor, the response to treatment & the age and overall health of the patient. The survival rate for osteosarcoma is based on statistics that show how many people with this disease are still alive after a certain time (usually 5 years). However, these statistics are only averages and do not reflect individual cases. Many factors can affect survival, such as how well a person responds to treatment and how quickly they get treatment.
Survival rates are estimates that show how likely a person with a certain type and stage of cancer is to survive for a specific period after diagnosis. Survival rates are usually based on previous outcomes of large groups of people who had the same cancer, but they cannot predict what will happen in any individual case. Survival rates are also influenced by many factors that are not taken into account by these statistics, such as:
– The type and location of osteosarcoma
– The response to treatment
– The age and overall health of the patient
– New treatments that may become available
One way to measure survival rates is by using relative survival rates, which compare people with osteosarcoma to people in the general population who do not have cancer. For example, suppose the five-year close survival rate for a certain stage of osteosarcoma is 70%. In that case, it means that people who have that stage of osteosarcoma are 70% as likely as people who do not have cancer to live for at least 5 years after diagnosis.
According to the American Cancer Society, based on data from people diagnosed with osteosarcoma between 2012 and 2018 in the United States, the five-year relative survival rates by stage are:
– Stage I: 91%
– Stage II: 73%
– Stage III: 61%
– Stage IV: 27%
These numbers are based on the MSTS staging system. If using the TNM staging system, the five-year relative survival rates by stage are:
– Stage IA: 91%
– Stage IB: 73%
– Stage IIA: 73%
– Stage IIB: 61%
– Stage III: not reported
– Stage IVA: 27%
– Stage IVB: not reported
It is important to note that these numbers are averages and do not reflect individual cases. Some people may have a better or worse prognosis than these statistics suggest. Also, these numbers are based on people who were diagnosed & treated at least five years ago. Since then, there have been improvements in diagnosis and treatment that could affect the survival rates of people currently diagnosed with osteosarcoma.
Stages Of Osteosarcoma
There are different ways to stage osteosarcoma, but one common system is the Musculoskeletal Tumor Society (MSTS) system, also known as the Enneking system. This system is based on three factors:
– Tumor Grade (G): This tells us how likely a tumor is to grow and spread. There are two grades: low (G1) and high (G2). Low-grade tumors look more normal and aren’t as fast-growing as high-grade ones, which look more unusual.
– The extent of the primary tumor (T): This shows if the tumor has stayed within the bone (T1) or spread beyond it into nearby areas (T2).
– Metastasis (M): This is when cancer has spread to other parts of the body like the lungs or brain. Metastasis is either absent (M0) or present (M1).
Using these factors, osteosarcoma can be divided into six stages:
– Stage I: The tumor is low grade (G1) and intracompartmental (T1). There is no metastasis (M0).
– Stage II: The tumor is high-grade (G2) and intracompartmental (T1). There is no metastasis (M0).
– Stage III: The tumor is high-grade (G2) and extracompartmental (T2). There is no metastasis (M0).
– Stage IV: The tumor is any grade and any extent. There is metastasis (M1).
– Stage V: The tumor has recurred after treatment. The recurrence can be local or distant.
– Stage VI: The tumor has developed in multiple bones at the same time. This is very rare.
The stage of osteosarcoma affects the treatment options and the prognosis. In general, localized osteosarcomas have a better chance of being cured than metastatic or recurrent ones. However, even localized osteosarcomas may have a microscopic spread that tests cannot detect. Therefore, chemotherapy and surgery to remove the tumor are important parts of treatment for most osteosarcoma.
Osteosarcoma Diagnosis
If you or your child has any symptoms of osteosarcoma, you should see a doctor as soon as possible. The physician will conduct a physical examination of the affected limb and ask about your medical and family history. The doctor may also order some tests to affirm the diagnosis & determine the extent of the disease. These tests may include:
– X-ray: An X-ray of the bones can show the presence and location of a tumor. It can also reveal if the tumor has caused any damage to the bone structure or nearby tissues.
– CT scan: A CT scan can give more precise images of the bones and other organs. It can help measure the size and shape of the tumor and show if it has spread to other parts of the body.
– MRI scan: An MRI scan can produce high-resolution images of soft tissues like muscles, nerves, blood vessels, and bone marrow. It can help assess how deep the tumor has grown into the bone and surrounding tissues and show if it has affected any nearby nerves or blood vessels.
– Bone scan: A bone scan can see if there are any abnormal areas of bone activity in the body. It can help identify if there are any other bones affected by osteosarcoma or other conditions.
– Biopsy: It is a diagnostic procedure that involves taking a small amount of tissue from the tumor for microscopic examination. It is the only way to confirm that the tumor is osteosarcoma and to determine its grade (how fast it grows and spreads). A biopsy can be done by putting a thin syringe through the skin into the tumor (needle biopsy) or by making a small incision in the skin & taking a piece of tissue (open biopsy).
Conclusion
In conclusion, osteosarcoma is a rare but aggressive form of bone cancer that primarily affects adolescents and young adults. Recognizing its symptoms, such as bone pain and swelling, is crucial for early detection and prompt medical intervention. While the prognosis can vary depending on factors such as the tumor’s size and location, advancements in medical research continue to improve outcomes and quality of life for individuals battling osteosarcoma. Early diagnosis, comprehensive treatment plans, and ongoing support are essential in the fight against this challenging disease.
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