Osteosarcoma is the most common type of cancer that begins in you or your teenager’s bones, usually in the arms or legs. Limited movement, bone pain, a lump and an unexplained broken bone are the most common symptoms. Many treatments are available. If the osteosarcoma doesn’t spread to other parts of the body, the survival rate is around 70%.
Osteosarcoma (osteogenic sarcoma) is a type of cancer that starts in your bones. In the beginning, the cancer cells appear to be regular bone cells. Then, they create tumors, and those tumors create immature, irregular, diseased bone. It is most often seen in teenagers, with the average age of diagnosis of osteosarcoma being 15.
A “sarcoma” is a type of cancer that develops in connective tissue such as bone, cartilage, or muscle. “Osteo” refers to bones.
Osteosarcoma most often affects long bones, such as those in the arms and legs. It usually occurs near the ends of your bones (the metaphyses) and near your knee where the fastest growth is taking place (if you’re a teenager). The bones and areas most often affected include the:
Other less common locations for osteosarcoma include your:
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There are trillions of cells in your body. Every day they grow, divide and form new cells. Cells die when they get old or damaged. Cancer happens when cells that should’ve died survive and new cells form when they’re not needed. This uncontrolled growth of cells eventually leads to enough extra cells that make masses. These masses are called “tumors.”
Osteosarcoma is one of many types of cancer.
A tumor is a lump or mass. Most cancers form tumors. Not all lumps are cancerous, so your healthcare provider will have to take a piece of the lump (by a biopsy) to determine if it is benign (not cancerous) or malignant (cancerous).
Osteosarcoma tumors can be categorized as low-grade, intermediate-grade, or high-grade. Low-grade means that your cancer will grow slowly and remain where it began (localized), while high-grade indicates that it will spread quickly and metastasize. (“Metastasize” is the process of cancer spreading to other parts of your body.)
Most osteosarcoma tumors found in children and teenagers are high-grade. The cells of high-grade osteosarcoma don’t look like normal bone under a microscope. There are nine types of high-grade osteosarcomas:
There is one type of immediate-grade osteosarcoma:
And, there are two types of low-grade osteosarcomas:
Osteosarcoma most often affects pre-teens and teens; the average age at diagnosis is 15. More than 75% of the cases are people less than 25 years old. This may be related to the “growth spurt” most teens experience at that age. Osteosarcoma can also occur in children and young adults.
Osteosarcoma is slightly more common in African Americans. Before adolescence, it occurs equally in males and females. After adolescence, it occurs slightly more often in boys, possibly because of a longer period of skeletal growth.
You’re at a higher risk of osteosarcoma if you:
Between 400 and 1,000 new cases of osteosarcoma are diagnosed in the United States each year.
Osteosarcoma accounts for about 3% of all childhood cancers. It is the most common primary bone tumor in children. Osteosarcoma is the third most common cancer in adolescence (after lymphomas and brain tumors).
Osteosarcomas can cause pain. If there are tumors in the bones of your arm, for example, it may be painful to lift things. If the tumors are in the bones of your legs, it may cause limping. However, osteosarcomas can also be painless.
People have reported that, yes, osteosarcoma pain is worse during activity and at night. It is unclear why this happens.
Maybe. Sometimes the mass (tumor) can be felt through the skin, but other times they are either too small or too deep to be felt.
If the osteosarcoma doesn’t metastasize, survival rates are about 70%. If the cancer has spread to other parts of your body, your survival rate may be as low as 30% to 50%.
The direct cause of osteosarcoma is unknown. However, there are some risk factors, including:
The most common symptoms of osteosarcoma include:
Your healthcare provider will begin with a thorough history and physical examination. They’ll ask about your symptoms and medical history; for example, any prior radiation treatment or whether anyone in your family has certain hereditary conditions. They’ll also look for lumps that may be protruding from bones.
Your healthcare provider might also use certain tests when making the diagnosis. These include:
After your healthcare provider diagnoses osteosarcoma, the next step is to find out if the cancer cells have spread of if they’ve remained localized. This is called “staging.” The cancer can spread through your blood, your lymph system, or tissues. If the cancer enters your lungs, it’s still referred to as osteosarcoma, not lung cancer. The following diagnostic tools may be used:
The most common forms of treatment for osteosarcoma are:
It takes a team of healthcare providers to treat osteosarcoma. If your child has osteosarcoma, the team will be led by a pediatric oncologist (a physician who works with children who have cancer). They may add the following specialists to the team:
Yes. Side effects may stick around for months or even years. They might include:
At this time, no, osteosarcoma can’t be prevented.
Unfortunately, research finds that there is nothing that can be done to prevent osteosarcoma.
There are no foods or drinks you should eat or avoid to reduce your risk of osteosarcoma.
The outlook depends on many factors, including:
Because of improvements in chemotherapy, surgery, radiation and control of side effects, more people with osteosarcoma are achieving better results, experiencing full recovery and living longer.
Survival rates are almost 70% for patients whose osteosarcoma hasn’t metastasized. If the osteosarcoma has spread to more than one part of the body, the survival rate drops to 30% to 50%.
Yes, recurrence can happen sometimes, typically within 18 months following treatment.
Maintaining or reclaiming a good quality of life is vital before, during and after treatment for osteosarcoma. You should not only take care of your physical health, but your mental/emotional health as well. See a therapist for counseling and, if necessary, a psychiatrist for medication (be sure to provide a list of your medications to all of your healthcare providers so that there are no problems).
Educate your friends and family about your condition. Help them understand your abilities and limits, especially as it relates to surgery, be it a limb-sparing surgery, rotationplasty or an amputation.
Checking in with your healthcare provider is vital. They’ll have to check periodically for signs of recurrence, treatment complications and metastasis. Initially these visits will be more frequent (every three to six months), and as you get further from treatment they will be spaced out (yearly). These visits will likely involve:
Contact a healthcare provider for persistent bone pain, tenderness, or swelling.
A note from Cleveland Clinic
Living with osteosarcoma isn’t easy. First there’s the pain, swelling, limited movement and, possibly, broken bones. Then there’s the pain of treatment and the lengthy recovery. After that you may have to adjust to a prosthetic limb and/or attend many follow up appointments to check for recurrence. Cancer is exceptionally challenging, but your healthcare providers are there to help as much as possible. There are many treatments available to both save your life and improve the quality of your life. Work closely with your healthcare providers and get support from your family and friends.
Last reviewed by a Cleveland Clinic medical professional on 02/24/2021.
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