What is Osteogenic Sarcoma

Osteogenic sarcoma, commonly called osteosarcoma, is a rare type of bone cancer that causes bone tumors. It often affects the ends of the long bones of the arms and legs.

It can also develop in the hip, shoulder, jaw, or other bones. Osteosarcoma often affects teenagers during times when their bones are growing quickly.

There are three types of osteosarcoma. The type depends on how the cells in the tumor are dividing. The three types are:

• High grade. This type of tumor grows most quickly. With this type, the tumor cells do not look like normal bone tissue, and many cells are dividing.
• Low grade. This type grows most slowly. With this type, the tumor cells look more like normal bone tissue, and not many cells are dividing.
• Intermediate grade. This type of tumor has a growth speed between the other two types. It is not common.

What are the causes?

The cause of this condition is not known.

What increases the risk?

You are more likely to develop this condition if you:

• Are 10–30 years old.
• Are male.
• Have a family history of the condition.
• Have Paget disease.
• Have certain conditions that are passed from parent or child (inherited), such as:
  • Li–Fraumeni syndrome.
  • A type of eye cancer (retinoblastoma).
  • A change in the retinoblastoma gene.
• Are of African-American or Hispanic descent.
• Have a history of:
  • Exposure to high doses of radiation.
  • Bone marrow transplant.
• Are tall for your age.

What are the signs or symptoms?

The most common symptom of this condition is pain in the area of the tumor. Other symptoms vary depending on where the cancer is located. Symptoms may include:

• Increased pain after activity.
• Swelling over the area where the cancer is growing.
• A lump that can be felt over the bone.
• A broken bone (fracture) from a minor injury or for no known reason.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam. Your health care provider may feel for a lump on your bone.
• Imaging tests, such as:
  • X-rays.
  • MRI.
  • CT scan.
  • PET scan.
  • Bone scan.
• A procedure in which a sample of the tumor is removed (biopsy). This lets your health care provider:
  • See how the tumor cells look under a microscope (what grade the tumor is).
  • Determine how big the tumor is and how much it has spread (what stage it is).

Information from the biopsy is important for planning your treatment. Osteosarcoma is staged from stage I to stage III. Stage III is the most advanced. Cancer staging depends on many factors, including the size of a tumor and whether it has spread to your lymph nodes or to other parts of your body (metastasized). Lymph nodes are part of the body’s disease-fighting (immune) system and are often the first place that cancer spreads to.

How is this treated?

Treatment for this condition depends on the grade and stage of your cancer. Treatment may include one or more of the following:

• Chemotherapy. This is the use of medicines to kill cancer cells.
• Surgery to remove the cancerous cells and surrounding tissue. The affected area of the bone will be removed, and nearby lymph nodes may also be removed and checked for cancer cells.
• Radiation therapy. This is the use of high-energy X-rays or gamma rays to kill cancer cells in a specific location in the body. Radiation may be applied from a source outside the body (external beam radiation), or radioactive chemicals may be injected into the body.
• Participating in clinical trials to find out if new (experimental) treatments are effective.

The most common treatment is a combination of surgery and chemotherapy.

Follow these instructions at home:

If you are on chemotherapy:

• Wash your hands often, especially before meals, after being outside, and after using the toilet. Have visitors do the same.
• Avoid crowded places and people who are sick.
• Keep your teeth and gums clean and well cared for. Use soft toothbrushes.
• Protect your skin from the sun by using sunblock and wearing protective clothing.
• Make sure that your family members get a flu shot (influenza vaccine) every year.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take dietary supplements or herbal medicines unless your health care provider tells you to take them. Some supplements can interfere with how well the treatment works.
• Try to eat healthy meals regularly. Some of your treatments might affect your appetite. If you are having problems eating or if you do not have an appetite, meet with a diet and nutrition specialist (dietitian).
• Talk with your cancer care team if you develop side effects from treatment. They may be able to recommend ways to relieve them.
• Avoid contact sports or other rough activities. Ask your health care provider what activities are safe for you.
• Consider joining a support group for people who have cancer.
• Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

• American Cancer Society: www.cancer.org  
• National Cancer Institute (NCI): www.cancer.gov  

Contact a health care provider if you:

• Have pain or swelling that is not relieved with treatment.
• Develop new symptoms.
• Have frequent diarrhea or vomiting while on chemotherapy.

Get help right away if you:

• Have a fever or chills.
• Have trouble breathing.

Summary

• Osteogenic sarcoma is a rare type of bone cancer that causes bone tumors.
• The most common symptom of this condition is pain in the area of the tumor. Other symptoms vary depending on where the cancer is located.
• The most common treatment is a combination of surgery and chemotherapy.
• Talk with your cancer care team if you develop side effects from treatment. They may be able to recommend ways to relieve the side effects.