Osteosarcoma is a type of cancer that originates in the bones. Treatment requires exceptional multidisciplinary care that the medical teams at Scripps can provide.
The disease usually forms in the ends of the body’s long bones, including the arms and legs. It is diagnosed each year in approximately 800 people in the U.S., according to the American Cancer Society. About 50 percent of patients are between the ages of 10 and 30.
Osteosarcomas can be localized or metastatic, where cancer has spread beyond the bones to other parts of the body.
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The following tests and procedures may be used to detect and diagnose osteosarcoma:
- Physical exam that includes a check for any signs of disease, including lumps or other abnormalities.
- X-ray of the possible area of cancer to look for tumors or to see if there is any spread beyond the cancer’s origin.
- Computed tomography (CT) scan, which is a painless, non-invasive way to see inside the body using X-ray imaging. Multiple images taken from different angles create cross-sectional images of soft tissue, organs, blood vessels and bone. The digital images can be combined to create 3-D pictures.
- MRI (magnetic resonance imaging) scan to capture detailed images of the inside of the body.
- PET (positron emission tomography) scan that is combined with a CT scan to track the possible presence of cancer cells. During the exam a mildly radioactive substance is injected with a solution of glucose. Cancer cells absorb glucose more quickly than healthy cells and will display on the PET scan.
- Core biopsy or incisional biopsy a small amount of a cancerous tumor is removed with a needle or surgically. The tissue is then examined in a lap to check for cancer cells.
- A bone scan can identify the presence of cells that are rapidly replicating themselves, including cancer cells. During this a bone scan, radioactive dye is injected into a vein. The dye can then be detected by the scanner if it collects in the bones and absorbed by cancer cells.
Treatment of osteosarcoma usually involves a combination of treatments aimed at eliminating the cancer with the fewest side effects and best outcome possible.
Treatment options may include:
The focus of surgery for osteosarcoma is to remove the bone tumor and preserve healthy tissue and bone. These surgeries can be highly complex and may require a bone graft or other procedures. A surgical recommendation will depend on several factors, including the size and spread of the osteosarcoma, the patient’s health and age, as well as other considerations. Surgical options may include:
- Wide local excision, which is the removal of the bone tumor and area of healthy tissue adjacent to the tumor.
- Limb-sparing surgery in which the cancer is removed, while saving a limb. This is most often the case for osteosarcoma cancer that has not grown into nearby vital structures.
- Amputation of the leg or arm for an osteosarcoma that is large and has spread into nerves or blood vessels. A prosthetic limb is fitted and physical rehabilitation is part of the post-surgery treatment plan.
Chemotherapy is commonly used before surgery and after surgery for osteosarcoma. A combination of chemotherapy drugs and doses are used. Scripps offers patients convenient access to infusion centers and physician office infusion facilities across San Diego.
External-beam radiation therapy such as intensity modulated radiation therapy (IMRT) and 3-D conformal radiation may be part of a treatment plan designed to attack any remaining cancer cells post-surgery, or in combination with chemotherapy if the osteosarcoma cancer is not a good candidate for surgery. It may also be used to shrink a tumor before surgery. Scripps offers San Diego’s most advanced radiation therapy options.