Osteosarcoma – Definition and Causes

What Is Osteosarcoma?

Osteosarcoma, also called osteogenic sarcoma, is a kind of bone cancer. It happens when the cells that grow new bone form a cancerous tumor. Treatment — chemotherapy and surgery to take out the tumor — is usually successful when the disease is diagnosed early, before it can spread.

Anyone can have osteosarcoma, but it’s the most common kind of bone cancer in children and teens. Teenage boys are most likely to get it.

Causes

It’s not clear what causes osteosarcoma. Doctors know this cancer forms when something goes wrong in one of the cells that are responsible for making new bone.

Osteosarcoma begins when a healthy bone cell develops changes in its DNA. A cell’s DNA contains the instructions that tell a cell what to do. The changes tell the cell to start making new bone when it isn’t needed. The result is a mass (tumor) of poorly formed bone cells that can invade and destroy healthy body tissue. Cells can break away and spread (metastasize) throughout the body.

Risk factors

These factors increase the risk of osteosarcoma:

1. Previous treatment with radiation therapy

2. Other bone disorders, such as Paget’s disease of bone and fibrous dysplasia

3. Certain inherited or genetic conditions, including hereditary retinoblastoma, Bloom syndrome, Li-Fraumeni syndrome, Rothmund-Thomson syndrome and Werner syndrome

Complications

Complications of osteosarcoma and its treatment include:

Cancer that spreads (metastasizes). 

Osteosarcoma can spread from where it started to other areas, making treatment and recovery more difficult. Osteosarcoma that spreads most often spreads to the lungs and to other bones.

Adapting to limb amputation. Surgery that removes the tumor and spares the limb is used whenever possible. But sometimes it’s necessary to remove part of the affected limb in order to remove all of the cancer. Learning to use an artificial limb (prosthesis) will take time, practice and patience. Experts can help you adapt.

Long-term treatment side effects.

 The aggressive chemotherapy needed to control osteosarcoma can cause substantial side effects, both in the short and long term. Your health care team can help you manage the side effects that happen during treatment and provide you with a list of side effects to watch for in the years after treatment.

Physiotherapy Management

Osteosarcoma should be treated at large medical centers where a multi-disciplinary team including physiotherapists, occupational therapists, pediatricians, surgeons, psychologists and nursing staff will help manage the patient care. In an oncology setting, physiotherapists manage the patient’s musculoskeletal, neuromuscular, integumentary and cardiopulmonary rehabilitation needs.

Physiotherapy interventions will consist of early postsurgical mobility training, strength and endurance restoration, pain control, and education and training of family members in helping patients with limited mobility. Physiotherapists will help to correct balance and coordination impairments, make recommendations for home modifications that will enhance the patient’s independence, and educate and train the family members to assist and enable the patient to function independently. In addition, physiotherapists will train the patient in stump management and training with the prostheses for those patients who undergo amputation.

Rehabilitation following limb sparing procedures or amputations focuses on retraining muscles, increasing strength and endurance, balance and range of motion as well as helping the patient return to school or work activities.

It is of vital importance for the physiotherapist to educate the patient and the adolescent’s family in appropriate strength training protocols and precautions of overuse post discharge with a limb-sparing procedure. 

It is also not uncommon to have a total knee replacement if the tumor is located near the distal femur and proximal tibia. These patients are frequently young adolescents eager to return to full activities and may place their salvaged limbs at risk if they proceed too aggressively at discharge.

For more details, appointments and specific information, contact PCA at 08130280496.