Osteo - comes from the ancient Greek word for bone, sarcoma – is the name given to cancer. Osteosarcoma is the most common type of primary bone cancer. It starts when bone cells become abnormal, growing out of control to form a lump of cancerous tissue. The cancerous tissue consists of abnormal cells that are attempting to make bone. Being able to see this abnormal bone under a microscope helps to confirm a diagnosis of osteosarcoma. The cause really is unknown but genetics can play a role. The majority of osteosarcoma arises from a single place within the area of a long bone known as the methaphysis, which contains the growing areas of the bone called the epiphyseal plate. The site at which the cancer starts is known as the primary tumor site. A long bone is much longer than it is wide. The best examples being the bones of the limbs: the femur and the humerus.
The three areas most often affected by osteosarcoma are the lower thigh bone nearest to the knee the distal femur 48%, the upper bone nearest to the knee the proximal tibia 27% and the upper arm bone nearest to the shoulder the proximal humerus 15%. Other bones can be affected such as the jaw, the spine, and the pelvis 6%. Tumors found in the bones of the face, skulls and spine are more common in older patients. Osteosarcoma usually behaves in an aggressive manner, which means it can spread in the bloodstream from or though the bone in which it starts to other places in the body. The most common place for it to spread is the lungs. Osteosarcoma can also spread to other places in the body including other bones. That is because osteosarcoma spreads at a early stage, as well as the treatment to the site of the primary tumor, patients needs treatment to the whole body, this is called a systemic treatment. This cancer can affect people of all ages, but is mostly found in older children, teenagers and young adults between the ages of 10 to 24 it affects 75% of this population. This type of cancer affect males slightly, females are mostly common affected approximately 1.4 times more females are affected than males it tends to occur at an earlier age in girls than in boys. That may be because girls have a growth spurt at an earlier age. About 400-1000 new cases are diagnosed per year in the United States.
The most common symptoms that people report and clinical signs are: bone pain, may be intermittent at first then becoming more persistent, especially at night. Swelling, this can be seen if it is on a bone near the surface of the body, but in other places like on the pelvis, it may not be visible. Last but not least, reduced movement on a joint, or a limp. If you have symptoms you might want to go to the doctor “General Practitioner”. He might tell you do to some exams such as: x-rays, blood test, MRI Scan, CT Scan, Bone Scan, PET Scan. He might as well refer you to a Bone Cancer Center or a specialist to perform a biopsy. After performing the entire tests and going to the doctors you might want to go to a Regional Cancer Center for more tests and to start treatment. When you start treatment you need to now three things: How aggressive the tumor is? Low grade: slow growing or high grade: fast growing, How extensive is the cancer? And has the cancer spread? When you decide and feel ready for treatment there are many options.
Options for Treatment:
A. Surgery and Chemotherapy “Systemic Treatment”
B. Chemotherapy then Surgery
C. Surgery, Chemotherapy and Radiation
D. Chemotherapy, Surgery and Non-adjutant (rare type of chemotherapy)
Examples of protocols of chemotherapy are:
The mix of Dexorubicin, Methotrexate, Cisplatin and Ifosfamide or the mix of Carboplatin, Epiribicin, Etoposide and Cytoxan. The combination of medicine depends on the patient weight, the height, the heart function and the age.
Examples of Surgery:
1. Intralesional – curettage, partial tumor removal.
2. Marginal – margin is reactive zone, may leave microscopic tumor behind....
Bibliography: American Cancer Society
The Liddy Shriver Sarcoma Initiative
St. Jude Children’s Research Hospital
National Cancer Institute
The Bone and Cancer Foundation
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