Osteosarcoma: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Osteosarcoma is a type of bone cancer that originates in the cells that make up bones. Osteosarcoma can start in any bone, but it usually appears in the long bones, especially the arms and legs. It very seldom occurs in soft tissue that is not bone-anchored.

Osteosarcoma is more common in teens and young adults, while it can also afflict younger children and older adults.

Treatment options include radiation therapy, surgery, and chemotherapy. When deciding on a treatment plan, the doctors take into account several aspects, including the osteosarcoma's location, the cancer's size, type, and grade, as well as if it has progressed outside of the bone.

Treatment developments over the years have improved osteosarcoma prognosis (or future course) considerably. After receiving aggressive therapy, it is essential to monitor patients for the rest of their lives to look for any potential adverse effects.

Causes Of Osteosarcoma 

It is uncertain what causes osteosarcoma. Doctors are aware that a defect in a cell responsible for producing new bone leads to the development of this malignancy.

Osteosarcoma begins when changes are made to a healthy bone cell's DNA. A cell's DNA contains instructions that tell it what to do. When new bone formation is not needed, the changes tell the cell to start. The result is a mass of abnormal bone cells called a tumour that can penetrate and kill healthy bodily tissue. Cells can divide and spread (metastasize) throughout the body.

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Symptoms Of Osteosarcoma

Signs and symptoms of osteosarcoma may comprise, but are not restricted to:

• Edoema adjacent to a bone
• Bone fracture or damage with no clear cause
• Joint pain, or bone pains

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Risk Factors Of Osteosarcoma

The likelihood of osteosarcoma is increased by the following factors:

• Previous administration of radiation therapy
• Other disorders of the bones, such as fibrous dysplasia and Paget's disease of the bones
• Certain genetic or inherited conditions, include hereditary retinoblastoma, Werner syndrome, Li-Fraumeni syndrome, Bloom syndrome, and Rothmund-Thomson syndrome

Diagnosis Of Osteosarcoma

Before diagnosing osteosarcoma, the physician may do a physical examination to have a deeper understanding of the symptoms.

Imaging tests

Imaging scans help your doctor find signs of metastasis, detect cancer, and look into any bone issues you may be having.

Imaging tests could include the following:

• Computerised tomography
• X-ray
• Magnetic resonance imaging is referred to as MRI.
• Positron Emission Toxin

Biopsy

A biopsy requires the removal of a cell sample from a tomography bone scan.

A biopsy is a procedure used to obtain a sample of suspicious cells for laboratory analysis. It is possible to test for cancerous cells. Laboratory tests are used to determine the kind and grade of cancer.

The osteosarcoma is diagnosed by the biopsy methods listed below:

• Using a needle for biopsy: The doctor makes a tiny needle incision through the skin and guides it into the tumour. The needle is used to remove tiny tissue fragments from the tumour.
• Biopsy via a surgical procedure: The doctor removes the tumour entirely (excisional biopsy) or just a portion of it (incisional biopsy) by a skin incision.
• The type of biopsy that is needed and the best way to perform it are decisions that the medical team must make with great consideration. Doctors have to do the biopsy in a way that won't interfere with planned cancer excision procedures. For this reason, ask your doctor to refer you to a team of specialists who specialise in treating osteosarcoma before the biopsy.

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Treatment Of Osteosarcoma

Surgery and chemotherapy are the usual treatments for osteosarcoma. Radiation therapy could be an option in some situations.

Surgery

The goal of surgery is to eradicate every cancer cell. But the process planning also takes into consideration how it can affect your daily routine. The extent of surgery needed for osteosarcoma depends on two key factors: the tumour's location and size.

The following methods are applied in the treatment of osteosarcoma:

• Surgery is restricted to the removal of the cancer (limb sparing). Most osteosarcoma procedures can be done in a way that leaves the affected area unaffected and removes all cancer, maintaining limb function. The extent of the cancer, among other things, will dictate whether or not this procedure is necessary and how much muscle and tissue need to be removed.

If part of the bone needs to be removed, the surgeon will reconstruct it. The procedure of reconstructing will depend on your particular circumstances, but options may include metal prostheses or bone grafts.

• Surgery for amputation is used to remove the injured limb. Thanks to advancements in limb-sparing surgery, the necessity for amputations the removal of a limb or part of a limb has dramatically declined over time. When amputation is necessary, new advancements in prosthetic joints can significantly improve prognosis and functionality.
• "Rotationplasty" surgery is used to remove the lower leg. This treatment, which is occasionally carried out on children who are still developing, entails the surgeon removing cancer along with the surrounding tissue, including the knee joint. The ankle then resembles a knee after that, and the foot rotates.
• Chemotherapy can be used after surgery to get rid of any cancer cells that could still be there. If osteosarcoma returns after surgery or spreads to other body areas, chemotherapy may be recommended in an attempt to slow the disease's progression.

Radiation therapy

Radiation therapy uses high-energy beams, such as protons and X-rays, to kill cancer cells. Radiation therapy might be a good alternative in some situations, such as when surgery is not an option or when doctors are unable to remove the cancer entirely during an operation.

The energy beams are delivered by a machine that spins around you as you lie on a table receiving radiation therapy. The beams are properly directed towards the osteosarcoma to reduce the risk of damaging the surrounding healthy cells.

Clinical Trials

Clinical trials are investigations of new cancer treatment modalities. Ask your doctor or your child's doctor if you might be eligible to take part in a trial.

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Complications Of Osteosarcoma

Complications with osteosarcoma treatment include:

• Cancer metastasizes, or spreads: If the tumour spreads to other areas, osteosarcoma treatment and recovery may become more difficult. The lungs and other bones are most commonly affected by osteosarcoma that spreads.
• Adjusting to life without a limb: Surgery that removes the cancer without causing damage to the limb is carried out whenever possible. Sometimes, though, the only way to fully remove the cancer is to amputate the afflicted section of the leg. Learning how to use a prosthetic limb will take time, training, and patience. Professionals can help you adjust.
• Long-term adverse effects of the drug: Intense chemotherapy is a necessary part of treating osteosarcoma, but it can have major short- and long-term side effects. In addition to giving you a list of side effects to be aware of in the years after treatment, your healthcare team can assist you in managing any adverse effects that occur during therapy.

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