Osteosarcoma is a rare and hostile form of cancer that originates in the bone. It primarily affects the long bones of the body, such as the humerus (upper arm bone), femur (thigh bone), and tibia (shin bone), but it can develop in any bone. Although it can occur at any age, osteosarcoma is most commonly found in children, teenagers, and young adults.
This cancer is distinguished from other types of bone cancer by the production of immature bone by malignant cells. In this article, we’ll explore osteosarcoma, covering its symptoms, causes, and treatment options.
What is Osteosarcoma?
Osteosarcoma is a rare and dangerous form of bone cancer that primarily affects long bones, including the humerus, tibia, and femur. Children, teenagers, and young adults are more likely to experience it, especially when their bones are growing at a faster pace.
The cells that make up bone tissue become the source of cancer, which results in the formation of immature bone. Symptoms typically include persistent bone pain, swelling, and reduced mobility, with the risk of fractures due to weakened bones.
Although the exact cause is unknown, established risk factors include genetics, fast bone growth, and prior radiation therapy. Treatment usually comprises a combination of chemotherapy and surgery.
Symptoms of Osteosarcoma
Osteosarcoma symptoms might change based on the tumour’s size and location. Early signs and symptoms, especially in young people, might be mild and readily confused with common medical conditions like growing pains or sports injuries. But when the tumour enlarges, the symptoms worsen and may include:
Bone Pain
The very first indication, in most cases, is constant pain in the afflicted bone. Although the pain may at first be intermittent, it eventually becomes intense and consistent, especially at night or when engaging in physical activity. The pain may also worsen with activity or pressure on the area.
Swelling
Swelling or a noticeable lump may develop around the affected bone. The area may feel warm to the touch and tender. The limb may become visibly distorted as a result of the swelling getting worse over time.
Reduced Mobility
It may be challenging to move a limb if a tumour is close to a joint because it might create stiffness and limit the range of motion. This limitation hinders daily activities and gets worse with time.
Fractures
Osteosarcoma can weaken the bone, even in cases of slight trauma. It increases the risk of fracture, which is frequently referred to as “pathological fractures. ” These fractures can happen suddenly and with minimal impact.
Fatigue and Weight Loss
General symptoms such as weakness, exhaustion, and unintentional weight loss may develop as the malignancy spreads. These widespread symptoms may be a sign of the body’s general reaction to the cancerous growth.
Limping
A leg bone affected by osteosarcoma may give rise to a limp or make walking difficult. As the tumour grows larger or the discomfort increases, this disruption in posture might become more noticeable.
Causes of Osteosarcoma
Although the specific cause of osteosarcoma is unknown, a number of factors are thought to play a role in its development. Some of the known causes include:
Genetic Predisposition
Osteosarcoma is more common in those with specific genetic abnormalities and hereditary disorders. For example, those who have Rothmund-Thomson syndrome, Li-Fraumeni syndrome, or inherited retinoblastoma have a higher risk. A hereditary propensity may also be indicated by a family history of cancer, particularly in close relatives.
Rapid Bone Growth
Osteosarcoma is often identified in teenagers during growth spurts because it is more likely during times of fast bone expansion. The connection between bone growth and cancer development is still being studied, but it may relate to increased cellular activity in growing bones.
Previous Radiation Therapy
Individuals who have received radiation treatment for other cancers, mainly while they are young, are more likely to acquire osteosarcoma in the future. High radiation dose recipients are more in danger, especially for their bones.
Bone Abnormalities
People who have multiple osteochondromas or Paget’s disease of the bone may be at risk for developing osteosarcoma. These conditions can cause abnormal bone growth, which may increase the likelihood of malignant transformation.
Treatment of Osteosarcoma
The treatment of osteosarcoma is complex and typically involves a mix of surgery, chemotherapy, and sometimes radiation therapy. The approach to treatment depends on a few factors, including the stage of disease, the size and location of the tumour, and the overall health of patient.
Surgery
Osteosarcoma is mainly treated with surgery, where the primary goal is to remove the tumour completely while maintaining as much function as feasible. To achieve this, various surgical options are considered based on the tumour’s location and size. In limb-sparing surgery, the tumour is removed while the limb is preserved, and the damaged bone is restored with a bone graft or metal implant.
Amputation might be required to guarantee total cancer eradication in situations where the tumour cannot be completely removed without seriously impairing the function of the limb.
Another specialised technique, rotationplasty, allows the ankle to operate as a knee joint for a prosthetic limb, offering a functional alternative to total amputation. It works by removing a section of the limb and rotating the remaining part to reattach it.
Chemotherapy
Chemotherapy is usually administered before and after surgery. Neoadjuvant therapy, or preoperative chemotherapy, helps reduce the tumour, facilitating its removal and lowering the possibility of recurrence. Adjuvant treatment, or postoperative chemotherapy, tries to eradicate any cancer cells that endure and prevent it from coming back.
Cisplatin, doxorubicin, and methotrexate are often used chemotherapeutic medications for osteosarcoma. Although side effects can be challenging to manage and need careful attention, the combination of these medications has greatly increased survival rates.
Radiation Therapy
While osteosarcoma is generally resistant to radiation, it may be used in cases where surgery is not feasible or to treat metastatic sites. Advanced techniques like proton beam therapy may offer more precise targeting of the tumour, sparing surrounding healthy tissues. In severe situations, radiation therapy may also be used as a palliative measure to reduce pain or other symptoms.
Rehabilitation
Following surgery, patients require post-treatment rehabilitation, especially those who have had amputations or limb-sparing procedures. Patients can restore function, strength, and mobility with the help of physical therapy.
Psychological support is an essential component of rehabilitation, as it helps patients return to life after surgery, manage changes in their body appearance, and resume regular activities.
Conclusion
In conclusion, osteosarcoma is a challenging and severe malignancy primarily affecting young individuals. Early detection, prompt treatment, and advancements in surgical and chemotherapeutic techniques have improved outcomes for many patients. Supportive care, including physical rehabilitation and psychological support, plays a vital role in helping patients cope with the physical and emotional challenges of osteosarcoma.
