An osteosarcoma refers to a malignant bone tumor and is therefore also colloquially called bone cancer. The cancer cells invade the bones and also spread throughout the body, especially in the lungs. If the disease is treated early, the chances of recovery are generally good.
What is Osteosarcoma?
The term osteosarcoma or osteogenic sarcoma is understood by physicians as a malignant tumor that affects the patient’s bones. Both the bone and often a nearby joint are affected and destroyed. The cancer cells migrate via the bloodstream to the lungs and form metastases there. See theinternetfaqs for Campomelic Dysplasia Basics.
Osteosarcoma is the most common bone tumor – around 200 people in Germany develop it every year. Males between the ages of 10 and 25 are particularly affected.
The disease usually affects the so-called tubular bones such as the upper arms or thighs, especially near the shoulder or knee joint. Osteosarcomas on the spine or skull, on the other hand, only occur in very rare cases.
Causes
The exact causes of osteosarcoma are not yet known. However, since the disease occurs particularly often during puberty, it is assumed that the increased bone activity that takes place at this time is related to the osteosarcoma.
In addition to bone growth, there is a high probability that genetic factors also play a role. Existing diseases of the bones or cartilage such as Paget’s disease ] or osteochondroma can increase the risk of osteosarcoma. A previous history of cancer with additional chemotherapy or radiation therapy can also contribute to the formation of an osteosarcoma.
Symptoms, Ailments & Signs
Osteosarcoma is mainly characterized by swelling around the affected bone. The swelling increases quickly, but is usually painless. If pain in the bone occurs independently of a load, this is a clear indication of an osteosarcoma.
Then, in addition to persistent bone pain, there is also tenderness at the site of swelling and redness. Bone cancer, which is located near a joint, causes particularly stressful symptoms. This can lead to a very painful limitation of mobility. Since the structure of the bone has been destroyed by the tumor, it can no longer adapt to everyday stress.
The affected bone therefore has a completely unstable structure. The risk of bone fractures is greatly increased. Sudden bone fractures can occur even under normal, non-loading conditions. Until the cancer has spread, symptoms remain localized to the affected bone or nearby joints.
After the formation of metastases in other organs, however, other symptoms appear, which are non-specific. Among other things, fever, exhaustion and a drop in performance are observed. If the cancer has not yet spread, the chances of recovery are very good, provided the tumor can be completely removed. As a rule, however, the removed bone has to be replaced by an endoprosthesis.
Diagnosis & History
If osteosarcoma is suspected, the doctor treating you will order an X-ray of the bones. A diagnosis can often be made based on this. In order to determine to what extent the cancer cells have already spread in the body, a computer tomography and a blood test can also be carried out.
A tissue sample taken directly from the tumor can also confirm the diagnosis and provide information about the patient’s condition. If the osteosarcoma is treated in time, there are good chances of recovery and survival, depending on the general condition and the spread of the metastases. Statistically, 70% of patients survive the first 5 years after diagnosis. However, if there is no therapy, osteosarcoma can be a life-threatening disease.
Complications
Osteosarcoma usually causes cancer in the bones. In most cases, this cancer occurs directly in the patient’s legs and arms, resulting in increased pain and limitations in the patient’s everyday life and movement. Those affected continue to appear exhausted and suffer from a significantly reduced resilience.
The tumor can also spread to other regions of the body and form cancer cells there. In most cases, the life expectancy of the patient is reduced. Complications and life-threatening conditions usually occur if the osteosarcoma is not treated. Self-healing does not occur in this case.
Osteosarcoma is usually treated with chemotherapy followed by surgery. Usually there are no complications. However, chemotherapy itself can have serious side effects. Osteosarcoma may also require radiation therapy to completely eradicate the cancer. In most cases, however, patients with osteosarcoma also need psychological treatment.
When should you go to the doctor?
Swelling of the bones or restricted mobility should be presented to a doctor. If there is a permanent or gradual impairment of the musculoskeletal system, there is cause for concern. Since the fastest possible diagnosis and treatment are important for the prospects of healing an osteosarcoma, a doctor’s visit should be made as soon as the first irregularities appear. Otherwise, in an advanced stage of the disease, there is a risk of the patient dying prematurely. Ulcers, pain or impairment of joint function should be examined and treated.
A general malaise, an unwanted loss of body weight and a feeling of warmth in the affected areas indicate a disease that requires treatment. Fever, a drop in physical resilience or general performance as well as fatigue and exhaustion are signs that should be presented to a doctor. Sensitivity disorders, numbness and hypersensitivity to touch should be clarified.
If there is inner weakness or restlessness, mood swings or listlessness, a medical examination should take place. If usual everyday activities can no longer be carried out without symptoms and if an inability to exercise occurs, the person concerned needs medical care. Characteristic of an osteosarcoma is the constant increase in symptoms and at the same time a gradual decrease in quality of life. A visit to the doctor is recommended at the first suspicion of a disorder.
Treatment & Therapy
If the attending doctor has clearly diagnosed an osteosarcoma , he will most likely order chemotherapy. This is intended to help prevent the cancer cells from growing and spreading further in the body.
In addition, this type of treatment usually shrinks the tumor and makes it easier to access. An operation is then performed to remove the tumor. If metastases already exist, these must also be surgically removed, if this is possible. In principle, healthy tissue from the immediate vicinity is also removed during this procedure in order to prevent the osteosarcoma from reoccurring.
Under certain circumstances, an amputation of the affected body part must be carried out; however, this is rarely the case. Chemotherapy is usually required again after the operation. If the tumor cannot be completely removed, radiation therapy can also be used.
Even after healing has taken place, regular follow-up care must take place to ensure that there are no more cancer cells in the body. Among other things, the lungs are examined in detail, over a period of about five years. Only then can one speak of complete healing in the medical sense. Whether the therapy works and whether the cancer can be defeated depends on the general condition of the patient and also on the stage of the disease.
Outlook & Forecast
The prognosis for an osteosarcoma essentially depends on how large the tumor is at the time of discovery, which bone was affected and whether metastases are already present in other organs. Tumors of the trunk and very extensive osteosarcomas are more difficult to treat successfully than small tumors and osteosarcomas of the extremities.
If the complete surgical removal of the tumor is possible and aggressive chemotherapy carried out before and/or after the operation responds well, doctors assume a 5-year survival rate of 50 to 80 percent under favorable circumstances. If lung metastases also have to be removed, the chance of survival or healing drops to around 40 percent. If the chemotherapy does not have the desired effect – i.e. less than 90 percent of the tumor cells can be killed – the long-term chance of survival also falls below 50 percent.
If the disease recurs (recurrence), the 5-year survival rate is statistically only about 25 percent; however, the actual prospect of long-term freedom from tumors depends on many factors and cannot be predicted in individual cases. Recurrences usually occur within the first two to three years after the initial diagnosis. Patients who live more than five years after diagnosis can usually be considered cured.
Prevention
Since the causes of an osteosarcoma have not been clearly clarified, prevention in the true sense of the word is not possible. However, if symptoms such as pain, redness and swelling in the area of the knee joint or the upper arm or thigh bone occur over a longer period of time, a doctor should always be consulted as a precaution in order to rule out a possible osteosarcoma.
Aftercare
After cancer treatment, patients are by no means completely cured. There is a risk that the osteosarcoma will return and spread. Follow-up care is therefore an indispensable part of any tumor treatment. Doctor and patient usually agree on the location and scope of the aftercare before the end of the therapy.
In the first few years there is usually an examination once a quarter. The distance from appointment to appointment then increases. From the fifth year of freedom from symptoms, annual follow-up checks are usually sufficient. Patients should definitely keep the suggested appointments. A diagnosis in the early phase promises the best treatment success.
Rehabilitation often takes place immediately after treatment for osteosarcoma. In this, the patient is prepared for reintegration into his job and his social environment. During this time, experts deal specifically with the complaints and promote the mobility and independence of those affected.
Subsequent medical follow-up examinations initially include a conversation in which the current condition is inquired about. If necessary, there will also be a physical examination. Imaging procedures such as X-rays and computed tomography are an important part of the treatment of osteosarcoma. In this way, the doctor can diagnose a tumor in the body from the outside.
You can do that yourself
Osteosarcoma is a serious disease that requires urgent medical treatment. Nevertheless, the patient can contribute to regeneration and improve his quality of life by helping himself in everyday life. This is possible through physically and psychologically oriented measures. It is always advisable to consult the doctor treating you.
In the physical area, osteosarcoma and its operation can lead to bone damage, which can be compensated for by muscle training. Stabilization through muscle training is instructed in physiotherapy and can be continued by the patient at home. Moderately dosed endurance training often restores fitness and well-being after therapy. Swimming and walking are particularly suitable in this context due to their joint-gentle properties.
Patients with cancer such as osteosarcoma receive mental stability in self-help groups and through psychologists and psychotherapists. Psycho-oncologists are specially trained to meet the needs of cancer patients. Conversations with relatives and friends are also often helpful, although sometimes it is the social get-together that brings distraction and creates normality.
Healthy nutrition and sufficient sleep are important for all cancer patients and therefore also for osteosarcoma. Dietary supplements or immune-stabilizing agents may only be taken after consulting a doctor. Procedures such as autogenic training, progressive muscle relaxation and yoga bring relaxation. This can be learned from health insurance companies, in adult education centers or in studios.