Osteosarcoma is a rare and aggressive type of cancer that usually mainly affects children and adolescents, although it may also be adults, especially men over 65 years of age. A disease whose prognosis has improved thanks to multidisciplinary treatment and polychemotherapy, reaching percentages of between 70 and 75% survival.
Early diagnosis of the tumor, before it develops metastases, is basic to get better, in addition to achieving better preservation of the affected limb and optimizing the quality of life of patients. Below we tell you what osteosarcoma, its causes, symptoms, and prevention are.
What Is It?
Osteosarcoma is a malignant bone tumor that can be located in any bone, being used to appear in the femur, tibia, or the area of the knee. The incidence is low, with one patient per 100,000 inhabitants in Spain. It is one of the most common types of cancer among children and adolescents after Ewing sarcoma. According to specialists, osteosarcoma usually appears between the ages of 10 and 16, spreading to any other organ or tissue of the body, the lungs being one of the areas to which it first usually extends.
The bones in which it usually appears are the distal femur, the tibia, and the proximal humerus, distinguishing three types of osteosarcoma according to their location in the bone: the surface, the intracortical, and the intramedullary or the central, the latter being the most common.
Causes
Specialists agree to point out that there is no clear cause, appearing sporadically on any bone in the body. Sometimes this type of tumor is also related to trauma suffered in that area of the body, although this link does not seem to be so manifest either.
Other causes that appear to be behind the onset of osteosarcoma are having a history of retinoblastoma in the family, having received radiation therapy in the bone, or having an evolution of a benign bone tumor such as fibrous dysplasia or Paget’s disease.
On the other hand, its development in the longest bones is often frequent, and it is common to manifest itself at times of higher growth rate, when osteoblast activity is higher, between 10 and 30 years of age, being between 12 and 15 years of age when the largest number of diagnosed cases are concentrated. Other risk factors predisposing to these types of pathologies are sex, being more common among men than among women.
Although not usual, in some cases it may be hereditary, while certain hereditary conditions enhance the risk of this type of sarcoma. In addition to retinoblastoma, other diseases such as Rothmund-Thomson Syndrome, Li-Fraumeni Syndrome, Werner Syndrome, and Bloom Syndrome can be related to the subsequent development of osteosarcoma.
Symptoms
The symptoms of osteosarcoma do not usually appear suddenly, and it is common to develop gradually over time. One of the most common manifestations is pain, swelling, reduction of the mobility of the affected joint, the appearance of some lump in the bone area, and, less often, the fracture of the bone.
Previous muscle trauma or overloads are not usually causes of osteosarcoma, but they can precipitate symptoms. If osteosarcoma is located, fever, weight loss, or tiredness is often not frequent. This type of tumor is also often related to rapid bone growth, especially those longer and located in areas close to the knee joint.
As the tumor grows, it invades the tissues surrounding the bone and eventually weakens it, causing pain and thickening of the affected part of the bone. The weakness of the bone can also lead to fractures after any trauma. The injuries associated with them can be very varied in their appearance and evolution.
Other symptoms that may occur are back pain intestinal incontinence and/or urinary.
Treatment
The treatment of osteosarcoma is also based on whether the tumor is located at a single point or there is already metastasis. If osteosarcoma is located, specialists usually opt for treatment that combines surgery and chemotherapy. Chemotherapy optimizes the results of surgery, reducing the percentage of recurrence.
Chemotherapy is also used before surgery on a preoperative basis and thus can assess the sensitivity to chemotherapy of the primary tumor. If tumor necrosis reaches an advanced percentage, it will be a sign that chemotherapy will be useful after surgery and the patient’s evolution will progress favorably.
In any case, the therapeutic strategy should be carried out by a multidisciplinary team of experts that fully assesses each decision.
In cases of osteosarcoma with metastasis, surgery, and chemotherapy are two really useful therapies for lengthening the patient’s life expectancy, although it depends heavily on where the metastasis is located. Thus, if the metastasis is also in the bones, the probability of lengthening the patient’s lifetime is shorter.
Survival rates in osteosarcoma patients have now been significantly increased thanks to treatments such as polychemotherapy. An option that combines different drugs to reduce the tumor and preserve the limb after it is removed through conservative surgery techniques.