What is an osteosarcoma ?
Osteosarcoma is a type of bone cancer that develops from cells that produce bone. It is a malignant tumor that can affect any bone, but most often develops in the bones of the limbs, such as the bones of the arm or the leg. Osteosarcoma is often diagnosed in young people and adolescents, but it can also affect adults.
What are the causes ?
The exact causes of osteosarcoma are not well understood, but there are several known risk factors that can increase the chances of developing this disease. Common risk factors for osteosarcoma include:
Age: Osteosarcoma is most common in adolescents and young adults, although it can occur produce at any age.
Genetics: Mutations in certain genes associated with osteosarcoma, such as the TP53 gene, are risk factors for this disease.
Hereditary retinoblastoma: People with this genetic condition have an increased risk of developing osteosarcoma.
Radiation therapy: Radiation therapy for other types of cancer may increase the risk of osteosarcoma.
Pre-existing bone diseases: Certain bone diseases, such as Paget's disease or Rothmund-Thomson disease, increase the risk of osteosarcoma.
Environmental factors: Certain chemicals such as asbestos have been linked to an increased risk of osteosarcoma.
Excessive physical activity: Some studies have suggested that excessive levels of physical activity at a young age may increase the risk of osteosarcoma.
What are the symptoms ?
Symptoms of osteosarcoma can vary depending on the location of the tumor. Here are some of the possible symptoms:
Bone pain: Bone pain is often the first symptom of osteosarcoma. The pain may be mild at first and gradually get worse.
Swelling: Cancer can cause swelling and inflammation of the affected area.
Fracture: The affected bone can become brittle and fracture with little or no trauma.
Fever: Some people with osteosarcoma may have a fever for no apparent reason.
Weight loss, fatigue and weakness.
How to diagnose ?
To diagnose osteosarcoma, doctors can use a variety of tests and procedures to assess symptoms, examine the affected area, and confirm the diagnosis. Here are some of the main steps in diagnosing osteosarcoma:
Medical examination and medical history: The doctor will examine the affected area, discuss the patient's medical history and perform a medical examination complete.
Imaging tests: Imaging tests such as X-rays, CT scans, or imaging Magnetic resonance scans (MRI) can be done to assess the affected area and detect the presence of bone tumors.
Bone biopsy: A bone biopsy is necessary to confirm the diagnosis of osteosarcoma. The biopsy is usually performed under local anesthesia and involves the removal of a small sample of bone tissue which can be analyzed in the laboratory.
Blood tests: Blood tests may be done to detect signs of cancer, such as tumor markers.
Complementary imaging tests: Complementary imaging tests, such as a bone scan or a PET scan by Positron Emission), can be used to determine the spread of tumor in the body.
What are the treatment options ?
Treatment for osteosarcoma depends on the size and location of the tumor, the spread of the disease, the patient's age, medical history, personal preferences, and associated risk factors. Treatment for osteosarcoma may include a combination of therapies such as surgery, chemotherapy, and radiation therapy.
Surgery: Surgery is often the first step in the treatment of osteosarcoma. Surgeons remove the tumor and some of the healthy bone surrounding the tumor to reduce the spread of the disease. In some cases, the affected bone must be replaced with an implant or bone graft.
Chemotherapy: Chemotherapy is often used to reduce the size of the tumor before surgery or to kill residual cancer cells after surgery. Chemotherapy uses drugs that kill cancer cells throughout the body. Patients may receive chemotherapy before surgery to reduce the size of the tumor or after surgery to reduce the risk of recurrence.
Radiation Therapy: Radiation therapy uses high-energy x-rays to destroy remaining cancer cells. It is not often used to treat osteosarcoma due to the sensitivity of the bone to radiation therapy. However, it can be used as an adjuvant treatment after surgery in certain cases.
Finally, patients with osteosarcoma also need supportive care such as pain management, post-surgery recovery assistance, physiotherapy, and palliative care to relieve pain and psychological stress .
How is the surgery performed ?
Surgery is a key step in the treatment of osteosarcoma. The goal of surgery is to remove the tumor while preserving as much function as possible in the affected limb. Here are the common steps in surgery for osteosarcoma:
Preparation: Prior to surgery, the patient is usually given medical tests to assess their physical condition and ensure that he is fit to undergo surgery. The surgeon will also discuss the surgical procedure with the patient, including potential risks and side effects.
Anaesthesia: The patient is anesthetized before surgery begins. There are two types of anesthesia, general anesthesia which completely numbs the patient and regional anesthesia which numbs a part of the body.
Incision: An incision is made to open the affected bone and expose the tumor. The surgeon then removes the tumor with a margin of healthy tissue to reduce the risk of recurrence.
Reconstruction: If the affected bone is important for function, it can be replaced with a surgical prosthesis, graft allogeneic or autologous bone or metal implants.
Closure: Once the tumor has been removed and the reconstruction done, the bone is closed using sutures or similar closure materials.
After surgery, the patient is closely monitored for any signs of infection or complications and begins a rehabilitation program to recover function in the treated area.
What is the recovery period ?
The recovery period after surgery for osteosarcoma is often long and involves physical and psychological rehabilitation. Recovery time may vary depending on the location and size of the tumor, the surgical procedure, the patient's previous medical condition, and the presence of other medical conditions.
Here are some of the key stages in recovery after surgery for osteosarcoma:
Hospitalization: After surgery, patients should stay in the hospital for a few days to watch for any signs of infection or complication. They may also receive postoperative care to relieve pain and discomfort.
Physical rehabilitation: After surgery, patients should work with a physical therapist to start moving and using their affected limb again . The physical therapist can recommend a variety of exercises to improve range of motion and muscle strength, promote wound healing, and prevent muscle tightness.
Medical follow-up: Patients should undergo regular follow-up examinations to monitor recovery and detect any signs of recurrence or complications.
Psychological support: Recovery after surgery for osteosarcoma can be emotionally draining. Patients may need psychological support to deal with recovery challenges.
Return to normal life: Recovery after surgery for osteosarcoma can take months or even years. Patients may need time to adjust to their new situation and return to normal life.
What are the advantages ?
Treating osteosarcoma can be challenging, but it can also have many benefits for patients. Here are some of the benefits of treating osteosarcoma:
Tumor removal: The primary goal of osteosarcoma treatment, especially surgery, is to remove the tumor and prevent its spread. Tumor removal is essential to improve the chances of survival for patients with osteosarcoma.
Improved function: Surgery and rehabilitation can help restore function and mobility to the affected limb. Patients may also benefit from additional support, such as prostheses, to help restore their quality of life.
Possibility of a cure: Treatments for osteosarcoma have made great strides over the years, which has significantly improved the possibilities of recovery for patients with this disease.
Access to supportive care: Patients with osteosarcoma also have access to a variety of supportive care to help them cope with the side effects of treatments and overcome the challenges associated with their disease.
Increased Awareness: Increased awareness of osteosarcoma has resulted in early detection of the disease, which can improve chances of treatment success.
What are the risks and complications ?
The treatment of osteosarcoma has potential risks and complications. Treatment for osteosarcoma is often complex and may involve a combination of surgery, chemotherapy, and radiation therapy, each with its own risks and complications. Here are some of the common risks and complications associated with the treatment of osteosarcoma:
Infection: Postoperative infections are common in surgical procedures for osteosarcoma. Patients with osteosarcoma undergoing surgery should be especially alert for any signs of infection, such as fever, joint pain, redness or swelling.
Bleeding: Surgical procedures may be associated with excessive bleeding and blood clotting problems. The risk of bleeding is particularly high in patients with osteosarcoma because the tumor can affect the production of platelets and red blood cells.
Pain: Pain is common for patients undergoing surgery for osteosarcoma. Patients may need strong analgesic medications to control pain.
Risk of recurrence: Recurrence is possible after treatment of osteosarcoma, especially if the tumor has progressed before treatment or if it was diagnosed late.
Side effects of chemotherapy and radiation therapy: The side effects of chemotherapy and radiation therapy can be severe, such as fatigue, nausea, vomiting, hair loss, anemia and neuropathy.
Long-term complications: Patients with osteosarcoma may be at risk for long-term complications, such as amputations, nerve damage, bone fractures, growth problems and other complications related to their treatment.
Osteosarcoma is a rare and aggressive form of bone cancer that primarily affects children and young adults. Treatment for osteosarcoma may include a combination of surgery, chemotherapy, and radiation therapy, as well as physical and psychological rehabilitation.