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Once osteosarcoma has been found, more tests may be done to find out if cancer cells
have spread to other parts of the body. This is called staging.
Instead, most patients are grouped depending on whether cancer is found in only one part
of the body (localized disease) or whether the cancer has spread from one part of the
body to another (metastatic disease).
Recurrent disease means that the cancer has come back (recurred) after it
has been treated. It may come back in the tissues where it first started or it
may come back in another part of the body. Osteosarcoma most often
recurs in the lung. When osteosarcoma recurs, it is usually within 2 to 3
years after treatment is completed. Later recurrence is possible, but rare.
Scientists have not discovered the cause of most cases of osteosarcoma. Osteosarcoma
can develop as a result of radiation to an area of the body. It can also be associated with specific
genetic changes and diseases.
RISK FACTORS ASSOCIATED WITH OSTEOSARCOMA
Age, height and gender are all risk factors for osteosarcoma.
General risk factors
SYMPTOMS OF OSTEOSARCOMA
Symptoms of osteosarcoma vary depending on the location of the tumor. Common signs of this
type of cancer include:
How bone pain is experienced may vary. Your child may feel a dull ache or have pain that keeps
him or her awake at night. If your child has bone painor if you notice any of the above
symptomsexamine his or her muscles. In the case of osteosarcoma, the muscles in the
cancerous leg or arm will appear smaller than those in the opposite limb.
Symptoms of osteosarcoma can mimic growing painspain in the legs caused by normal bone
growth. However, growing pains typically stop during the early teenage years. Contact a doctor
if your child has any chronic bone pain or swelling past his or her initial growth spurts, or if the
pain is causing your child serious issues.
An x-ray is often the first diagnostic test that osteosarcoma patients receive, and an experienced
radiologist may recognize immediately that bone cancer is the likely diagnosis. There are several
additional tests that are a critical part of osteosarcoma diagnosis and staging:
An MRI of the entire bone where the primary tumor is located. This test can rule out
"skip metastases" (spread of the tumor to other areas of the bone).
A chest x-ray and CT scan of the chest to detect lung metastases
A bone scan of the body to rule out distant spread of the disease
A biopsy of the tumor, which provides a definite diagnosis based on the characteristics of
tumor tissue seen under a microscope. The biopsy will also show whether the tumor is
high grade (highly malignant, which is the case for most osteosarcomas) or low grade.
Blood tests are not needed to diagnose osteosarcoma, but they may be helpful once a
diagnosis is made. For example, high levels of chemicals in the blood such as alkaline
phosphatase and lactate dehydrogenase (LDH) can suggest that the osteosarcoma may be
more advanced than it appears.
TREATMENT
The types of treatment used for osteosarcomas include:
Surgery
Chemotherapy
Radiation therapy (in certain cases)
NURSING DIAGNOSIS:
Acute pain related to physical injuring agents
Ineffective breathing pattern related to musculoskeletal impairment as evidenced by
usage of accessory muscles in breathing
Activity intolerance related to pain
Impaired social interaction related to limited physical mobility
Ineffective role performance related to body image alteration; physical illness
NURSING RESPONSIBILITIES: