Sophia Chlosta

Honors Anatomy and Physiology

Mrs. Murray

November 26, 2018

Osteosarcoma

Osteosarcoma is cancer that increases in immature bone. This cancer arises that are at the

end of the long bones or the knee. Cancer occurs more in males than females. “Osteosarcoma is

not a very common cancer. Every year there is “about 800 to 900 new cases of osteosarcoma in

the United States.” Most of it is in children and teens. Osteosarcoma happens in kids between 10

and 30. Around 10% of all osteosarcoma “occur in people older than 60.”

The causes of osteosarcoma in some cases have not yet been discovered by scientists.

Osteosarcoma can spread as a result of radiation to a area of the body. This also can be related to

a particular “genetic changes and diseases.” People with osteosarcoma do not feel sick, they may

have “a history of pain in the affected area and may get limp.” Sometimes the pain it mostly of

muscle soreness or “growing pains.” The patients only see the doctor when there is an injury to

that specific area or when the tumor weakens a bone to a point where it breaks.

There are two types of osteosarcoma, one is a central tumor is called an medullary tumor

and the second one is a surface tumor that is called a peripheral tumor. “The central type of can

have an osteoblastic, chondroblaric, fibroblastic and mixed types, telangiectatic osteosarcoma,

intraosseous well-differentiated, or low-grade, osteosarcoma, small cell osteosarcoma.”

“Parosteal, well-differentiated or low-grade, osteosarcoma. Also called juxtacortical

osteosarcoma.Periosteal osteosarcoma that is low grade to intermediate grade

High-grade surface osteosarcoma.” How to diagnosed osteosarcoma is getting an x-ray that is

usually the first diagnostic test that the patients receive. A skillful radiologist often recognizes

that bone cancer is the likely diagnosis. There are various other tests that are critical of

osteosarcoma diagnosis and staging: there is an MRI of the entire bone where the primary tumor

is pinpointed. From the MRI the test can rule out “skip metastases” (spread of the tumor and to

other areas of the bone). Also, you get a chest x-ray and CT scan of the chest to detect lung

metastases, a bone scan of the body to see how the distant spread of the disease, the biopsy,

which helps a definite diagnosis based on the characteristics of the tumor tissue seen under a

microscope. The biopsy will show if the tumor is high grade (highly malignant, which is the

case for most osteosarcomas) or low grade. The two main types of biopsy is a needle aspiration

and a surgical biopsy. The location, incision and technical aspects of the biopsy can affect a

patient’s treatment options and outcome.”

The treatment of osteosarcoma is “surgery and the goal is the get rid of the cancer cells,

also the surgeon performs operations to persevere function and reduce disability.” “The extent of

surgery for osteosarcoma depends on several factors, such as the tumor size, location, and the

person's age.” There is a surgery that is limb-sparing surgery, in some cases, the surgeons

focused on removing the tumor and sparing the limb so it can still function. This all depends on

the size of the tumor and how much muscle and tissue needs to be removed. There is always a

possibility you need an amputation, but because of the limb-sparing surgery, the need for

amputation has lessened over the years. But if it is necessary, the advances in prosthetic joints

can notably improve outcomes and function. There is also radiation therapy in some cases. “This

radiation therapy uses high-energy beams, such as X-rays and proton to kill cancer cells. Though

typically radiation is not used due to lack of effectiveness in treating osteosarcoma, newer forms
of radiation therapy are being studied and may rarely be used.” The people who diagnosis are

doctors.

There is research that is being done on osteosarcoma is testing one drug that is

immunotherapy drug called mifamurtide (Mepact).” Immunotherapy, is called biologic therapy,

is to help improve the body’s natural defense to fight cancer.” Mifamurtide is currently allowed

in Europe by the European Medicines Association for the treatment of localized osteosarcoma

that can be removed with surgery. This is not allowed by the FDA in the United States.

“Additional approaches on how best to stimulate the patients’ own system are in the early stages

of research. The Children’s Oncology Group pegylated interferon alpha (multiple brand names)

was added to treatment after 8 months of standard chemotherapy. This study was done with

people who have localized osteosarcoma or metastases to the lungs or bones that can be

surgically removed and whose tumor was almost completely eliminated by the first 10 weeks of

chemotherapy treatment. The early results of this study showed that adding pegylated interferon

alpha did not benefit these people. More information will become available as people are

followed for a longer time. In the same study (AOST 0331), etoposide (Toposar, VePesid) and

ifosfamide (Ifex) were added to standard chemotherapy treatment for a total of 10 months of

treatment instead of the standard 8 months. This study was done with people when the

osteosarcoma was not completely eliminated by the first 10 weeks of chemotherapy. According

to the results of this study, adding these drugs after surgery caused more side effects and did not

improve the outcome of treatment. Therefore, the more intensive chemotherapy approach is not

recommended. The Children’s Oncology Group and most of the world's experts consider this

combination to be standard treatment: cisplatin (Platinol), doxorubicin (Adriamycin), and high-

dose methotrexate (multiple brand names). Selected other combination therapies are similarly
effective, but none of them is better.”

https://www.mayoclinic.org/diseases-conditions/osteosarcoma/diagnosis-treatment/drc-

20351053

https://www.cancer.net/cancer-types/osteosarcoma-childhood/overview
http://sarcomahelp.org/osteosarcoma.html

https://www.cancer.org/cancer/osteosarcoma/about/new-research.html

https://www.cancer.net/cancer-types/osteosarcoma-childhood/latest-research