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Osteosarcoma is a bone cancer most often seen in children and young adults. It is the most common childhood bone tumor.
About 400 children and teens in the U.S. are found to have osteosarcoma each year.
Osteosarcoma may develop in any bone. But it usually forms in the wide ends of long bones of the leg or arm. It most often begins in immature bone cells that form new bone tissue.
The most common places for osteosarcoma to develop are in the:
It sometimes forms in flat bones such as the pelvis or skull.
In rare cases, osteosarcoma can form in soft tissue other than bone.
Osteosarcomas may form inside the bone or on the outer surface of bone. Most pediatric osteosarcomas are inside the bone.
Children with a single site of osteosarcoma that can be removed with surgery have a 65–70% chance of long-term cure. Survival rates are lower if the cancer has spread at the time of diagnosis.
Osteosarcoma damages and weakens the bone. Symptoms depend on where the tumor is located. They may be hard to notice at first. They can also be like symptoms of other conditions.
Symptoms of osteosarcoma include:
Pain may worsen over weeks or months. The pain may cause your child to wake up in the middle of the night.
Over-the-counter pain medicines such as ibuprofen or acetaminophen may not relieve pain over time.
Osteosarcoma typically develops after age 10. It is rare before the age of 5.
These factors may increase risk for osteosarcoma:
Several tests are used to diagnose osteosarcoma. They include:
X-rays are used to see if the cancer has spread to other parts of the bone.
A CT scan of the chest is used to see if osteosarcoma has spread to the lungs.
Osteosarcoma is usually described as either localized or metastatic.
Prognosis depends on several factors:
Patients with a single, localized osteosarcoma that can be completely removed with surgery have a 65–70% chance of long-term cure.
If osteosarcoma has already spread at diagnosis, the chance of survival is about 30%.
About 30% of patients will have cancer that comes back. This most often occurs in the lungs.
For those who relapse, prognosis depends on factors such as:
If cancer is treated and comes back, the 10-year survival rate is about 17%. Advances in therapies are continuing to help some children.
Talk to your care team about problems to expect and ways to help manage them. Palliative care can help you manage symptoms, promote quality of life, and make informed decisions.
Your child needs follow-up care every few months to see if cancer has returned. These visits occur for several years after treatment ends.
Screening tests usually include:
Patients with certain inherited syndromes or genetic conditions may be at risk for future cancers. They may need other follow-up care.
Most osteosarcoma patients who have amputation or limb-sparing surgery do well over time.
They report good physical function and quality of life. Follow-up care is important.
Your child should have an annual exam to check muscle and bone function. It is important to make sure that there are no ongoing problems. Uneven limb length, changes in the way your child walks, joint issues, or other problems can cause chronic pain or disability.
All survivors should continue to have regular checkups and screenings by a primary health care provider. Your child is encouraged to be physically active, eat healthy, and get enough sleep. These lifestyle habits promote general health and help prevent diseases.
Survivors of bone cancer tend to be less active. Regular exercise is important to maintain health, fitness, and physical function. This is quite important for patients who have had limb-sparing surgery or amputation.
Survivors treated with chemotherapy or radiation should be monitored for late effects of therapy.
Your child’s care team should give you a survivorship care plan after treatment ends. This report will include needed screening tests and tips for a healthful lifestyle.
Talk to your child’s health care provider if you have osteosarcoma treatment or late effects. Always follow the instructions given by your care team.
Reviewed: December 2022