What is Osteosarcoma (osteogenic sarcoma)?

Osteogenic sarcoma, also called osteosarcoma is the most common form of cancer that starts in the cells that form bones. Unlike metastatic bone disease, where the cancerous cells come from another part of the body, osteosarcoma originates in the bone itself. It is most often found in the long bones in children and young adults. Teens are most commonly diagnosed with osteogenic sarcomas, but they can occur at any age. This rare form of bone cancer, osteosarcoma produces malignant (cancerous) cells which create irregular bone tissue and tumors. The bone tumor usually develops at the ends of the long bones and most often around the femur, near the knee, or in the humus, near the shoulder. In very rare instances, osteosarcoma can occur in the soft tissue outside of the bone. The experts at BICMD have extensive experience diagnosing and treating patients with osteogenic sarcoma. We can offer the most up-to-date treatment options available during a telemedicine visit, done through our state-of-the-art telehealth platform.

 Where does osteosarcoma start?

Osteosarcoma can develop in any bone, including the bones of the pelvis (hips), shoulder, and jaw. This is especially true in older adults. In younger adults and children, osteosarcoma usually begins in the area where bone growth is rapidly occurring. This growth is usually near the growth plates at the ends of the long bones in the legs and arms.

What are the types of bone tumors?

Osteosarcomas are tumors, or bone cancer that originate in the bones. They are a type of malignant (cancerous) tumor. Malignant bone tumors can spread to other parts of the body and can be life threatening. Benign bone tumors are non-cancerous and are not life threatening. Benign bone tumors will not spread to other parts of the body and can usually be cured by surgery.

What are the grades of osteogenic sarcomas?

Doctors classify osteogenic sarcomas into grades based on how the cells look under a microscope. The type or grade of tumor tells doctors how likely the cancer will grow or spread (metastasize) to other parts of the body. Grades of osteosarcomas are:

  • High-Grade Osteosarcoma – The most rapidly growing type of osteosarcoma. Also, the most common grade among children and teens.
  • Intermediate-Grade Osteosarcoma – Between high and low grade and are treated in a similar manner to low-grade osteosarcomas.
  • Low-Grade Osteosarcoma – Slowest growing type of osteosarcoma. The cells of the tumor look more like normal bone.

What are the symptoms of osteogenic sarcoma?

  • Pain in the affected bone
  • Pain that may come and go
  • Pain that worsens to become severe and constant
  • Visible swelling (if the tumor grows)
  • Decreased range of motion
  • Limping – with tumors in the leg
  • Pain when lifting – with tumors in the arm or shoulder
  • Fracture at the site of the tumor (called pathological fracture)

How are osteogenic sarcomas diagnosed?

The first step in diagnosing an osteosarcoma is to obtain an x-ray of the affected bone. If the x-ray suggests a tumor a CT scan or an MRI scan will show the size, shape and location of the tumor. A skilled and experienced orthopedic oncologist, like the experts at BICMD, should perform a biopsy of the tumor in order to identify the type. It is important to have a physician who has expertise in cancer surgery to ensure that the biopsy is done in a specific way, so that subsequent surgical procedures are not put at risk. Follow up CT scans and a bone scan will be ordered to find out if the cancer has spread.

Proper diagnosis of osteogenic sarcomas includes the grading and staging of the cancer.

  • Grading – As mentioned above, the higher the grade, the more aggressive the cancer.
  • Staging – Once the biopsy of the tumor has been identified as an osteogenic sarcoma, the doctor will use the imaging studies and blood tests to determine if the cancer has spread. Doctors often use a simple system that divides osteosarcomas into 2 groups: localized and metastatic.
    • Localized – The osteosarcoma is found only in the bone where it began and possibly in the tissues next to the bone.
    • Metastatic – The osteosarcoma (cancer cells) have spread to other parts of the body from the point of origin.

What is the treatment for osteogenic sarcoma?

Treatment for the osteosarcoma is based on the size, grade and stage of the cancer. Treatment for an osteogenic sarcoma may include:

  • Surgery – Surgery may include amputation (removal of a limb) or removal of part of the affected bone, which is then replaced by a prosthesis (artificial limb). A limb-sparing surgery that removes only part of the affected bone is used when the limb can be saved, while still removing the cancer.
  • Chemotherapy – Sometimes used before and after surgery. Chemotherapy is the use of drugs to kill quickly-growing cells. It is used before surgery to shrink the tumor and after surgery to prevent the spread of cancer cells and to kill any cells that have metastasized.
  • Radiation – The use of high-dose x-ray to kill cancer cells and shrink tumors. Radiation for osteosarcomas is usually appropriate for a select type of osteosarcoma and is not a common treatment.

For more information and resources on osteogenic sarcoma or osteosarcomas and the treatments available, or if you’ve been diagnosed with bone cancer and would like an expert 2nd opinion, please contact our orthopedic specialists, by clicking on “Connect With a Doctor.” You will be connected to one of our orthopedic oncology telemedicine experts through our state-of-the-art telemedicine platform.