Childhood Osteosarcoma
Osteosarcoma is a bone tumor that consists of malignant cells that produce immature bone. It is the most common type of bone cancer in children and adolescents and affects more males than females. Nearly 80% of osteosarcomas appear in the distal femur, the portion of the thigh bone closest to the knee, or the proximal tibia, the lower leg bone near the knee. Osteosarcoma may also develop in the proximal humerus, the upper arm bone connected to the shoulder.
Of all childhood cancers, osteosarcoma is rare, but it is the most common bone tumor in children; it affects approximately 400 children under age 20 every year.
Osteosarcomas are classified as low, intermediate or high-grade tumors. A low-grade osteosarcoma has few dividing cells in the tumor, while a high-grade osteosarcoma is filled with dead tumor cells. Most tumors that occur in children are high-grade.
Patient Education
- Osteosarcoma I Español (pdf)
Survivor Stories
Read survivor stories from Shelby and Emily. Shelby and Emily are both osteosarcoma survivors who were treated at the Children's Cancer Hospital.
Symptoms
The most common complaint is a constant dull ache in the bone or joint, often increasing at night when sleeping. The pain tends to increase over time rather than subside. At the site of the tumor, there may be swelling or a lump. If the tumor is in the leg, a child may limp. Osteosarcoma may make the muscles in the affected leg or arm appear smaller.
Tests & Procedures
A delay in diagnosis is not uncommon because the symptoms, such as pain and swelling, can be easily mistaken for normal teenager activity. Osteosarcoma is diagnosed by an X-ray. An MRI and CT scan are also performed to show doctors how much bone the tumor has destroyed and whether it has spread. A biopsy, a procedure to acquire a sample from the bone, will confirm the presence of cancer cells. Orthopedic oncologists at M. D. Anderson have expertise in surgical management of this disease.
Treatment
The most common treatment for osteosarcoma is a combination of chemotherapy and surgery to remove the cancer and some healthy tissue. Treatment may first begin with chemotherapy, then surgery and follow with adjuvant therapy, a post-surgery treatment that may include chemotherapy, radiation, hormone or biological therapy with the goal to destroy remaining cancer cells. Adjuvant chemotherapy is now considered the standard treatment for osteosarcoma at M. D. Anderson. Radiation therapy is also another option, which uses high-energy rays to kill cancer cells as it shrinks the tumor.
At one time, nearly all children with osteosarcoma had to undergo amputation of part of the leg or arm with the tumor. Today, doctors are typically able to peform “limb-sparing” surgery to remove the tumor without amputation. If amputation is not required, doctors will place an artificial device in the area where the bone was removed.
Clinical Trials
The most innovative treatments for childhood solid tumors are offered as part of clinical trials, which are closely monitored studies to test the safety and effectiveness of new treatments. Go to M. D. Anderson's list of current pediatric clinical trials to see if your child might be eligible.
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