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Nearly 80% of the tumors are in the thighbone (femur) or lower leg bones (tibia or fibula). They also may develop in the upper arm bone (humerus). Usually, tumors develop during “growth spurts,” or periods of rapid growth in the teen years.
Although osteosarcoma may appear to be in only one location in the lower leg or forearm, almost all patients have tumor cells called micrometastases in the lungs.
Bones support, give structure to body
Bones, which usually are hollow, have three main parts:
Matrix: The outer part of bones, which is made of fiber-like tissue and covered with a layer of tissue called the periosteum.
Bone marrow: The soft tissue in the space in hollow bones, which is called the medullary cavity. Cells inside bone marrow include:
- Fat cells
- Red blood cells, white blood cells and platelets
- Fibroblasts, a type of cell that helps build connective tissue
- Plasma, in which blood cells are suspended
Cartilage: Material that is at the end of most bones. It is softer than bone, but it is firmer than soft tissue. Cartilage and other tissues, including ligaments, make up joints, which connect some bones.
Bone constantly changes as new bone forms and old bone dissolves. To make new bone, the body deposits calcium into the cartilage. Some of the cartilage stays at the ends of bones to make joints.
Many types of cancer that start in other organs of the body can spread to the bones. These are sometimes referred to as metastatic bone cancers, but they are not true bone cancers.
Osteosarcoma risk factors
The cause of osteosarcoma, or bone cancer, is unknown, and it usually does not run in families. However, certain things seem to put children at a higher risk of developing osteosarcoma:
- Age: Osteosarcoma, or bone cancer, is most common in people between 10 and 30 years old, particularly teenagers in rapid growth cycles or “growth spurts.”
- Height: Most children with osteosarcoma are tall for their ages.
- Gender: More males than females develop the disease.
- Race: African Americans have a slightly higher risk of osteosarcoma.
- Previous radiation therapy
- Non-cancer bone diseases including Paget's disease and osteochondromas
- Rare inherited cancer syndromes, including, Li-Fraumeni, Rothmund-Thompson, and the RB1 gene mutation, which causes retinoblastoma
- Other rare genetic conditions, including Bloom syndrome and Werner syndrome
Osteosarcoma is rare, and not everyone with risk factors gets the disease. However, if you are concerned about your child’s risk for bone cancer, you should talk to his or her doctor.
Learn more about childhood osteosarcoma:
Some cases of osteosarcoma can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
Why choose MD Anderson for childhood osteosarcoma care?
At MD Anderson Children's Cancer Hospital, our customized approach to osteosarcoma, or pediatric osteosarcoma, means that each child is the focus of a highly specialized group of experts. This team follows your child closely from diagnosis through survivorship, ensuring a continuity of care that can make an important difference to your child and family.
Childhood osteosarcoma is rare, and many oncologists have little experience treating it. Our program is one of the nation's most active, translating into a high degree of expertise.
Leading-edge diagnosis and treatment
Diagnosis of sarcomas can be challenging, but accurate findings are essential to successful treatment. Our pathologists are focused on osteosarcoma, which means they know what to look for to diagnose this type of bone cancer, and they use the latest, most sophisticated tests to pinpoint the type and extent of the cancer.
Treatment of bone cancer often requires a multi-level approach. Children's Cancer Hospital's specialized surgeons use the most advanced techniques to save limbs, and they are joined by dedicated oncologists, radiologists, rehabilitation experts, nurses and therapists. We offer the very latest in chemotherapy and other types of treatments.
Research and discovery
Many patients with osteosarcoma are treated with clinical trials. We participate in protocols of the Children's Oncology Group and offer innovative treatments through clinical trials, many available only at Children's Cancer Hospital and a few other hospitals in the nation.
Our Osteosarcoma and Ewing's Sarcoma Center coordinates care and access to clinical trials, streamlining and expediting enrollment in clinical trials. In addition, sarcoma researchers work with clinicians to translate laboratory research into new clinical trials.
Researchers at Children's Cancer Hospital are pioneering new, less toxic and more effective treatments for osteosarcoma. For instance, they discovered chemotherapy can be used with radiation to control osteosarcoma tumors that cannot be removed surgically. They are investigating new targeted therapies, as well as aerosolized treatments that target osteosarcoma that has metastasized to the lungs.
Children's Cancer Hospital is designed just for children, with a full range of services and amenities that help make the child and family's experience as comfortable as possible. We go beyond medical care to deliver a comprehensive experience that treats the whole child.
And at Children's Cancer Hospital, your child benefits from the resources and expertise of one of the nation's top cancer centers.
The one gift cancer gave me is perspective. Now each day is a new day and is filled with possibilities.
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Prevention & Screening
Many cancers can be prevented with lifestyle changes and regular screening.
Anthony Quinn hardly remembers his osteosarcoma treatment, but he sees a reminder of
his journey each day. At just 4 years old, Anthony lost his leg
shortly after his osteosarcoma diagnosis. But Anthony has never let
that hold him back. Today, the 27-year-old is training with big
dreams: to one day make it to the Paralympics.
"I've always been competitive and loved sports," Anthony says. "I've always felt that if I was given the opportunity to compete athletically in adaptive sports, I would excel."
Remembering pediatric osteosarcoma treatment
Anthony remembers going to the doctor after hitting his ankle on the coffee table -- an accident that occurred while running around with his older brother and eventually led to his osteosarcoma diagnosis. He remembers how nice the nurses were. He remembers his IV -- which he called "Robot Charlie" -- and the smells of the drugs used to save his life.
And he remembers picking out the color of the cast he would wear after the amputation. After undergoing several rounds of chemotherapy, it was clear the cancer wasn't going away. The doctors needed to amputate Anthony's leg to save his life.
His first few steps on crutches were difficult. He fell the first
time. He was tired, frustrated and didn't understand. But as he grew,
Anthony chose not let the amputation stop him. Inspired by his
basketball star older brother, he played basketball in elementary and
Training after an amputation
But when Anthony made it to high school, he decided not to try out for the basketball team. It was something he always regretted.
After college, he became determined to get back in shape. Anthony purchased a running leg in hopes of participating in some 5Ks and other similar competitions.
Getting back in shape was a slow process, but one that Anthony has learned from.
"The biggest challenge for me is probably patience and courage," he says. "I'm still very new to competitions and not as fast as I would like to be. It's a bit unnerving at times. Maintaining a positive attitude is a must."
But when Anthony discovered the Texas Regional Paralympic Sports through Facebook, he started thinking about competing more seriously. Since then, Anthony has received seven gold and silver medals (mostly gold) in 100-meter, 200-meter, 400-meter and 5K races throughout Texas. At the 2014 Texas Regional Paralympic Sports' Texas Regional Games, Anthony qualified for the U.S. Paralympics Track and Field National Championships in the 100-meter and 200-meter races. He is planning on competing again soon in hopes of qualifying in the 400-meter race as well.
Finding another way to represent his country
Anthony had always wanted to serve in the military, but was extremely frustrated when he discovered his amputation prevented him from doing so. But he's found another way he can represent the U.S.
"I feel indebted to my country and the men and women who sacrificed, some with their lives, in defense of our Constitution," he says. "I love my country and would be honored to represent the U.S. in the Paralympics."
Based on the number of gold medals he's already won, it seems he's well on his way to doing just that.
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