How Osteosarcoma Is Treated

How Osteosarcoma Is Treated Image

There are a number of treatment options for osteosarcoma patients, including surgery, chemotherapy and radiation. Learn more. Osteosarcoma is a bone cancer that occurs most often in teenagers and young adults. It typically affects the long bones in the body, such as the arms and legs. If caught early, at a localized stage, there is a five-year 70% survival rate.If you or a

Osteosarcoma is a bone cancer that occurs most often in teenagers and young adults. It typically affects the long bones in the body, such as the arms and legs. If caught early, at a localized stage, there is a five-year 70% survival rate.

If you or a loved one is diagnosed with osteosarcoma, there are several treatment options. Which treatments are recommended will be determined by multiple factors, including your overall health, the size and location of the tumor, and the stage of the disease.

This article will review the various treatment options for osteosarcoma.


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Surgery

Surgery is usually the first-line treatment option for osteosarcoma. The goal of surgery is to remove all of the cancer to prevent the risk of the cancer recurring or spreading.

When possible, a biopsy (a procedure to remove a tissue sample of the tumor to be sent to a lab for testing) to confirm the diagnosis, and surgery to remove the tumor will be planned at the same time. The surgery is done with the patient under general anesthesia.

During the procedure, an orthopedic surgeon will remove the cancerous tissue and some of the normal tissue that is around it (called the margin). This type of surgery is called a wide excision.

If the tumor is located in the arms or legs, a patient may undergo two types of surgery, depending on the size and location of the tumor. These include:

  • Limb-sparing surgery: This procedure aims to remove the entire tumor and some surrounding tissue but leave the limb intact. The surgeon will try to save the blood vessels, nerves, and tendons to maintain the limb's function and appearance as much as possible. The surgeon may replace the section of bone removed with the tumor with a bone graft (transplanting healthy bone from elsewhere in the body) or prosthesis (an artificial part). Limb-sparing surgery is a complex operation that requires an experienced specialized surgeon.
  • Amputation: If the tumor is very large, or if cancer has grown into the blood vessels, nerves, and tendons, amputation may be the best option. In this case, the surgeon will determine how much of the arm or leg needs to be removed, and plan surgery so that muscles and skin will form a cuff around the bone. This cuff will fit into an artificial limb (prosthesis) that will be created during the recovery.

Additional reconstructive surgery may be needed after the initial tumor removal. Your healthcare team will also work with you throughout your rehabilitation to help you regain functionality with your affected limbs. Physical and occupational therapy will be needed.

Chemotherapy

Chemotherapy is frequently used in combination with surgery to treat osteosarcoma to reduce the risk of the cancer returning.

Chemotherapy is a drug that is given either by pill or through an IV (an intravenous drip). It works to kill cancer cells.

Osteosarcoma patients are typically treated with chemotherapy for approximately 10 weeks before surgery to help shrink the tumor and make the surgery easier. This is known as neoadjuvant chemotherapy.

After surgery, chemotherapy is often given again in intervals for up to a year (known as adjuvant chemotherapy).

Chemotherapy drugs that treat osteosarcoma include the following:

  • Otrexup, Xatmep, Trexall, Rasuvo (methotrexate), given in high doses, along with leucovorin to help limit side effects
  • Cytoxan (cyclophosphamide)
  • Vepesid (etoposide)
  • Gemzar (gemcitabine)
  • Adriamycin (doxorubicin)
  • Platinol (cisplatin)
  • Ifex (ifosfamide)

Radiation

Radiation (targeted high-energy rays that destroy cancer cells) is not typically used to treat osteosarcoma. This is because osteosarcoma cells are not easily killed by radiation.

In advanced osteosarcoma cases, bone-seeking radioactive drugs are sometimes used to slow tumor growth and help manage symptoms such as pain. These drugs, including Quadramet (samarium-153-EDTMP) and Xofigo (radium-233), are injected into a vein near the tumor and amass in the bone, where they give off radiation that kills the cancer cells.

Targeted Therapy

There are some new medications that doctors are researching and studying that work differently than chemotherapy. These medications are known to target specific molecules in cancer cells that lead to tumor growth.

For instance, targeted therapy drugs that are being used for bone cancers block the action of certain proteins (called kinase) that signal cells to grow. This action can prevent or slow the growth of some tumors.

While targeted therapy drugs are not currently approved by the Food and Drug Administration (FDA) for treatment of osteosarcoma, they are being used to treat other bone cancers. These drugs are promising and may help patients with osteosarcoma in the near future.

A Word From Verywell

An osteosarcoma diagnosis can be life changing and overwhelming. But remember that there are many treatment options that can help.

Don't hesitate to talk with your cancer care team about any concerns or questions you may have concerning your treatment options and your recovery. They are there to point you toward resources, including physical therapy and local support groups.

Treating osteosarcoma can be a long, hard journey, and it is important to take care of your mental health as much as your physical health. Reach out to family and friends for support. You may also consider talking to a licensed mental health professional, who can help you navigate living with cancer and adjusting to the lifestyle changes that can come with the potential loss of a limb.

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