Osteosarcoma is the most common type of bone cancer in children and adolescents, typically occurring in long bones like the arms and legs, particularly near the knee or shoulder. While it is a rare form of cancer, accounting for about 3% of all childhood cancers, it is the most frequent bone tumor in young individuals. The disease primarily affects children and teenagers between the ages of 10 and 20, especially during periods of rapid bone growth, such as adolescence. (Source)
What is Childhood Osteosarcoma?
Osteosarcoma is a malignant tumor that arises from the osteoblast cells responsible for forming new bone. In osteosarcoma, these cells develop abnormally, creating bone tissue that is weaker than normal. This cancer typically begins in the metaphysis—the area where new bone tissue forms at the ends of long bones like the femur (thighbone), tibia (shinbone), or humerus (upper arm bone). Osteosarcoma can also spread to other parts of the body, most commonly the lungs or other bones. (Source)
Also, read: Now Know All about Childhood Langerhans Cell Histiocytosis: Cause, Symptoms, Diagnosis, Treatment
Causes of Childhood Osteosarcoma
The exact cause of osteosarcoma is not well understood, but several factors are believed to contribute to its development:
- Genetic Factors:
- Some children inherit genetic mutations that increase their risk of developing osteosarcoma. For example, children with Li-Fraumeni syndrome or hereditary retinoblastoma have a higher risk of developing this cancer.
- Growth Spurts:
- Rapid bone growth during puberty might increase the likelihood of developing osteosarcoma, which is why it is more common in teenagers.
- Previous Radiation Therapy:
- Children who have undergone radiation therapy for other cancers have a higher risk of developing osteosarcoma, particularly if radiation is directed at their bones.
- Other Conditions:
- Certain benign bone diseases or bone defects can increase the risk of developing osteosarcoma. (Source)
How Does Childhood Osteosarcoma Spread?
Osteosarcoma can spread from its original location (usually the bone) to other body parts through the bloodstream. The most common sites for metastasis (spread) include:
- Lungs: The lungs are the most frequent site where osteosarcoma cells spread.
- Other Bones: In some cases, osteosarcoma may spread to other bones beyond the initial tumor location.
The spread of osteosarcoma can complicate treatment and affect the overall prognosis.
Symptoms of Childhood Osteosarcoma
Symptoms of osteosarcoma vary depending on the location of the tumor. Common symptoms include:
- Bone Pain:
- Persistent or intermittent pain in the affected bone, often worsening at night or with activity.
- Swelling:
- It is swelling or lumps near the affected bone, may become more visible as the tumor grows.
- Fractures:
- Osteosarcoma weakens the bone, making it more prone to fractures, even with minor trauma.
- Limping:
- If the tumor is located in the leg, a child may limp due to pain and bone weakness.
- Limited Range of Motion:
- Tumors near a joint may limit movement or cause stiffness.
- Fatigue and Weight Loss:
- Children may experience fatigue, weight loss, and general malaise in more advanced cases. (Source)
Diagnosis of Childhood Osteosarcoma
Diagnosing osteosarcoma involves a series of tests and examinations:
1. Physical Examination:
- A thorough physical exam to evaluate the symptoms, such as swelling or pain near the affected bone.
2. X-rays:
- X-rays are the first imaging test used to detect bone abnormalities or the presence of a tumor.
3. MRI (Magnetic Resonance Imaging):
- MRI scans provide detailed images of the tumor and help determine its size and the extent of bone and soft tissue involvement.
4. CT Scan (Computed Tomography):
- CT scans of the chest are often performed to check if the cancer has spread to the lungs.
5. Bone Scan:
- A bone scan can help identify the spread of cancer to other bones.
6. Biopsy:
- A sample of the tumor is taken (biopsy) to confirm the diagnosis of osteosarcoma and determine its specific characteristics. This is done either through a needle biopsy or surgical biopsy.
7. Blood Tests:
- Blood tests may be conducted to rule out other conditions and assess overall health. (Source)
Treatment of Childhood Osteosarcoma
Treatment for osteosarcoma typically involves a combination of therapies aimed at removing or shrinking the tumor and preventing its spread. Common treatments include:
1. Surgery:
- Surgery is a primary treatment for osteosarcoma. Surgeons aim to remove the entire tumor along with some surrounding healthy tissue to ensure no cancer cells are left behind.
- Limb-sparing surgery: Whenever possible, doctors try to avoid amputation by performing limb-sparing surgery, where the tumor is removed while preserving the limb.
- Amputation: In cases where the tumor is too large or involves critical structures like nerves or blood vessels, amputation may be necessary.
2. Chemotherapy:
- Neoadjuvant chemotherapy is given before surgery to shrink the tumor, making it easier to remove while reducing the risk of recurrence.
- Adjuvant chemotherapy is administered after surgery to kill any remaining cancer cells.
- Common drugs used in osteosarcoma chemotherapy include doxorubicin, cisplatin, and methotrexate.
3. Radiation Therapy:
- Radiation therapy is less commonly used in osteosarcoma but may be recommended if the tumor cannot be completely removed or if it has spread to the lungs or other bones.
4. Targeted Therapy:
- In some cases, newer targeted therapies may be used to attack specific genetic mutations within the cancer cells. These therapies are still under investigation in clinical trials.
5. Clinical Trials:
- Children with osteosarcoma may have the option to participate in clinical trials that explore new treatments and therapies, such as immunotherapy or advanced targeted drugs. (Source)
Can Childhood Osteosarcoma Be Prevented?
There is no known way to prevent osteosarcoma since its exact cause is not fully understood. While certain risk factors like genetic conditions and previous radiation therapy are associated with a higher likelihood of developing the disease, most cases occur sporadically without any identifiable risk factors.
Is Childhood Osteosarcoma Hereditary?
Osteosarcoma is not typically inherited, although there are some hereditary syndromes that increase the risk. Children with Li-Fraumeni syndrome, retinoblastoma, or other genetic conditions that affect tumor suppressor genes are at a higher risk. However, most children who develop osteosarcoma do not have a family history of the disease. (Source)
Can Childhood Osteosarcoma Be Cured?
Osteosarcoma can be cured, especially if it is diagnosed early and treated aggressively. The 5-year survival rate for children and adolescents with localized osteosarcoma (cancer that has not spread) is around 70-75%. However, if the cancer has spread to the lungs or other parts of the body at the time of diagnosis, the survival rate decreases to 30-40%.
Survival rates are higher for children who respond well to chemotherapy and whose tumors can be completely removed through surgery. Long-term follow-up care is essential to monitor for recurrence or long-term side effects of treatment. (Source)
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Conclusion
Childhood osteosarcoma is a rare but serious form of bone cancer that primarily affects teenagers during periods of rapid growth. Although its cause is not fully understood, genetic factors, growth spurts, and radiation exposure may play a role in its development. Treatment typically involves a combination of surgery, chemotherapy, and, in some cases, radiation therapy. While it cannot be prevented, osteosarcoma can often be cured with early diagnosis and aggressive treatment, offering hope to affected children and their families.
