Alongside plasmacytoma, osteosarcoma is the most common type of bone cancer. However, osteosarcomas are still very rare. The disease causes new malignant bone cells to form continuously, which produce a so-called tumor osteoid.
Below you will find further information and selected osteosarcoma specialists.
In German-speaking countries, two to three people per million inhabitants per year are diagnosed with osteosarcoma.
The disease sometimes occurs at an early age. On average, girls are 14 and boys 18 years old at the time of the disease. The incidence then decreases again.
However, the probability increases again between the ages of 40 and 60.
Osteosarcoma often causes little or no symptoms. The tumorous swelling is also often painless.
If pain occurs in a bone irrespective of stress, it is an indication of bone cancer. About half of all patients experience pain in the knee, but this is usually interpreted as an injury. If pain occurs, it is important to see a doctor as soon as possible.
Some patients also have breathing problems at a later stage.
Extensive examinations are necessary to determine whether these complaints are really caused by cancer.
Osteosarcoma is the most common form of bone cancer. Unexplained bone pain, for example in the knee, is an indication of this © Crystal light | AdobeStock
A precise diagnosis is used to determine the location, spread and stage of the tumor. It is crucial for choosing the right treatment. Examinations should be carried out by a specialist doctor.
During an initial consultation, the doctor will inquire about the nature of the symptoms and their progression. He or she will palpate the bone and have the patient perform exercises to identify movement restrictions.
This is followed by imaging procedures:
An X-ray examination is used to detect a tumor. Small tumors can often not be detected by this examination. To enable a comparison, an X-ray is also taken of the same bone on the other side of the body.
The most precise examination is a magnetic resonance imaging (MRI) scan. It allows the location of the tumor and its spread into the bone and soft tissue to be determined. In the past, computer tomography (CT) was often used instead. However, CT is not as accurate and is therefore no longer state of the art.
In addition to these imaging procedures, a tissue sample (biopsy) is also taken. The samples taken are examined in the laboratory by a pathologist. He determines whether the tumor is benign or malignant.
An X-ray examination and a CT scan of the chest are used to rule out lung metastases. The liver can be examined for metastases using an ultrasound scan or a CT scan of the abdomen. Scintigraphy allows doctors to determine whether the tumor has metastasized to other bones.
Today, angiography is only rarely necessary to determine the spread of a tumor. As a rule, this examination is not performed.
If chemotherapy is planned, a dynamic MRI with contrast medium or a scintigraphy with contrast medium is recommended. This is ideal for comparing the size of the not yet calcified scar tissue and vital tumor tissue before and after chemotherapy.
Many patients are unsure and nervous until they find out the results of these examinations. Talking to relatives or friends often helps during this difficult time. For some patients, it can also be useful to seek professional psychotherapeutic help.
The standard procedure for osteosarcoma is neoadjuvant chemotherapy followed by surgery. Neoadjuvant means that the purpose of chemotherapy is to shrink the tumor and thus make surgery easier.
Chemotherapy can also treat any existing tumor metastases in the rest of the body. This may allow a less radical approach, i.e. extremity-preserving surgery.
Osteosarcoma is hardly sensitive to radiation, but radiotherapy is also carried out if the tumour location is unfavorable (e.g. spine).
Side effects of chemotherapy for osteosarcoma are numerous and depend on the cytostatic drugs used.
During the first three to five years after diagnosis, follow-up examinations are carried out at intervals of three to six months.
Whether it is beneficial for the patient to attend a rehabilitation clinic after treatment depends on their situation. Outpatient rehabilitation measures are also possible. The aim of rehabilitation measures is to enable the patient to participate in professional, family and social life again.
Depending on the patient and the severity of the illness or the consequences of the illness, the focus is on
Through rehabilitation measures, the patient can learn to
Good rehabilitation can
Exercises tailored to the patient allow them to regain their physical strength. They also help to increase self-confidence. As a result, mobility and independence can be achieved and less care is required.
Active movement therapy is preferred, but passive treatments are also possible.
If multimodal therapy is carried out correctly
local recurrence can be achieved.
Depending on the number of sites originally affected, the 5-year survival rate is 66 to 79 percent for peripheral sites and 35 to 52 percent for sites on the trunk.
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